I had the opportunity to recently attend the 3rd Annual Forum on Physician Payments Disclosure & Aggregate Spend Conference in New York City on October 17. The timing of the event should have been perfect, as the dates were likely selected based on the expected date of the finalization of the Sunshine Provision rules; however as we’ve documented on Transparent Innovations, that wasn’t the case. Despite the absence of final regulatory language, it was fascinating to get a better appreciation of the many viewpoints shared during the two days.
The highlight of the event was the keynote by Jim Sheehan, former Medicaid Inspector General for New York and Assistant U.S. attorney. In his previous line of work, Mr. Sheehan was an enforcer and brought his perspective on how publicly reported data might change how state and federal prosecutors corroborate and fact check investigations. It was a reminder that aggregate spend reporting may be just the beginning of a new era of monitoring sensitive data that carries media, regulatory and competitive risk.
The conference also underscored the real complexity that life science companies face in capturing and reporting this data. As with most projects, the devil is always in the details and failure to properly attribute and classify payments will make it difficult to report comprehensively and accurately. The final rules by CMS will need to provide a sufficient level of specificity around reporting requirements and terminologies; otherwise each company’s interpretation may vary slightly and make industry-wide extrapolations difficult without sophisticated data analysis solutions.
Finally, one audience participant remarked that when his company polled a group of physicians at a recent event, over 50% were unaware of the Sunshine provisions and that information on manufacturer payments to providers was being disclosed publicly. While this percentage seems extremely high, there appears to be a need for both educational outreach and online profile management for health care providers who will be impacted by this new regulation. This goes for hospitals and academic medical centers as well - the deluge of public data may be an added burden for compliance teams and office of industry interactions, who will be busy tracking data on staff members and making sure that conflicts-of-interest are managed proactively.