Physician Payments Sunshine Act: Communication Key To Maintaining Good Relationships During Open Payments Review and Dispute
Today, June 30, the Centers for Medicare and Medicaid Services (CMS) is set to release the second year of Open Payments data, detailing in a searchable database the transfers of value drug and device manufacturers make to physicians and teaching hospitals. While manufacturers alone are responsible for collecting and reporting this data—and face penalties for non-compliance with the Open Payments requirements—physicians bear a large share of media scrutiny and professional liability for inflated or otherwise inaccurate reports. Thus, CMS allows for a 45-day window after manufacturers submit data and before the data is r...
Source: Policy and Medicine - June 30, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Until Next Year
It’s been our great pleasure to collaborate with the Health Affairs Blog on this series stemming from the Third Annual Health Law Year in P/Review symposium at Harvard Law School. This annual event takes a look back over the prior year and previews the year to come with regard to hot topics in health law.
After the symposium, we asked our speakers to keep the conversation going online by expanding on their topics from different angles or by honing in on particularly intriguing features. These pieces were published on the Health Affairs Blog through the spring and into summer.
We heard more from Kevin Outterson on how to...
Source: Health Affairs Blog - June 24, 2015 Category: Health Management Authors: Holly Fernandez Lynch, I. Glenn Cohen and Gregory Curfman Tags: Costs and Spending Featured Insurance and Coverage Medicaid and CHIP Organization and Delivery Population Health Public Health ACA Antibiotics Brittany Maynard Common Rule Ebola FDA Harvard Law Hobby Lobby MassHealth Petrie Source Type: blogs
Nature And Nurture: What’s Behind the Variation In Recent Medical Home Evaluations?
Recent evaluations of two regional medical home pilots (i.e., efforts to improve the capabilities and performance of primary care practices) within the Pennsylvania Chronic Care Initiative (PACCI) have produced differing results.
In the southeast region of the state, the intervention was associated with improvements in diabetes care, but no changes in other measures of quality, utilization, or costs relative to comparison practices. By contrast, the northeast region’s intervention was associated with favorable changes, relative to comparison practices, in a wider array of quality measures as well as reductions in rates o...
Source: Health Affairs Blog - June 19, 2015 Category: Health Management Authors: Mark Friedberg, Connie Sixta and Michael Bailit Tags: Featured Health Professionals Hospitals Long-term Services and Supports Organization and Delivery Population Health Quality AHRQ Chronic Care Commonwealth Fund EHRs medical homes NCQA Patient-Centered Medical Home Pennsylvania Source Type: blogs
AMSA Scorecard Provides Useful Conflicts of Interest Tool For Industry Compliance Professionals
Periodically since 2007, the American Medical Student Association (AMSA) has released a “Scorecard,” ranking medical schools on how strict their policies are regarding interactions between their students and faculty and the pharmaceutical and device industries. The AMSA Scorecard is decidedly anti-industry, but by consolidating all of the conflict of interest documents for schools around the country, the list is actually a very useful tool for compliance professionals who must be attentive to a wide range of university policies.
This initial AMSA Scorecard graded medical schools simply on whether the...
Source: Policy and Medicine - June 11, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
CMS Releases 2013 Medicare Payment Data for Hospitals and Physicians
Yesterday, the Centers for Medicare and Medicaid Services (CMS) announced the release of utilization and payment data for both Medicare hospital services (inpatient and outpatient) and for physicians and suppliers. This is the third year the hospital data was released and the second year that the physician and supplier data was released. Indeed, the big troves of healthcare data keep coming. On April 30, CMS published information on 2013 Medicare Part D payments. At the end of this month, on June 30, CMS is scheduled to release the first full year of pharmaceutical and medical device trans...
Source: Policy and Medicine - June 2, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
OIG Releases Mid-Year 2015 Work Plan, Includes New Provisions Related to Open Payments Oversight and Scrutiny into Clinical Laboratory Payments
Yesterday evening the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released their Work Plan Mid-Year Update for fiscal year (FY) 2015, which summarizes new and ongoing reviews and activities that OIG plans to pursue. A number of new terms find its way into the mid-year plan, including a provision related to OIG’s anticipated oversight of the Open Payments program, as well as a provision stating that OIG will analyze CMS payments to the top 25 clinical diagnostic laboratories.
View the Work Plan here.
The OIG’s job is to detect fraud, waste, and abuse; identify opportunities to improve...
Source: Policy and Medicine - May 29, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
The Smoking Gun: How U.S. Health Care Came to Cost Insanely More
By JOE FLOWER
Cost is the big factor. Cost is why we can’t have nice things. The overwhelmingly vast pile of money we siphon into health care in the United States every year is the underlying driver of almost every other problem with health care in the United States from lack of access to waste to fragmentation to poor quality. We can’t afford to fix the problems, cover everyone, do real outreach, build IT systems that are interoperable and transparent and doc-friendly — or so it seems, because at least on weak examination every fix seems to add even more cost. And in the old ways of doing things in health care, the ...
