Sunshine Act Report: Docs See Nothing Wrong With Taking Payments

Leigh Page

Disclosures

August 27, 2019

In particular, doctors question the site's reports of little payments and wonder how accurate they could be. The minimum reportable yearly payment is $10, though it can be lower if the recipient gets more than $100 in payments.

Keeping track of so many tiny payments would seem to be an administrative nightmare, rife with reporting errors. But the postings have turned out to be quite accurate, according to a recent assessment by the HHS Office of the Inspector General.

That report found that out of more than 12.4 million payments in 2015, only 0.09% were missing a required data element. For example, 75% of the errors involved lack of physician specialty, and 21% didn't name the third party who received the payment.[19]

Of 11.4 million records published in 2018, disputes were lodged against 762 general payments and 258 research payments.

Doctors have the opportunity to dispute the amounts and to have them corrected, but the 2018 Open Payments report revealed very few disputes. Of 11.4 million records published in 2018, disputes were lodged against 762 general payments and 258 research payments.

There are no estimates on how much is spent to keep the website going, but most of this is not taxpayer's money. The reporting and dispute resolution are carried out by the drugmakers and device-makers themselves, and not by the Centers for Medicare & Medicaid Services (CMS), which oversees the site.

Will the Website Survive?

There are no signs that the Open Payments site will go away. The program is part of the Affordable Care Act, which President Trump is trying to repeal, but Sullivan says Trump supports the notion of transparency in healthcare.

The Trump administration is now expanding and refining the program. Sullivan believes that CMS is planning to use the site in a new way—to link payments on the website to the actual drugs and devices that doctors order.

CMS has not announced this, but Sullivan points to a statement by Econometrica, CMS' recently hired contractor for the website. Econometrica says it will be "aggregating and matching information from various datasets to accurately summarize the business relationships between the healthcare industry and providers."[20]

Sullivan interprets this to mean that Econometrica will compare industry payments to doctors with their utilization of a company's drugs or medical devices. The company would be looking for physicians whose utilization of a drug spiked after they received payments, he says.

However, Sullivan believes honest physicians who take payments should have no problems with probes like this.

"Providing promotional talks about a drug for a speakers' bureau is fine if you truly believe that a drug or device is useful for your patients," he says. "But it is important that you remain unbiased in your presentation and that you don't work frequently and exclusively for one company."

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