A cohort of physician groups wrote a letter to CMS asking the agency to delay launching the public Open Payments database of physician payments to allow physicians more time to register, review and dispute any reported data.
"Many of our organizations supported passage of the Sunshine Act and, fundamentally, we have no issue with efforts to increase transparency in the interactions between physicians and industry," reads the letter. "However, we have a number of serious concerns regarding how the Open Payments System has been implemented."
The letter outlines the following three main concerns of the Sunshine Payment implementation.
1. The proposed expanded reporting requirements include educational activities. Originally, continuing medical education activities were exempt from reporting inclusion. The proposed Medicare Physician Fee Schedule for 2014 revokes that exemption and instead exempts third party transfers to continuing education when an industry donor is unaware of the recipients before and after the funds are transferred. The physician organizations fear such identification of speakers and/or participants after funds have been transferred could negatively affect continuing education.
Similarly, the original Sunshine Act exempted reporting payment regarding educational materials that are directly beneficial for patients or are intended for patient use. However, CMS said medical textbooks, reprints and other physician education services would not be covered by the exclusion, which the physician organizations wrote "is inconsistent with the statutory language on its face, Congressional intent and the reality of clinical practice where patients benefit directly from improved physician medical knowledge."
2. The system does not allow enough time for physician registration. The physician organizations suggest CMS postpones the public revealing of the data until March 31, 2015, to allow physicians adequate time to register for the system and review and potentially dispute any data. "[CMS] has not provided effective notification to the vast majority of physicians nor provided a reasonable amount of time for the undersigned organizations to engage and educate physicians on the registration and dispute process," reads the letter.
3. The registration process is too complex, and the guidance is incomplete. The letter indicates a shared frustration among many physicians "at an overly complex registration system which, combined with the condensed time frame, makes the task of reviewing and disputing reports by Aug. 27 effectively impossible for [CMS'] estimated 224,000 covered physician recipients." The organizations urge CMS to streamline the registration process and, again, extend the publication date to March 31, 2015.
The letter also highlights regulatory language in the supplementary documents of the May 5 Federal Register Notice indicating manufacturers can dismiss information disputes initiated by physicians or hospitals. According to the letter, the final rule issued in February 2013 does not allow for such action. While CMS officials have said they clarified the guidance to manufacturers, the physician organizations request seeing the clarification in written form.
More articles on the Sunshine Act:
CMS temporarily suspends Open Payments due to glitch
Physician groups identify 'pressing issues' regarding Sunshine Act
Fines Possible if Manufacturers Don't Validate Sunshine Act Data