What Doctors, Hospitals Provided
Free by Drug Firms, Suppliers Released by CMS
Information promotes transparency in
financial relationships between health care industry, doctors and
1, 2014 – For the first time, consumers have information on consulting
fees, research grants, travel reimbursements, and other gifts the health
care industry – such as medical device manufacturers and pharmaceutical
companies – provided to physicians and teaching hospitals. The
information was released yesterday by the Centers for Medicare &
Medicaid Services (CMS) for the last five months of 2013. It meets a
requirement of the Affordable Care Act (Obamacare) to help consumers
understand the financial relationships between the health care industry,
and physicians and teaching hospitals.
In a news release on the first
round of Open Payments data, CMS said it is “part of our ongoing effort
to increase transparency and accountability in health care.” Future
reports will be published annually and will include a full 12 months of
payment data, beginning in June 2015.
This data contains 4.4 million
payments valued at nearly $3.5 billion attributable to 546,000
individual physicians and almost 1,360 teaching hospitals.
“CMS is committed to transparency
and this is an opportunity for the public to learn about the
relationships among health care providers, and pharmaceutical and device
companies,” CMS Administrator Marilyn Tavenner said.
“This initial public posting of
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.”
Financial ties among medical
manufacturers’ payments and health care providers do not necessarily
signal wrongdoing. Given the importance of discouraging inappropriate
relationships without harming beneficial ones, CMS is working closely
with stakeholders to better understand the current scope of the
interactions among physicians, teaching hospitals, and industry
manufacturers. CMS encourages patients to discuss these relationships
with their health care providers.
“Using this new data, it is now
possible to conduct a wide range of analyses of payments made by drug
and device manufacturers,” said Dr. Shantanu Agrawal, deputy
administrator and director of the Center for Program Integrity at CMS.
“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.
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
Manufacturers submitted data to CMS
this summer and CMS performed initial matching to aggregate payments to
a single physician or teaching hospital. After the data were collected
and displayed, registered physicians and teaching hospitals had the
opportunity to review payments reported about them and dispute
information they believed inaccurate.
More than 26,000 physicians and 400
teaching hospitals registered in the Open Payments system to review
payments attributed to them. 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 or the record was not available for
review and dispute but the company had attested that the payment had
been made, the personally-identifiable information has been suppressed
temporarily in the record. About 40 percent of the records published
today are de-identified. This data will be fully identifiable in 2015
after the reporting entity submits corrected data, and physicians and
teaching hospitals have a chance to review and dispute.
In addition, data that were
disputed and not resolved by the end of the September 11 review period
have not been published and will be updated at a later date.
Over time, CMS expects to make
enhancements such as introducing new tools to allow for easier data
searches. This improved search functionality will allow users to more
easily review payments received by their personal physician, or search
on criteria such as specialty, location, or types of payments received.
The CMS news release said,
“Building on its commitment to transparency, the Open Payments program
is the latest effort by CMS to make health care cost data available to
the public. For example, the agency continues to publicly release and
update data allowing consumers to compare what hospitals charge for
common inpatient and outpatient services across the country.”
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