Week in Review, August 5, 2014

Industry groups ask CMS to help clarify context of physician payment data, a study finds most physicians have yet to visit the Open Payments website, another medical device company settles a False Claims case and Senator Grassley weighs in on the concept of a gold standard certification for compliance programs.

The calendar tells us the dog days of summer are upon us. Luckily, some of us have had a bit of a “cold spell” recently, so those dog days haven’t had quite the bite they normally do. As you seek ways to deal with the combined heat of the sun and of the Dog Star (as ancient stargazers may have believed), we offer a cool refreshing break of a different sort, with this week’s Compliance News in Review.

Industry and medical groups are putting the heat on CMS. Over 20 medical associations, PhRMA, and BIO sent a letter to CMS asking how the agency plans to help the public understand the nature and purpose of the physician data that will soon be available through Open Payments. The groups cited the recent release of Medicare Part B payments as an example of why they are concerned about proper context. They claim that context was missing when CMS released the Part B data, causing confusion as to which doctors were abusing the system and which were receiving large payments for legitimate reasons. The letter also asked CMS to reach out to the physicians and make them aware that the data will be published soon. Responding to inquiries from the Wall Street Journal, a CMS spokesperson said the agency plans to publish that nature of payments to physicians and teaching hospitals and provide context for the public.

A majority of physicians are slow to step into the Sunshine according to a new survey. The study found only 7% of physicians have visited the Open Payments website and 85% want to review payment data before it is sent to CMS. 80% want to be informed of the value of items before they accept them. The survey also indicates the majority of physicians are concerned with public perception once the data is published. Physicians seem to be more willing to accept certain payments over others. For example, only 16% of physicians said they would no longer accept meals but, 40% say they will no longer accept gifts. The study also addressed companies’ best practices in aggregate spend systems and global transparency.

On the settlement front, medical device company, Vascular Solutions, agreed to pay $520,000 to settle allegations it violated the False Claims Act by promoting its product for an unapproved use. The suit was brought by a former sales rep, and alleged the company promoted a kit for the treatment of veins deep in the leg, rather than varicose veins near the surface of the skin, the use for which it has been approved.

No gold stars for compliance programs says Senator Chuck Grassley. At a House subcommittee meeting on the False Claims Act (FCA), several witnesses referenced a Chamber of Commerce report that proposed a program through which companies could be certified as having a “gold standard” compliance program. Companies achieving the certification would be treated differently under the FCA and requirements for whistleblowers would change. In comments following the meeting, Senator Grassley said he was not in favor of a program that provided such a “get out of jail free card.” Grassley is skeptical about companies self-reporting and he claims having a certified compliance program will not change whether they do or do not self-report.

With that, we close our dog days of summer issue of the Week in Review. Have a great week everyone and we’ll see you by the pool!

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