Transparency Program Must Allow Physicians to Review Data, Says AAFP

June 11, 2013 03:00 pm News Staff

The AAFP is urging CMS to create an interim review process for a national transparency program to give physicians an opportunity to review pertinent data before drug and device manufacturers and group purchasing organizations (GPOs) submit the data to CMS as part of the program's reporting requirements.

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The National Physician Payment Transparency Program, also known as the Physician Payments Sunshine Act, requires drug and device manufacturers and GPOs to report payments or gifts of $10 or more made to physicians, hospitals and other health care professionals on a yearly basis. The law also requires drug and device manufacturers and GPOs to report ownership and investment interests held by physicians or their immediate family members in these entities. CMS plans to start posting the data on a public website next year.

In a May 29 letter(2 page PDF) to CMS Administrator Marilyn Tavenner, M.A., AAFP Board Chair Glen Stream, M.D., M.B.I., of Spokane, Wash., urged CMS to create a specific mechanism for physicians to review, correct and dispute interim data before manufacturers and GPOs send the data to CMS for posting.

"The AAFP remains very concerned that CMS is creating a data collection mechanism which directly pertains to an individual physician's financial information without first providing physicians with the ability to review and correct the interim data gathered by the applicable manufacturers," said Stream.

He added that if CMS provided the review mechanism, "all physicians could then, as needed, review their reports and make corrections with the specific manufacturer prior to the federal government aggregating a physician report across multiple applicable manufacturers.

"The time for this pre-CMS submission review period should be in addition to the existing review period available post-CMS submission."

CMS is requiring manufacturers and GPOs to start collecting data on Aug. 1 and to submit data collected between Aug. 1 and the end of the year to CMS by March 31, 2014. CMS then will provide an initial 45-day period during which physicians and teaching hospitals can review and dispute any data they consider inaccurate. If the dispute can be resolved in that 45-day window, the corrected information will appear on the website when it launches.

That will be followed by a 15-day period to allow for further review of data and to give physicians and teaching hospitals more time to resolve outstanding disputes with manufacturers and GPOs. Physicians and teaching hospitals may continue to initiate disputes during this period, but resolutions may not be reflected in data that are publically displayed.

During the first year of the program, CMS will post five months' worth of data on Sept. 30, 2014; in subsequent years, the agency will post a year's worth of data annually on June 30.

In the letter, Stream praised CMS' continued efforts to implement the policy. Such transparency "can help the public and policymakers understand the dynamic relationships between health care professionals and the medical industry," he said.

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