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What Physicians Need to Know about Open Payments

Posted By Administration, Wednesday, December 10, 2014

Why It’s Time to Time to Take a Closer Look at the Physician Payment Sunshine Act

By Brian Bowles, MAOPS Executive Director

 

By now, you’ve likely heard a lot about how the Affordable Care Act, which implemented the Physician Payment Sunshine Act (i.e., Open Payments), now requires certain industries to report payments and transfers of value to physicians. While there is no mandate on physicians to do anything differently, it does have implications physicians need to be aware of.

What You Should Know:

  • Transfers of Value Will be Reported and Published – Stipends, giveaways, dinners, etc., from pharmaceutical companies, durable medical equipment companies and other similar industries must be reported to the Centers for Medicare and Medicaid Services (CMS), and CMS will then publish the information. Companies even have to report copies of articles they leave for you! Also, say a pharmaceutical company wants to entice you to come to work for them to do research. Under the Sunshine Act, the dinner they buy for you during the interview has to be reported, as does the hotel and airfare they offer to get you to the interview.
  • Physician Responsibility – As a physician, you don’t need to stop seeing pharmaceutical representatives. However, please keep in mind that information about any transfers of value will be accessible. In my opinion, very few people will actually look at this data, and even fewer will care.
  • Data Reports – To monitor the data that industries are reporting about you, click here to register. By registering, you’ll be able to review what has been reported about you, as well as appeal any data you don’t agree with.
  • Tracking – Consider downloading a tracking app or creating your own method of tracking to monitor what you have received from industries so you can appeal erroneously reported information. During the first reporting period, which was only six months long, more than $3.5 billion was reported. Industry officials believe much of this was misreported, primarily by over-reporting to make sure they were in compliance with the law.

As for additional impacts the law might have on industry-physician relationships, some hospitals and employers might prohibit physicians from seeing vendors. Vendors are already cutting back on office visits and pharmaceutical companies are spending more on direct marketing tactics.

One aspect of the original law that did not make it into the final law is that of exhibitions, like the one held at the Missouri Osteopathic Annual Convention (MOAC). Originally, vendors would have had to report a certain value for their “exhibit fee” for each attendee at the conference. Due to advocacy by organizations like MAOPS, the American Osteopathic Association and other national associations, this piece of the law was deleted. Therefore, exhibit halls, like the one at MOAC, are about the only venue left where industry representatives and physicians can network and discuss new innovations and products without government intervention and without report of any transfers of value occurring. The 117th MOAC will be held April 29 through May 2, 2015, in Branson, Mo., and it has one of the largest exhibit halls of its type in the nation. I hope you all will take advantage of it this year!

To learn more about Open Payments or any of the points referenced in this blog post, contact me at (573) 634-3415, or visit the quick links below.

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