The troubled Open Payment System, a public database disclosing financial relationships between physicians and drug/device manufacturers and group purchasing organizations, remains scheduled to go live on September 30.

The database is authorized in the Physician Sunshine Payments Act, which was a provision that Sen. Charles Grassley (R-Iowa) placed in the Affordable Care Act.

The database, built by the Centers for Medicare and Medicaid Services and used for months by manufacturers to report information and physicians to register, has had numerous problems with data integrity and was shut down periodically. Problems included manufacturers submitting intermingled data, such as the wrong state license number or national provider identifier, for physicians with the same names.

And substantial integrity problems remain. Because of the inability to properly match physicians with data about them, CMS is expected to withhold from publication one-third of submitted reports from drug/device manufacturers until next spring.

The law requires reporting of “payments and transfers of value” to physicians as it relates to covered products under Medicare and Medicaid, says Elizabeth Carder-Thompson, a partner in the Washington, D.C. office of the Reed Smith law firm. This covers consulting fees, meals over $10, royalty payments, research payments, and honoraria for speaking at events, among other gifts.

But while the law’s intent is to give consumers insight on relationships in the healthcare industry, there is not yet any sign that the information offered on the Web site will provide context to help consumers understand the relationships, Carder-Thompson notes. Drug and device manufacturers 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.

Physicians, who had considerable trouble registering on the Web site so they can be matched with their data from the manufacturers, remain skittish about having information that may be wrong or without context being published.

The resolution process for disputing reported information loaded into the system has tight timeframes to resolve issues, another cause for concern. There is a fear, Carder-Thompson says, that the Web site will increase lawsuits against drug/device manufacturers and physicians, even if data integrity problems persist.

An August online survey the American Medical Association conducted found 68 percent of respondents reporting an overall bad registration experience, and 62 percent of those able to access the system found inaccurate data in their reports. Forty-four percent of respondents who tried to register were not successful.

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