CMS published its first round of data as laid out in the Sunshine Act, and stakeholders, including the American Medical Association, are concerned.
In an effort to promote transparency and accountability in healthcare stemming from conditions laid out in the Affordable Care Act’s Sunshine Act, CMS recently released the first round of Open Payments data to help consumers understand the financial relationships between the healthcare industry and physicians and teaching hospitals. Consulting fees, research grants, travel reimbursements and other gifts the healthcare industry, including medical device manufacturers and pharmaceutical companies, provided to physicians and teaching hospitals during the last five months of 2013 are detailed in the data, which contains 4.4 million payments valued at nearly $3.5 billion attributable to 546,000 individual physicians and almost 1,360 teaching hospitals.
The official numbers bring greater definition to previous research. In one such instance, ProPublica tracked relationships between doctors and the pharmaceutical industry for the past four years, finding there were 3.4 million payments since 2009, totaling more than $4 billion, of which $2.5 billion was for research. For 2013 alone, there were 1.2 million payments valued at nearly $1.4 billion.
Dr. Shantanu Agrawal, deputy administrator and director of the Center for Program Integrity at CMS, said the data released does not identify which financial relationships are beneficial, but notes the “data could discourage payments and other transfers of value that might have an inappropriate influence on research, education, and clinical decision-making.” Agrawal adds the data could also “help identify relationships that lead to the development of beneficial new technologies.”
For its part, the American Medical Association, which had called on CMS in August to delay the publication of the data to “allow physicians adequate time to review and seek correction of inaccurate claims made by pharmaceutical companies, device manufacturers, and group purchasing organizations,” remains “very concerned about the accuracy of the data,” as only 26,000 out of the nearly 550,000 physicians affected by the Act had time to register and review their data, according to the association.
Over time, CMS plans to make enhancements to the system, including the addition of tools to allow for easier data searches. In the future, reports will be published annually and will include a full year of payment data, beginning in July 2015.