Deadline Near for Physicians to Verify Pharma Pizza and Cash

April 07, 2017

One of the lesser known provisions of the Affordable Care Act (ACA) lets the world know if a physician is receiving free pizza — or funds — from a drug or medical device company.

Such companies must report the food, speaking and consulting fees, and other "transfers of value" they bestow on physicians each year to the Centers for Medicare & Medicaid Services (CMS), which then posts the information online. It's called the Open Payments program, and the ACA authorized it to spotlight — and discourage — possible conflicts of interest in the medical profession.

But what if a drug rep delivers $50 worth of breakfast burritos to the practice of John Doe, MD, one sunny morning, but the company reports the recipient's name as Jon Doe, MD? The Dr Jon Doe who never lets a drug rep through the door?

The Open Payments program anticipates this problem by allowing a window for physicians to review and, if need be, dispute industry payment reports before CMS publishes them on June 30 every year.

This is that window: Physicians can now double-check reported payments for 2016, but they have only until May 15 to challenge erroneous information in hopes of a drug or medical device maker correcting it for the June 30 release. If physicians miss the May 15 deadline, they still have a shot at a correction when CMS updates the 2016 payment data in early 2018, but they must submit their challenge by the end of this year.

Information on how physicians can review and dispute any reports of industry payments made to them is available on the CMS website.

Follow Robert Lowes on Twitter @LowesRobert


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