October 24, 2013
Area(s) of Interest: Advocacy Payor Issues and Reimbursement
The California Medical Association (CMA), the American Medical Association (AMA) and other health associations recently sent a letter to U.S. Department of Health and Human Services Secretary Kathleen Sebelius, asking that textbooks and scientific peer reviewed medical journal reprints, supplements and abstracts be among the items excluded from the Sunshine Act’s reporting requirements.
The act requires reporting of certain payments and items of value – including consulting fees, travel reimbursements, research grants and other gifts – given to physicians and teaching hospitals.
There are a number of exclusions from the reporting requirements, including “educational materials that directly benefit patients or are intended for patient use.” In its interpretation of the statute, the Center for Medicare and Medicaid Services (CMS) concluded that medical textbooks, reprints of peer-reviewed scientific clinical journal articles and abstracts of these articles are “not directly beneficial to patients, nor are they intended for patient use.” CMA and AMA believe this conclusion is inconsistent with the statutory language on its face, congressional intent and the reality of clinical practice where patients benefit directly from improved physician medical knowledge.
CMA is concerned that CMS's interpretation presents a clear disincentive for clinicians to accept high quality, independent educational materials, an outcome that was unintended when the provision was passed into law.
The importance of up-to-date, peer-reviewed scientific medical information as the foundation for good medical care is well documented. Scientific peer-reviewed journal reprints, supplements, and medical text books have long been considered essential tools for clinicians to remain informed about the latest in medical practice and patient care. Independent, peer-reviewed medical textbooks and journal article supplements and reprints represent the gold standard in evidence-based medical knowledge and provide a direct benefit to patients because better informed clinicians render better care to their patients.
CMA is concerned that the final regulations could inadvertently prevent the timely distribution of rigorous scientifically reviewed medical information to clinicians and patients and undermine efforts to improve the quality of care provided to patients.
Contact: Elizabeth McNeil, (415) 882-3376 or firstname.lastname@example.org.