Physician 'Open Payments' Data Available for Public Viewing

AAFP Applauds Transparency, but Reiterates Concerns

October 03, 2014 03:45 pm Sheri Porter

On Sept. 30, CMS released, as scheduled, the first set of data in conjunction with the agency's Open Payments(www.cms.gov) transparency program that was created to implement the Physician Payments Sunshine Act.

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The program was designed to give health care consumers insight into the financial relationships that exist between the medical industry and physicians and teaching hospitals.

"We completely agree with the need to be transparent about relationships and payments from industry to family physicians. Patients deserve to have access to this information," said AAFP President Reid Blackwelder, M.D., of Kingsport, Tenn., in response to the data posting.

"However, the AAFP continues to have concerns about the accuracy of the published information and urges family physicians to register on the site and ensure their data are correct," he added.

According to a CMS press release,(www.cms.gov) the entire data collection contains information on 4.4 million payments assigned to 546,000 physicians and nearly 1,360 teaching hospitals.

Cumulatively, those payments are valued at close to $3.5 billion.

Story Highlights
  • On Sept. 30, CMS released the first set of data in conjunction with the agency's Open Payments transparency program.
  • The entire data collection, including both identified and de-identified data, contains information on 4.4 million payments assigned to 546,000 physicians and nearly 1,360 teaching hospitals.
  • AAFP President Reid Blackwelder, M.D., applauded the transparency program's intent, but reiterated the Academy's concerns about the accuracy of published data.

A CMS Fact Sheet(www.cms.gov) further refined that dollar amount: Payments linked to identified data total approximately $1.3 billion; the de-identified data set accounts for about $2.2 billion.

The data include money paid out as consulting fees, research grants and travel reimbursements during the last five months of 2013.

"This initial public posting of data is only the first phase of the Open Payments program," said CMS Administrator Marilyn Tavenner, M.A., in the release. "In coming weeks, we will be adding additional data and tools that will give consumers, researchers and others a detailed look into this industry and its financial arrangements."

In the same release, Shantanu Agrawal, M.D., deputy administrator and director of CMS' Center for Program Integrity, signaled that the presence of a physician's name on the site does not necessarily imply any wrongdoing.

"Open Payments does not identify which financial relationships are beneficial and which could cause conflicts of interest. It simply makes the data available to the public," said Argrawal. "So while these data could discourage payments and others transfers of value that might have an inappropriate influence on research, education and clinical decision-making, they could also help identify relationships that lead to the development of beneficial new technologies.

CMS noted that more than 26,000 physicians and 400 teaching hospitals reviewed their data in the Open Payments system before it was published. About 40 percent of the data published were de-identified because of issues with matching physicians to their records or because certain information was not available for review and dispute.

Late in August, CMS told AAFP News that it would not post about one-third of the data in hand until 2015 because of the data integrity concerns linked to mismatched information. To date, CMS has not responded to an AAFP News inquiry about its apparent change of course on that front.

CMS did, however, confirm in the release that data that remain under dispute would be published at a later date.

Physicians looking for guidance on how to respond to patients' questions about data published on the site might want to review a list of talking points(www.ama-assn.org) the AMA created specifically to assist physicians in fielding both general inquiries about the Open Payments data release and specific questions about personally identifiable data found on the CMS site. (If you're not an AMA member, you'll be asked to create a free nonmember account to access the document.)

Blackwelder also noted the AAFP's interest in another piece of the open payments data puzzle -- namely, CMS' proposed treatment of the CME exemption.

"We have and will continue to work with CMS to address how the agency intends to designate activities such as physician-led CME presentations and physician attendance at CME activities," said Blackwelder, alluding to the proposed 2015 Medicare physician fee schedule in which CMS removed language regarding an existing exemption for reporting indirect payments or transfer of value related to such events.

"That proposal potentially could create great confusion about how such activities should be reported," said Blackwelder.

Related AAFP News Coverage
Open Payments Registration Systems Reopens for Business
CMS Extends Deadline for Physician Review, Correction of Data

(8/15/2014)

Shut Down: Open Payments Registration Site Temporarily Closed to Physicians
Physician 'Review and Dispute' Timeline Unclear

(8/13/2014)

More From AAFP
Open Payments/Physician Sunshine Act

Additional Resources
CMS Fact Sheets and User Guides(www.cms.gov)


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