CMS Open Payments program releases data on ODs, other physicians

Drug and device manufacturers paid optometrists approximately $965,000 in the latter part of 2013, according to an initial AOA analysis of public data released under the federal Open Payments program. This represents just a small percentage of the total payments made to doctors.

It's more important than ever for ODs to know what has been reported about them.

Authorized by the Affordable Care Act, the "Sunshine Act," or Open Payments program, requires that certain manufacturers and others report any payments or gifts provided to ODs and other physicians. Such items include consulting fees, honorarium, gifts, food and beverage, lodging and travel, and education.

On Sept. 30, the Centers for Medicare and Medicaid Services (CMS) made data on these types of financial transactions publicly available for the first time. The data includes 4.4 million payments valued at about $3.5 billion. The payments were made to 546,000 doctors and 1,360 teaching hospitals over the past five months of 2013, according to a statement from CMS.

In analyzing data specific to eye care professionals, the AOA determined that:

  • Among transactions for "general payments," there were 6,621 reports of transfers of values from drug and device manufacturers to ODs. This represents less than 0.2 percent of all payments.
  • The total amount under general payments to ODs was about $965,541, less than 0.03 percent of the value of all payments.
  • By comparison, there were 3,495 transfers of value made to ophthalmologists under the general payments category for a total of $1,812,548.

In addition, 14 ODs were reported to have ownership or investment interest in an applicable manufacturer or group purchasing organization, and 116 ODs were reported to have received payments or other transfers of value made in connection with a research agreement or research protocol.

Concerns about accuracy remain
The AOA continues to have questions about the accuracy of the data's physician specialty definitions as well as the accuracy of data reported by manufacturers. 

ODs and other providers had the opportunity this past summer to register for the Open Payments program and review data reported by manufacturers and others for accuracy. Providers had just 45 days to review and, if necessary, correct any data before it was made public. 

Many physicians did not register to review their data, however, raising concerns about possible unidentified errors in manufacturer-reported information. Of the 546,000 doctors listed in the CMS data, only 26,000 registered to review their listings in advance.

AOA also has concerns about the lack of context provided for consumers to interpret and understand the data. As CMS has indicated, the program doesn't identify which financial relationships may cause a conflict of interest or may be beneficial.

ODs: Know what's in these reports
Now that this information is public, patients can research it and ask doctors about it. So it's more important than ever for ODs to know what has been reported about them.

CMS plans to release future reports on Open Payments on a yearly basis, starting in June 2015. Before each public release of data, there will be a 45-day review and dispute period for physicians.

The AOA will provide its members with alerts when review periods are approaching.

If you have issues obtaining your data, email Kara Webb, the AOA's associate director for coding and regulatory policy.

October 3, 2014

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