Physician Payment Sunshine Act: Survey of Physicians Reveals Little Understanding of Open Payments Program

Policy and Medicine recently reported that physicians remain concerned about the implications of the Physician Payment Sunshine Act (Open Payments) as the first reporting period comes to a close and the first annual reporting deadline, March 31, 2014, quickly approaches. Policy and Medicine has reported extensively on Open Payments, including publishing a Quick Reference Guide and a helpful overview of the Top 50 Things to Know about the requirements of the law. Although several companies, associations, and agencies have distributed information, pamphlets, webinars, and articles regarding Open Payments, a recent survey conducted by QPharma, Inc. reveals that many physicians still do not have a good working knowledge of the requirements of the law.

QPharma Survey Reveals Lack of Information and Split Between PCPs and Specialists

QPharma surveyed 300 U.S. physicians, representing 27 states, across various specialties and sub-specialties to gather the latest available data about what covered recipients, specifically physicians, understand about the Physician Payment Sunshine Act and its requirements. Over 900 physicians across the country were invited to participate, and the survey was conducted on September 5, 2013. Data collection was cut off within twelve hours after 300 responses, and the respondents were paid a small honorarium.

According to QPharma, respondents to the comprehensive survey answered questions on topics that included awareness of reporting thresholds, fees to charity, and whether Sunshine Act requirements will influence physicians’ future interactions with industry. The survey was conducted under the direction of QPharma Chief Medical Officer Peter Shaw, M.D., and a full report is available for purchase online.

Although the question may have been misunderstood, one key surprising result that places a spotlight on physician confusion regarding Open Payments is the fact that 11% of respondents stated that they had “registered” on the Open Payments website, when registration will not be available until after January 1, 2014. Currently physicians can only subscribe to receive Open Payment updates via email.

General lack of knowledge was revealed by the fact that 45% of respondents didn’t know that fees they directed to charity would still be reported with their name and that the applicable charity would be identified. 41% of respondents did not know that payments under $10, but over $100 in aggregate, would be reported. Broadly, a full quarter of physician respondents did not know that reportable payments would be published on a publicly searchable website. A whopping 83% of physicians were not aware of the mobile app available to help physicians track their received payments.

There was also a notable difference between the responses of specialists versus primary care providers (PCPs). 25% of specialists claimed to “fully understand” the Physician Payment Sunshine Act underlying Open Payments. In contrast, almost 30% of PCPs claimed to have “no” or “minimal” understanding of the Act. 56% of specialists and 43% of PCPs did not know that a record of samples received, including physician signatures, would be reported to the FDA; although, the FDA has not yet issued a final rule regarding this requirement. As a result, 60% of specialists and 49% of PCPs stated that they will be less likely to accept and distribute samples.

All told, more than half of specialists and PCPs are “concerned” or “very concerned” about patients’ perceptions regarding physician financial relationships with pharmaceutical, biotech, or medical device companies. 38% of specialists and 30% of primary care physicians who participate in speakers programs stated their attitude for participating in those programs were changing due to the sunshine regulation. For research the number that will reconsider is significantly smaller at 11% for specialty and 5% for primary care.

Additionally, of the respondents who stated they “fully understood” the Act at the start of the survey, 17% concluded that they actually had “no understanding” of the transparency laws by the end of the survey. The concern regarding perceptions and the evident lack of understanding both underscore the need for additional targeted Open Payments information for physicians.