Source: The Health Care Blog - May 27, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Media Outlets Using 2013 Open Payments Data To Imply Misconduct
Open Payments, a public list of the transfers of value made from pharmaceutical and device manufacturers to physicians and teaching hospitals, has yet to be the basis for a government enforcement action. The Justice Department has not, for example, explicitly used the Centers for Medicare and Medicaid Services’ database as the foundation for bringing kickback allegations against a company. That day may be a ways off—after all the database currently lists only five months of payment data covering September through December of 2013, and a large portion of that data is aggregated, meaning it doesn't list the physician rec...
Source: Policy and Medicine - May 25, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Open Payments Data Correction Period: May 21 - June 5
Today, May 21, the Open Payments 15-day data correction period begins for applicable manufactures and group purchasing organizations. The correction period will end June 5. During this time, applicable manufacturers and GPOs should acknowledge and resolve disputes initiated by physicians and teaching hospitals during the review and dispute period conducted between April 6 and May 20, 2015. The 2014 Open Payments data will become public on June 30, 2015.
The data correction period follows the 45-day dispute process, where physicians and teaching hospitals could inspect manufacturer or GPO submitted data b...
Source: Policy and Medicine - May 22, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
The Smoking Gun: How U.S. Health Care Came to Cost Insanely More
By JOE FLOWER
Cost is the big factor. Cost is why we can’t have nice things. The overwhelmingly vast pile of money we siphon into health care in the United States every year is the underlying driver of almost every other problem with health care in the United States from lack of access to waste to fragmentation to poor quality. We can’t afford to fix the problems, cover everyone, do real outreach, build IT systems that are interoperable and transparent and doc-friendly — or so it seems, because at least on weak examination every fix seems to add even more cost. And in the old ways of doing things in health care, the ...
Source: The Health Care Blog - May 20, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
The Readmissions Penalty at Year Three: How Are We Doing?
By ASHISH JHA, MD
A few months ago, the Centers for Medicare and Medicaid Services (CMS) put out its latest year of data on the Hospital Readmissions Reduction Program (HRRP). As a quick refresher – HRRP is the program within the Affordable Care Act (ACA) that penalizes hospitals for higher than expected readmission rates. We are now three years into the program and I thought a quick summary of where we are might be in order.
I was initially quite unenthusiastic about the HRRP (primarily feeling like we had bigger fish to fry), but over time, have come to appreciate that as a utilization measure, it has value. Anecdotal...
Source: The Health Care Blog - May 19, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Open Payments Analytics Offers Companies "Competitive Intelligence"
The Open Payments database lists most transfers of value made by pharmaceutical and device manufacturers to physicians and teaching hospitals, from a $10 sandwich to consulting arrangements in the thousands of dollars. The government database allows for users to search for a particular physician, but so far the challenge for manufacturers has been how to assemble Open Payments data—both for their own company and their competitors—into a meaningful business tool. A new resource entitled Open Payments Analytics, created by business analytics and software developer Streebo, now offers companies this ability.
Open P...
Source: Policy and Medicine - May 15, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Pharmaphobia: How the Conflict of Interest Myth Undermines American Medical Innovation
Long a champion of physician and industry collaboration, Thomas Stossel, M.D., has published a new book entitled Pharmaphobia: How the Conflict of Interest Myth Undermines American Medical Innovation. In it, Stossel, a distinguished Harvard hematologist and researcher, decries the conflict of interest movement as detrimental to medical progress and ultimately the patients who would benefit from new, innovative therapies.
Writing about conflicts of interest has been an increasingly surefire way to get published—the Journal of the American Medical Association even has its own conflict of interest category. What...
Source: Policy and Medicine - May 8, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Results From The 2015 GME Matches: GME Positions Continue To Grow
Recently the preliminary results from the 2015 National Resident Matching Program® (NRMP®) and the American Osteopathic Association (AOA) Match were released. While final Match data from the NRMP will be released later this spring, the preliminary results from both programs provide important insights on Graduate Medical Education (GME) trends of interest in the policy community. Three issues are of particular interest in the policy community:
Are GME positions continuing to grow? While many people thought that GME positions would not increase after the Medicare program capped the number of positions the program would p...
Source: Health Affairs Blog - May 1, 2015 Category: Health Management Authors: Edward Salsberg Tags: Featured Health Professionals AOA GME Graduate medical education Match Day matching programs NRMP Physicians Primary Care Source Type: blogs
