Physicians and Teaching Hospitals - Register to Track and Dispute Publicly Available Payment Disclosures from Drug and Device Manufacturers

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In the coming months, all direct or indirect payments to physicians and teaching hospitals from drug and device manufacturers will be publicly available.  It is imperative physicians and teaching hospitals register to ensure accuracy of these payments and to track the number of payments individuals or organizations are receiving from drug and device manufacturers.

Section 6002 of  the Patient Protection and Affordable Care Act required the Centers for Medicare and Medicaid Services (“CMS”) to implement transparency programs as it pertains to physician ownership and investment interests. The result of this section is the open payments program, also known as the Physician Payment Sunshine Act, which is a national transparency program requiring certain manufacturers of drugs, devices, biologicals, and medical supplies and government purchasing organizations (“GPOs”) to disclose certain financial relationships with teaching hospitals and physicians.

Manufacturers of covered products and entities under common ownership with those manufacturers must, on an annual basis, report payments or other transfers of value made to teaching hospitals and physicians. Further, GPOs are required to report payments or other transfers of value made to physician owners or investors. It is worth noting that such ownership or investment interests also include physician’s immediate family members, which includes the broad definition of “immediate family members” under the Stark Act.

The information and data that will be submitted by these organizations will include general payments, research payments, and ownership and investment interests. The types of payments that will be reported include both direct and indirect payments to both physicians and teaching hospitals. Further CMS will also collect any information on payments which have been designated by the teaching hospital or physician to other third parties.

Currently, CMS is in the registration phase of the process. This means that manufacturers and GPOs have been registering and submitting information on payments or transfers of value to physicians and teaching hospitals throughout the past few months. However, on June 1st physicians and teaching hospitals are able to register with CMS so they can receive notifications on information submitted by those organizations. Once registered, physicians and teaching hospitals will be able to review information for accuracy and they will be able to dispute any inaccurate data which has been reported by manufacturers or GPOs.

Once the data has been submitted, CMS will make this data publicly available.  To manage this public data, CMS allows physicians and teaching hospitals to register in order to track and dispute payments.  Physicians and teaching hospitals should take a proactive approach to limit risks of this data being released.  Earlier this year, CMS released Medicare payment data on over 800,000 medical professionals substantially increasing risks for those individuals under the False Claims Act.  It is possible this information could have a similar effect, therefore it is advisable that individuals and entities register.

If you have any questions about the risks of this data being released, or the registration process, please feel free to contact Robert A. Wade at (574) 485-2002 or Alex T. Krouse at (574) 485-2003.