CMS Database Brings Transparency to Payments made to Doctors

As our employer and insurance industry clients are well-aware, skyrocketing medical costs have greatly contributed to rising exposure and expense in workers’ compensation claims.  Often, respondents in workers’ compensation claims are in the dark as to the doctors’ motivation for prescribing a given course of care.   Although opinions certainly differ as to the 2010 Affordable Care Act, one part of that Act may become a useful tool for investigating this question by proving a tool to examine the relationship between doctors and the pharmaceutical industry.

As a result of The Physician Payment Sunshine Act, the Centers for Medicare & Medicaid Services has released an Open Payments database that provides information regarding the payments made to physicians from pharmaceutical and medical equipment companies whose products they prescribe.  For now, the information only documents payments made from August 2013 through December 2013, but it is anticipated that information for all of 2014 will published in 2015. The database is also limited in other ways, such as not including payments made for research on new products and not including payments made to a physician’s assistant or nurse.

However, the database has documented and identified approximately $1.3 Billion in payments that have been made to approximately 360,000 medical professionals, 873 teaching hospitals, and 1,379 purchasing organizations.  While the database is currently constrained in its coverage and clumsy when it comes to user-friendliness, it signifies the beginning of a very useful and important tool in identifying the influence of pharmaceutical companies upon medical professionals.  The Open Payments data can be found at:

Be sure to return in June of 2015, when a significantly larger set of information will be released. Thanks to I&F attorney Michael Bantz for covering this important issue.

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