Open Payments Data Release Has Big Gaps

September 30, 2014

The federal government has published information on 4.4 million payments worth almost $3.5 billion from drug and device makers to almost 1360 teaching hospitals and 546,000 physicians, dentists, podiatrists, and other clinicians on its new and controversial Open Payments Web site, according to the Centers for Medicare & Medicaid Services (CMS).

The idea behind the Web site, created by the Affordable Care Act, is to spotlight and deter potential conflicts of interest that might cause a clinician to lose sight of a patient's best interest, as in prescribing an expensive brand-name drug when a generic would do. However, for 40% of the payments, which drug and device makers were obliged to report to CMS, those goals are hard to achieve because there's no name of a clinician or hospital attached to the payment.

In a news briefing today, a CMS official said that those payments — everything from research grants and consulting fees to meals and travel reimbursement — were "de-identified" for 2 reasons. In most cases, drug and device makers had submitted errant payment reports that made CMS unsure about who was the actual recipient, said Shantanu Agrawal, MD, director and deputy administrator of the agency's Center for Program Integrity. These reports include those initially rejected by CMS earlier this year as inaccurate. Payments also were stripped of identifiers when physicians and teaching hospitals did not have an opportunity to review and dispute the payment reports during a 45-day window that ended September 11.

The data posted on the government Web site today reflects industry payments made during the last 5 months of 2013. Dr. Agrawal said that CMS will disclose the recipients of the de-identified payments later, once drug and device makers correct their mistakes and the physicians and teaching hospitals in question are afforded a chance to double-check their data.

Before the launch of the Open Payments Web site, the American Medical Association and other medical societies had urged CMS to delay the data release until March 31, 2015, saying that physicians needed more time to review industry payments credited to them. Dr. Agrawal said that more than 26,000 physicians and other clinicians, along with 400 teaching hospitals, had registered with the Open Payments system so they could inspect their information beforehand and challenge inaccuracies.

The AMA has said that the online registration process was so hard that roughly 4 in 10 physicians who tried to register were unsuccessful.

Organized medicine has contended that inaccurate information about a physician's financial relationship to industry could harm his or her reputation and make patients less trusting. During today's news briefing, Dr. Agrawal noted several times that CMS was not intent on putting physicians in a bad light.

"Financial ties and relationships between medical manufacturers and healthcare providers do not necessarily signal wrongdoing," he said. "The Open Payments program does not identify which financial relationships are beneficial and which could cause conflicts of interest. We're simply making the data available to the public."

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