Physician Payment Sunshine: Medical Data Informatics Mines Currently Available Data

In response to the enactment of the Physician Payment Sunshine Provision (section 6002) contained within the Affordable Care Act (ACA), a number of stakeholders in the health care industry are beginning plans to help providers and practitioners with the reporting, disclosure and transparency provisions required under the act.  One company, Medical Data Informatics, provides a full range of data mining and analytics services. 

The  “Physician Payments Sunshine Provision” requires that companies begin reporting gifts or payments  starting  January 1, 2012. This information is to be reported to HHS  by March 31, 2013, and annually thereafter. HHS will then post this information on a publicly available, searchable on-line database as of September 30, 2013, and on June 30 of each year beginning thereafter. 

According to the company’s website, they have “wide ranging expertise in database technologies and can assist your organization in customized reporting, data mining or systems integration, from project planning and architecture to development and testing and can help you meet compliance requirements mandated by new legislation and transparency initiatives.” 

The company has their own database that contains records of payments to healthcare practitioners and other payees from pharmaceutical and medical device manufacturers who have made national data publicly available on their websites.  Medical Data Informatics updates its payments database whenever new national public data is available from Pharmaceutical companies and Medical Device manufacturers.  The website states that the database contains over 280,000 records of individual payments to over 200,000 healthcare practitioners in the United States.    

The company uses a variety of extract, transformation and load techniques and tools to load data and after each database update they use a quality assurance process to verify accuracy as far as is possible. Data fields maintained are: 

• Year payment made
• Reporting Company
• Health Care Practitioner Name
• Health Care Practitioner City and State
• Health Care Practitioner Professional Designation (e.g  MD, DO)
• Payee Name (Organization or Individual receiving payment)
• Amount Paid  or Payment Range (*)
• Payment Method (**)
• Payment Type 

Some reporting companies show a range of amounts paid e.g. “From $10,000 to $20,000.”  Some reporting companies list a Payment Method of Cash/Noncash or Payment in kind, but typically this field is blank. We also use this field to show a payment as “Partial” (flagged by an asterisk in the results next to the amount)  in cases where several Health Care Practitioners are listed as recipients of a total payment made to an organization but where the reporting company does not show how the distribution is made. Where the payment amount is zero, it indicates that the Healthcare Practitioner was identified as a recipient of a payment but that the amount is currently unspecified. 

To access their payments database individuals must register with the company and provide a valid email address and phone number.