CME pay­ments to docs must be re­ported

Modern Healthcare - - NEWS - By Jaimy Lee

Con­sumer groups ap­pear to have won the lat­est round of the reg­u­la­tory tussle over whether man­u­fac­tur­ers’ in­di­rect pay­ments to doc­tors for con­tin­u­ing med­i­cal ed­u­ca­tion ac­tiv­i­ties must be re­ported to the Open Pay­ments data­base.

The CMS said in new guid­ance last week that some pay­ments made by med­i­cal-de­vice and drug man­u­fac­tur­ers to physi­cians for par­tic­i­pat­ing in con­tin­u­ing med­i­cal ed­u­ca­tion ac­tiv­i­ties will have to be re­ported start­ing in 2016. Con­sumer groups have ar­gued for dis­clo­sure of th­ese pay­ments, while in­dus­try groups have sought to ex­clude them, say­ing that ac­cred­ited CME pro­grams have stan­dards that pre­vent con­flicts of in­ter­est.

In the Dec. 15 guid­ance, the CMS clar­i­fied that pay­ments must be re­ported by the sec­ond quar­ter of the fol­low­ing re­port­ing year if the man­u­fac­turer finds out the name of a physi­cian paid to speak at a CME event the company funded. That in­cludes cases where the man­u­fac­turer did not pay the physi­cian di­rectly or se­lect the speaker.

This is a change from a 2013 fi­nal rule that ex­cluded cer­tain CME pay­ments from the data­base. Another rule and the guid­ance, both of which came out in 2014, are ex­pected to stream­line the re­port­ing process, in part by no longer dis­tin­guish­ing be­tween ac­cred­ited CME and nonac­cred­ited ed­u­ca­tion ac­tiv­i­ties. “The ac­cred­i­ta­tion as­pect is no longer rel­e­vant… That is re­ally the driv­ing force be­hind the rule change,” said Dr. Shan­tanu Agrawal, di­rec­tor of the CMS’ Cen­ter for Pro­gram In­tegrity. “We didn’t im­ple­ment the change to ex­pand or con­tract re­port­ing.”

But the new guid­ance is ex­pected to in­crease re­port­ing. Ac­cred­ited CME providers usu­ally pro­mote the events and the names of doc­tors hired to speak, said Dr. Daniel Car­lat, for­mer di­rec­tor of the Pre­scrip­tion Project at Pew Char­i­ta­ble Trusts. “It would almost be unimag­in­able for the company not to learn the iden­tity of the physi­cians speak­ing.” The CME Coali­tion, which rep­re­sents com­pa­nies pro­vid­ing ac­cred­ited CME pro­grams, said the new guid­ance is in­con­sis­tent with the fi­nal rule from Oc­to­ber. “We be­lieve this cre­ates the need for fur­ther clar­i­fi­ca­tion,” An­drew Rosenberg, the CME Coali­tion’s se­nior ad­viser, said in a writ­ten state­ment.

The pur­pose of the Open Pay­ments data­base is to make fi­nan­cial re­la­tion­ships be­tween man­u­fac­tur­ers and health­care providers more trans­par­ent and dis­cour­age con­flicts of in­ter­est.

“We didn’t im­ple­ment the change to ex­pand or con­tract re­port­ing.” Dr. Shan­tanu Agrawal, di­rec­tor, CMS’ Cen­ter for Pro­gram In­tegrity

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