Cracks are appearing in CMS' drive to publish Physicians Sunshine Act data

The runup to the Sept. 30 date for releasing national data on payments to physicians under the Physicians Sunshine Act is becoming challenging, but for now CMS is sticking to that date, at least for what it says are two-thirds of the data that can be confirmed prior to publication. The CMS system, also known as the Open Payments system, was opened for individual physicians to review on Aug. 3; when errors appeared, it was temporarily closed, but then reopened on Aug 15. CMS is giving physicians (and teaching hospitals, among other healthcare organizations) 45 days to dispute the data; that review period has been extended to Sept. 8. According to ProPublica, the nonprofit investigative-journalism enterprise which has a search window open to the public on its homepage under its longrunning “Dollars for Docs” investigation, a CMS spokesperson said that about one-third of the data will be withheld until next June. Senator Charles Grassley (R-IA), one of the Congressmen who wrote the original legislation, is pushing CMS to be more forthright about changes and updates, according to press statements.

Also during August, the American Medical Assn. and 110 other medical associations called for a six-month delay in publishing the data (even before CMS’ most recent decision to delay part of the reporting).

Press coverage has focused on payments made by manufacturers to physicians or their affiliated employers; the logic all along has been that these payments (which can range from in-office pizzas to million-dollar clinical trial projects) influence how physicians prescribe drugs and other healthcare products. But there are many other potential landmines in the data collection: relationships between prescribers and group purchasing organizations, and ownerships of healthcare facilities by physicians and their immediate families.

Industry wags are also comparing the ramp-up of the Open Payments system to last year’s healthcare exchange fiasco (both systems are part of the original Obamacare legislation). However, the tech issues appear to be vastly different; CMS’ Aug. 15 statement cited difficulties such as “the wrong state license number or national provider identifier (NPI), for physicians with the same last and first names.” (And it’s worth noting that the NPI system itself is a CMS operation.)

Fasten your seatbelts, it’s going to be a bumpy ride…