The Open Payments program, which was created by the Physician Payments Sunshine Act, requires manufacturers of drugs, devices and other medical supplies and group purchasing organizations to report certain payments to physicians or teaching hospitals. CMS will make all payment data available to the public no later than September 30, 2014.
However, soon after the ink dried on the CMS final rules for the Open Payments program, concern was raised about a so-called “CME reporting exemption” that found its way into the final rule. In response, CMS recently proposed removing this particular provision, section 403.904(g), which covers conditions under which CME funding doesn’t have to be reported to the government.
Now, industry groups from the pharmaceutical, medical device, and provider communities are publicly voicing their need for secrecy when it comes to the payment of CME funds. The AMA said that removal of the CME exemption would likely result in fewer physicians taking part in CME events.
CME speaker and attendee payments have been useful guises for physician kickbacks and for seed money for illegal off-label promotions. In fact, dozens of successful False Claims Act cases have exposed pharmaceutical and medical device companies engaged in the same or similar misbehavior.
The Physician Payments Sunshine Act was meant to shine the light of transparency on all payments flowing from industry players to healthcare providers. If CME payments remain in the dark, fraud will mushroom.
More information for whistleblowers is located at the Nolan Auerbach & White website.