Life Science Compliance Update

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June 30, 2015

Physician Payments Sunshine Act: CMS posts 2014 Open Payments Data Totaling $6.49 Billion

Open Payments

The Centers for Medicare & Medicaid Services (CMS) today published 2014 Open Payments data about transfers of value by drug and medical device makers to health care providers. The data includes information about 11.4 million financial transactions attributed to over 600,000 physicians and more than 1,100 teaching hospitals, totaling $6.49 billion. This is compared to 4.3 million records attributed to 470,000 physicians and 1,019 teaching hospitals covering $3.43 billion dollars, according to CMS’s summary data.

Like last year, the datasets are available in three separate spreadsheets—general payments, research payments, and ownership interests. Interestingly, it appears ownership interests in life science companies by physicians have dropped around 23 percent.  

Type of Payments

2013 – 5 months
(8/2013-12/2013)

2014 – 12 months  
(1/2014 – 12/2014)

General

$972 million

$2.56 billon

Research

$1.55 billion

$3.23 billion

Ownership

$908 million

$703 million

Total

$3.43 billion

$6.49 billion

Acting CMS Administrator Andy Slavitt said, “Consumer access to information is a key component of delivery system reform and making the health care system perform better. In year 2, Open Payments is now a highly searchable resource to provide transparency to over 1 1/2 years’ worth of financial transactions between drug and device companies and physicians and teaching hospitals. This is part of our larger effort to open up the health care system to consumers by providing more information to help in their decision making.”

Increased Validation Rates from the Rocky 2013 Roll-Out

For all 2014 and 2013 data, CMS was able to validate that 98.8% of all records submitted in the Open Payments system contained accurate identifying information about the associated covered recipient. Records that could not be verified to align to an individual covered recipient were rejected and were not processed by the system. CMS will continue to update the Open Payments website annually with data collected from the previous year.

Today’s data posting also includes a group of 2013 submissions that could not be verified before the first data publication last September, 2014, CMS states.

Dr. Shantanu Agrawal, CMS deputy administrator and director of the agency’s Center for Program Integrity, said the agency has improved the Open Payments’ user interface to highlight valuable information for people who want to view payments and other financial transactions involving doctors, hospitals, and drug and medical device makers. Other consumer website upgrades are expected in late summer.

“CMS’ role is to facilitate discussion and analysis of the data by making it publicly available for consumers and researchers,” Agrawal said. “CMS has improved our interfaces for both collecting and reporting this data about compensation and other payments between drug and medical device manufacturers and physicians and teaching hospitals.” 

“We expended a tremendous level of effort to resolve inconsistencies in the reporting of these 2013 transactions and are very pleased to be able to align them with the rest of the payments,” Agrawal stated. 

Review and Dispute Activity

The press release indicated that registered physicians and teaching hospitals reviewed nearly 30% of the total value of the reported data. “We are pleased that so many providers participated this year, but will continue to work with doctors and hospitals to increase their review rate,” Agrawal said.

An analysis of the physicians and teaching hospitals included in reported data reveals that there are distinct differences between those that have registered and those that have not. For example, the median value of total payments made to registered physicians is $3,644, compared to $747 made to non-registered covered recipient physicians. View our article on some difficulties that remain in the review and dispute process. 

"CMS will update the Open Payments data at least annually to include updates to data disputes and other data corrections made since the initial publication," the press release states. 

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We will provide continued coverage of Open Payments in the coming days as we delve into the database, though we will leave you with our favorite stat so far. The general database lists 590 payments of less than a penny and a whopping 158,402 payments of $1 or less. 

Detailed analysis of the Open Payments data, including useful trends and comparisons from 2013 to 2014 will be available in August's issue of Life Science Compliance Update

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