Physician Payments now Online, but Accurate?

The Open Payments Web site is live with the first round of data available to help consumers understand financial relationships between physicians and businesses, particularly drug and device manufacturers. How helpful the information will be is a legitimate concern.


The Open Payments Web site is live with the first round of data available to help consumers understand financial relationships between physicians and businesses, particularly drug and device manufacturers. How helpful the information will be is a legitimate concern.

The go-live comes despite substantial problems with data integrity that have bedeviled the Centers for Medicare and Medicaid Services and caused it to withhold one-third percent of the information gathered from companies until next spring. Further, 40 percent of the records published on Sept. 30 are de-identified because CMS could not match information or records were not available for review and dispute purposes.

Under the Physician Sunshine Payments Act within the Affordable Care Act, companies doing business with physicians must report consulting fees, meals over $10, royalty payments, research grants, and honoraria for speaking engagements, among other gifts, as they relate to covered products under Medicare and Medicaid.

The Web site launched with data on financial relationships during the last five months of 2013, covering 4.4 million payments to 546,000 physicians and 1,360 teaching hospitals, collectively valued at nearly $3.5 billion, according to CMS. The agency will publish subsequent reports annually starting in June 2015 and the reports will cover a full year.

Financial ties among medical businesses and physicians do not necessarily indicate wrongdoing, CMS cautions.  However, it remains to be seen how much, if any, context is added to the data to explain the necessity of payments.

“Open Payments does not identify which financial relationships are beneficial and which could cause conflicts of interest,” Shantanu Agrawal, M.D., deputy administrator and director of the Center for Program Integrity at CMS, said in a statement. “It simply makes the data available to the public. So while these data could discourage payments and other transfers of value that might have an inappropriate influence on research, education and decision-making, they could also help identify relationships that lead to the development of beneficial new technologies.”

Health law attorney Elizabeth Carder-Thompson, a partner in the law firm Reed Smith, notes that companies are concerned that the need for payments to physicians, such as paying them to be trained on a new device, will not be apparent to consumers.

CMS expects over time to make the site easier for consumers to review payments received by their own physicians and to increase search functionality across specialties, locations and types of payment.

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