Physician Payments Sunshine Act: Call for Comment CMS Responses

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Back in July 2013, the Centers for Medicare and Medicaid Services (CMS) issued a notice for the public to comment on the Physician Payments Sunshine Act. Specifically, they wanted to inform the public about information collected that is necessary for registration, attestation, dispute resolution and corrections, record retention, and submitting assumptions documents with Open Payments. CMS has published the 17 responses they received.

We noticed a large discrepancy between how CMS responded to the pharmaceutical industry verses PEW. CMS was much more receptive to PEW’s comments, despite the fact that industry members are the ones that actually have to set aside tremendous resources to comply with the Sunshine Act.

Most CMS responses stated: “This comment is outside the scope for CMS-10495, Registration, Attestation, Dispute & Resolution, Assumptions Document and Data Retention Requirements for Open Payments. The overall burden of compliance commented by PhRMA relates to CMS-10419, Data Collection and Submission of Transparency Reports and Reporting of Physician Ownership or Investment Interests, with OMB control number 0931-1173.

View the file here.

PHRMA Comments and Responses

PhRma CommentsPEW Comments and Responses:

The Pew Prescription Project, founders of the payment tracking movement, commented to CMS as well. Pew’s comments essentially claimed that every process having to do with Open Payments would be much less burdensome than CMS initially stated. Especially surprising is the 30 minutes that PEW recommended as the current estimate of physician registration. As physician registration requires physicians to generate a EIDM user ID with CMS, provide their NPI, DEA and license number, as well as specialty code and name as listed in the NPI Database, we believe the process could prove to be cumbersome. As far as Pew’s comments about reducing the number of physician disputes to 10,000, only time will tell in the next few months how much companies are burdened with this process.

Pew Commens
American Medical Association
AMA Comments

The ACCME weighed in as well, but their comment too was deemed outside the scope for CMS-10495, Registration, Attestation, Dispute & Resolution, Assumptions Document and Data Retention Requirements for Open Payments.

ACCME Comments

The two other comments, which were both “outside the scope” included:

“Requesting CMS use a unique identifier for each record. This should be a simple hash from the NPI.”

“The Association of Health Care Journalists requests CMS release the data with unique identifiers allowing the public and journalists to more easily aggregated payments to individual doctors. AHCJ urges CMS to assign a random unique identifier to each individual payee.”

Latest Call for Comment

Recently we wrote that the Centers for Medicare and Medicaid Services (CMS) posted a notice for interested parties to submit comments on the Dispute Resolution period of Open Payments (Physician Payment Sunshine Act) in the Federal Register,.

Physicians and teaching hospitals will be able to register in the CMS system starting June 1st. However, they will not be able to access the system or dispute the data until a yet unannounced date in July, August or September.

In its call for comment, CMS states:

“[W]e are announcing the addition of the dispute resolution and corrections process to this information collection request (ICR). The dispute resolution and corrections process was discussed in our initial submission to OMB. However, based on the detailed processes of review and corrections as well as the sensitivities around these processes, we felt it appropriate to solicit additional public feedback on how these interactions would occur. Therefore we are resubmitting a revised ICR for OMB review and approval. While we are submitting a revision of the entire ICR, we are specifically seeking comments on the dispute resolution and comment process” (emphasis added).

Comments are due by June 2, 2014. The fact that CMS wants you to comment on the dispute resolution and registration process one day after registration for Open Payments for physicians is scheduled to open is the equivalent of giving a customer one day to comment on how they like the new store.

Given the moving target nature of the dispute resolution process, with physicians being repeatedly told that the registration with Open Payments would be coming soon, stakeholders should consider giving input asking for more time for physicians to register into the system before their data goes public. The idea of a small window (45 days) with little to no notice, is unsettling for many physicians. It is not clear given that the window start date is still uncertain that physicians and teaching hospital staff will even be able to register and check their data within the 45 days.

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