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The OIG watches as physicians come into the sunshine
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From international law firm Arnold & Porter LLP comes a timely column that provides views on current regulatory and legislative topics that weigh on the minds of today’s physicians and health care executives.
Publication of data for the first full year of the Physician Payments Sunshine Act has now been made. Although the Sunshine Act was promoted as a way to ensure transparency to allow patients the ability to understand the financial relationships between their physicians and industry, it has been widely predicted that these data also would serve as a source for data mining by government enforcers. The recent Office of Inspector General (OIG) Work Plan Mid-Year Update suggests that this speculation is correct. In particular, the OIG has added a new item to its Work Plan — a review of financial interests reported under the Open Payments program. Specifically, the OIG entry reads as follows:
Alan E. Reider
“We will determine the number and nature of financial interests that were reported to CMS under the Open Payments program. We will also determine the extent to which CMS oversees manufacturers’ and group purchasing organizations’ (GPOs’) compliance with data reporting requirements and whether the required data for physician and teaching hospital payments is accurately and completely displayed in the publicly available database.”
This description suggests that this OIG project will focus on the integrity of the program to ensure that the information submitted was accurate and complete. The fact that this project is under the auspices of the Office of Evaluation Inspection (OEI) of the OIG, rather than the Office of Investigations, appears to affirm this assessment. Nevertheless, to the extent that OEI identifies any anomalies or outliers, it is reasonable to anticipate that such information will be passed across the hall to the OIG’s Office of Investigations for more in-depth investigation. For this reason, it is critical that physicians monitor the data submitted by manufacturers to assure that it is accurate and, more importantly, review their financial relationships with industry to be certain that they are compliant and can withstand the scrutiny that almost certainly will take place.
Alan E. Reider, JD, MPH, a partner at Arnold & Porter LLP, can be reached at Alan.Reider@aporter.com.