Practice Economics

Deadline nears to dispute industry payment data


 

References

Physicians and teaching hospitals have until Aug. 27 to review and dispute payment data from drug, device, and biological manufacturers under the federal government’s new Open Payments Program. But recent technical problems with the online system could push that deadline back by a few days.

The Centers for Medicare & Medicaid Services had been scheduled to publish information on industry payments to physicians and teaching hospitals on Sept. 30 as part of the new transparency initiative created under the Affordable Care Act.

AMA

Dr. Robert Wah

On Aug. 7, CMS announced that the Open Payments website had been taken offline temporarily and that physicians and other providers would not be able to review data until the system was again operational. For each day that the system is offline, CMS said it will accordingly adjust the review and dispute deadline.

CMS did not explain why the system had to be taken offline, but Dr. Robert M. Wah, president of the American Medical Association, said in an interview that CMS officials had discovered earlier in the week a problem in which a manufacturer had attributed payment data to the wrong physician.

While CMS is planning for a small delay because of the technical problems, the AMA and more than 100 specialty and state medical societies are pushing for a 6-month delay on the public release of the payment data, a move that would change the scheduled publication date to March 31, 2015.

In an Aug. 5 letter to CMS, the AMA and the other organizations wrote that while they have "no issue" with efforts to increase transparency in the interactions between physicians and industry, they do have "serious concerns" about the implementation of the program.

A top concern for the groups is the length and complexity of the registration process required for physicians and teaching hospitals to access their data in the Open Payments systems.

CMS officials have told physicians to expect to spend 30-45 minutes to complete a 5-step registration process. But the AMA and the other societies contend that the process is much more involved. They estimate that after the initial preregistration step to verify a physician’s identify, there are another 11 steps in the registration process. And reviewing and disputing data is another 5 steps, they wrote.

"What we’re hearing from physicians is [that] this process is extremely time consuming and difficult," Dr. Wah said. "The user guide to go through this multistep process is 359 pages long. And the time that it’s taking people is in the hours, not minutes, to get through it."

The complexity of the process makes it "effectively impossible" for physicians to review and dispute payment data within the July 14-Aug. 27 window provided by CMS, the organizations wrote in their letter. After Aug. 27, physicians and teaching hospitals can continue to dispute data, but any subsequent corrections would not be reflected in the first publication of data on Sept. 30.

The groups also noted that many physicians are not aware of the program or its deadlines. The medical societies wrote that CMS has not done an adequate job of notifying physicians about the need to review their data. Further, delays by the government in setting a date for physicians to register for the program have made it difficult for medical societies to get information out to their members.

"It takes time to get the word out about these kinds of things, even in our electronically connected world," Dr. Wah said.

mschneider@frontlinemedcom.com

On Twitter @maryellenny

Recommended Reading

House panel looks into rocky rollout of healthcare.gov
MDedge Family Medicine
It’s official: Oct. 1, 2015, is the ICD-10 compliance date
MDedge Family Medicine
Bill introduced to keep Medicaid pay bump through 2016
MDedge Family Medicine
Is it time for telemedicine?
MDedge Family Medicine
CMS finalizes plan to cut hospital payments, move ahead with two-midnight policy
MDedge Family Medicine
Questions surround EHR security
MDedge Family Medicine
Big data destined for the bedside within 5 years
MDedge Family Medicine
Health sector well represented among lobbying top spenders
MDedge Family Medicine
Comparative effectiveness research results alone don’t change clinical practices
MDedge Family Medicine
VA health care reform signed into law
MDedge Family Medicine