Tony has a strong expertise in the healthcare and managed care/payer arena. He currently manages the workflow of Oncology Business Management, a business trade journal geared towards community oncologists/hematologists.

CMS Shuts Down Pharma Payment Verification System

Published: Friday, Aug 08, 2014

The Centers for Medicare & Medicaid Services (CMS) took down its Web site that verifies payments from pharmaceutical companies to physicians, after at least 1 doctor had payments attributed to him that were actually made to someone else, reports ProPublica.

The glitch came to light after David E. Mann, a Louisville eletrophysiologist, logged on to the Open Payment system to verify his payment record. In addition to viewing his own records, he was also able to see payments to a physician with the same name, an oncologist from Florida. Mann wrote a blog post about it, pointing out the different addresses, different middle names, and importantly, the different National Provider Identifier (NPI) numbers, a unique number for covered health care providers. The tracking system is part of the Sunshine Act, a provision of the Affordable Care Act.

CMS has recommended that physicians log onto the system to review the data and identify any discrepancies. On September 30 the data will be released to the general public. The data in question is a list of payments (whether food and drink, honoraria, travel expenses, etc.) submitted by drug and device companies for the previous year. 

ProPublica alerted CMS about the problem and CMS responded via email:

"After an assessment of the data resulting from a complaint, we discovered that a limited number of physician payment records submitted by at least one manufacturer incorrectly contained information about other physicians," CMS spokesman Aaron Albright said. "To protect physician privacy and correct the issue, we have taken the system offline temporarily and will work with the industry to eliminate incorrect payment records."

The Open Payment program is supposed to provide greater transparency around the financial relationships of manufacturers, physicians, and teaching hospitals. CMS annually receives:

  • Payment reports from manufacturers of covered drugs, devices, biologicals, and medical supplies to physicians and teaching hospitals to CMS;
  • Information about ownership or investment interests held by physicians or their immediate family members from manufacturers and group purchasing organizations (GPOs); and
  • Reports from GPOs about payments or other transfers of value made to physician owners or investors if they held ownership or an investment interest at any point during the reporting year.

Pharmaceutical industry groups and 20 medical societies have sent a letter to CMS requesting that the agency flesh out data that will be published and to explain what context will be provided to help the public understand the justification for payments.

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