$6.49 Billion Paid to Doctors by Medical Manufacturers in 2014

The Centers for Medicare & Medicaid Services (CMS) published full year of 2014 financial data about transfers of value by drug and medical device makers to health care providers.  The data includes information about 11.4 million financial transactions attributed to over 600,000 physicians and more than 1,100 teaching hospitals, totaling $6.49 billion.

The massive data release was done under the Open Payments program that was created by the Affordable Care Act.  It requires drug and device makers to report transfers of value, including direct payments, as well as honoraria and research grants, to health care providers, as well as other industry-related providers.  The role of this program is to shine a light of transparency on any conflicts of interest that exist in the medical marketplace and, as acting CMS Administrator Andy Slavitt said, “this is part of [a] larger effort to open up the health care system to consumers by providing more information to help in their decision making.”

This is the second year of operation for the Open Payments system and it sports an improved web site with enhanced searching capabilities for easier data access.  According to the CMS press release, CMS was able to validate nearly 98.8% of all records submitted drug and device makers, as well as group purchasing organizations, in the Open Payment system for all of 2013 and 2014.  The system relies on health care providers to voluntarily review the compensation data submitted by companies and nearly 30% of the total value of the disclosed data was reportedly reviewed by registered physicians and teaching hospitals.

The American Medical Association (AMA), the leading physicians’ organization, criticized the annual data release by CMS and warned that media should take caution in reporting on the information. “Media should verify the accuracy of data; understand the context of financial relationships between physicians and industry when reporting on Open Payments Data,” admonishes the AMA press release.

CMS states that it plans to regularly update the Open Payments data to include changes from any data disputes and corrections made by health care providers and companies.

We wrote in more detail about the Open Payments program in our past article.

You may visit the Open Payments web site here: https://openpaymentsdata.cms.gov/.

If you have any questions about Medicare or Medicaid participation or billing disputes, antikickback, or if you are a target of an investigation or an audit, please contact our office.