FEATURE
Physicians Still Foggy on Accuracy
of Sunshine Act Data
O
n September 30, the Centers for Medicare & Medicaid Services (CMS) released the first round of Open Payments
data. More than 4 million payments – valued
at almost $3.5 billion – from drug and device
companies to physicians and teaching hospitals
between August 1 and December 31, 2013,
were detailed – valued at almost $3.5 billion.
This data release is part of the Physician Payments Sunshine Act, created by the Affordable
Care Act, which was designed to increase transparency and accountability in health care by publically
listing consulting fees, research grants, travel reimbursement, and other gifts received by physicians
and teaching hospitals from manufacturers.
However, many physicians are asking the
$3.5-billion question: How accurate are the
data detailed in the Open Payments system?
On the same day as the data release, the
American Society of Hematology (ASH)
released a statement expressing concerns about
these data, pointing out that the data in the
system “are only beneficial if they are complete
and accurate.” The American Medical Association issued a statement expressing similar
sentiments.
ASH Clinical News recently spoke with
ASH President Linda J. Burns, MD, and Raed
Dweik, MD, a lung specialist and chair of the
Innovation Management and Conflict of Interest Committee at the Cleveland Clinic, about
the Sunshine Act, the initial release of data,
and possible improvements to the transparency
process in health care.
Echoes of Another Problematic
Government Website Launch ...
A quick refresher of the bumpy road to this data
release: To meet the requirements of the Sunshine
Act, pharmaceutical and device manufacturers
had to submit payment information to CMS in
summer 2014. Physicians were not required to
register with the website (cms.gov.openpayments),
but had to register if they wanted a chance to
review – and possibly dispute – any submitted
payment information before it was released to the
public. (See FIGURE 1 for a simplified breakdown
of the process.) CMS originally allotted a 45-day
period from July 14 to August 27 for physicians to
review and dispute the data, followed by a 15-day
correction period.
According to Dr. Dweik, the Open
Payments system and CMS put together a
thorough system designed to properly identify physicians in an attempt to reduce the
ASHClinicalNews.org
FIGURE 1.
Understanding the Open Payments process
Source: www.CMS.gov
possibility of reporting errors.
“When registering for the website, it verified your identity almost like you were getting a
credit card,” Dr. Dweik said. “You had to enter
your name, Social Security number, medical
license number, and answer questions like, for
example, ‘Who held your last mortgage?’”
Dr. Dweik gave CMS credit for the rigorousness of the registration process. Prior
to Open Payments, he said, several websites
attempted to provide similar transparency in
the health-care industry, but these sites lacked
a vetting process and often reported erroneous
conflicts of interest for physician “Jane Smith,”
who may not have been the correct “Jane
Smith” with the conflict.
However, this rigorous registration process
also carried some drawbacks. According to Dr.
Burns, it was a bit frustrating.
“I am an educated person and even I had
difficulty registering,” Dr. Burns said. “The
first time I attempted to access the site I spent
about an hour trying to get in, only to have the
system go down.”
On August 3, within a month of opening the Open Payments system for review
and dispute, CMS was forced to pull the site
down temporarily after at least one physician
reported that the data posted in his profile had
been mixed together with the information of
another physician with the same name.
After resolving a “technical issue,” the Open
Payments site was re-opened August 15, and
the review period was extended to account for
the days when the website was offline.
Are These Data Complete
and Accurate?
Dr. Dweik also spent time registering for and
reviewing his list of manufacturer payments
on the Open Payments website. Among his
payments, he noticed a listing for a lunch that
he knew he did not attend, and he entered a
dispute for the payment.
In an attempt to keep any potential conflicts
visible, the Cleveland Clinic maintains a comprehensive conflict-of-interest database for its
employees. As chair of its Conflict of Interest
Committee, Dr. Dweik was familiar with b