September 30, 2014
Area(s) of Interest: Payor Issues and Reimbursement Practice Management
The Centers for Medicare & Medicaid Services (CMS) today launched its Open Payments website, which allows consumers to see the financial relationships between drug and medical device manufacturers and physicians as reported under the Physician Payments Sunshine Act.
The data published online contains 4.4 million payments made between August 1 and December 31, 2013, valued at nearly $3.5 billion and attributable to 546,000 individual physicians and almost 1,360 teaching hospitals. The database is divided into three categories, general payments, research payments and physicians ownership and investments. CMS says that these reports will be published annually and will include a full 12 months of payment data, beginning in June 2015.
The Sunshine Act requires drug and medical device manufacturers and group purchasing organizations to report their financial interactions with licensed physicians – including consulting fees, travel reimbursements, research grants and other gifts.
According to CMS Administrator Marilyn Tavenner, the initial public posting of the data is only the first phase of the Open Payments program. “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,” she said.
More than 26,000 physicians and 400 teaching hospitals registered in the Open Payments system to review payments attributed to them. Physicians were invited to review and dispute the records.
During the review and dispute period, CMS identified payment records that had inconsistent physician information, such as National Provider Identifier (NPI) for one doctor and a license number for another. In cases where CMS was unable to match the physician information, the personally identifiable information has been suppressed temporarily in the record.
Because of this, about 40 percent of the records published today are de-identified. This data will be fully identifiable in 2015 after the reporting entities submit corrected data, and physicians and teaching hospitals have a chance to review and if necessary dispute the data. In addition, data disputes that were not resolved by the end of the recent review period have not been published and will be updated at a later date.
Physicians who weren’t able to review their data by the September 11 deadline for the initial public data release should do so now. Two-thirds of the data that has been released has yet to be verified by physicians and other covered recipients, according to the American Medical Association (AMA). Physicians have until December 31 to file disputes for any inaccurate information that should be corrected in the next data release. View instructions for doing so on the AMA’s Sunshine Act Web page.
To view the Open Payments physician payment dataset, click here.