Inside CMS: "Doctors Worry About Erroneous Reports To Physician-Sunshine Database"

Posted: February 29, 2012

Physician groups worry they will not be able to correct falsities on the "physician sunshine" database being set up by CMS to disclose gifts that drug and device companies give doctors and teaching hospitals, according to comments on the agency's proposed Sunshine Act rule. But a recent report found that nearly half of surveyed physicians did not even know of the law.

The Medicare Payment Advisory Commission is urging CMS to include more information in the database, but physicians are focused on ensuring that what is reported is accurate. MedPAC and consumer advocates are OK with letting companies explain financial transactions so they are not misleading to patients, and the proposed rule calls for "a streamlined and automated process for reporting disputes and changes to ensure that the review and correct process is as smooth as possible."

However, the American Academy of Family Physicians said the proposed rule fails to include sufficient safeguards against posting inaccurate information and erroneous reports could hurt physicians' credibility with patients. AAFP said it is not enough to merely publish both a drug or device company's reported value and the physician's self-reported amount. The group also wants CMS to structure the review and arbitration process such that physicians do not incur legal fees to defend themselves from erroneous reports.

"The AAFP therefore encourages CMS to reexamine the agency's role and responsibilities to prevent the dissemination of inaccurate or disputed data," the comments state.

AAFP also worries that although the law states that indirect payments are not supposed to be included in the database, CMS statements about the proposed rule discuss indirect transfers of value. Including indirect payments are especially problematic for "continued medical education" because drug and device companies often fund conferences that offer those physicians attending receive CME credit. That means speakers and attendees of those conferences end up being listed as having financial ties to companies by merely attending CME programs, AAFP says.

The American Academy of Pediatricians also worries about about how CME could be affected. "Organizations, such as the AAP, may become responsible for reporting all payments and transfers of value to covered recipients, including those faculty who participate in commercially supported accredited CME activities. Implementing this requirement would place a significant administrative burden on the AAP and other accredited CME providers and would require substantial resources to implement and manage. Thus, it is imperative that the potential regulatory impact on third parties be considered," AAP says.

The American Association of Clinical Endocrinologists also worries about errors in the database that hurt physicians' reputations. "Given the volume of data that will be collected, reported and publicly disclosed, there is great potential for errors in reporting, and misinterpretation and misunderstanding of the reported information among patients," the AACE states. "We are extremely concerned the ensuing confusion will impugn the inherent trust that we share with our patients and unnecessarily undermine the physician-patient relationship, with secondary adverse impact on the delivery of healthcare in this country."

But despite the concerns of many physician groups, a survey of 500 compliance officers and physicians found the 47 percent had not heard of the Sunshine Act, and 53 percent of respondents were not aware that this information will be publicly available. The survey was done by MMIS, a New Hampshire-based company that provides compliance software to the healthcare industry.   — John Wilkerson

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Posted on Apr 23, 2012 8:50:35 AM

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