Physician Payment Sunshine Act: CMS Shuts Down Open Payments Portal After System Mixes Up Physician Information

 

Screen Shot 10:00pm EDT Monday August 4, 2014

The Centers for Medicare and Medicaid Services (CMS) has scheduled July 14 – August 28 for the dispute resolution phase of the Physician Payments Sunshine Act. This 45-day time frame is designed to allow physicians to register in the Open Payments system, review any transfers of value made to them from pharmaceutical and device manufacturers, and potentially resolve any inaccuracies found in the database before the information is presented to the public on September 30.

Breaking news from ProPublica, however, states that CMS has temporarily suspended the system to complete this process after at least one doctor had payments attributed to him in the system that actually went to a different doctor. David Mann, a Crestview-Florida based oncologist, posted a blog about his experience with the website this past week.

The blog breaks down the long identification process the doctor went through to register in Open Payments, only to find his payments were matched up to the wrong identity.

Just getting to the data is not easy.  There is a 2 step registration process outlined here.  The instructions are contained on a 42 slide powerpoint presentation.  Undaunted, I plunged ahead.  During part of the process, I was asked questions like “where did my last bank loan come from” and other private information that I had no idea CMS would have in their files.  In another part of the process, there was a 15 minute time limit to answer the questions correctly.  Knowing your NPI number and your practice specialty code (this could easily have been a drop down list — I ended up googling the code) is necessary.  As we shall see below, all this caution to make sure that the person registering was actually me was a waste of time.

Mann goes on to say that after he finally got into Open payment,

The spreadsheet I encountered was full of payments from drug companies I never dealt with.  After tediously viewing the details of each entry, I discovered that my data had been freely mixed with another doctor with my name who practices in Florida.  This despite having different addresses, different middle names, and, importantly, different NPI numbers!

ProPublica contacted CMS about the mix-up, and received the following email from CMS Spokesman Aaron Albright:

After an assessment of the data resulting from a complaint, we discovered that a limited number of physician payment records submitted by at least one manufacturer incorrectly contained information about other physicians…To protect physician privacy and correct the issue, we have taken the system offline temporarily and will work with the industry to eliminate incorrect payment records.

Jonathan Wilkenfeld, Healthcare Compliance Consultant at Potomac River Partners, states that this example cited by CMS is “not the only instance of doctors receiving information about other doctors with the same name. One of our clients also received a dispute by a physician with the same name as the submitted transaction that was clearly labeled as a different recipient than the disputer (different state, NPI, etc).” He  notes that “CMS rescinded that dispute after a few days – but still very troubling.”

This shutdown comes three weeks before the August 27 cutoff for physicians to check the accuracy of the payment data ascribed to them by pharmaceutical and device companies. Right now, doctors are in a rock and a hard place—the system may have matched improper transfers of value to their name. But now that the system is down how will they know? There is no word on when the bug will be fixed. The CMS vendor CGI Federal has been busy this year fixing up other websites including the infamous healthcare.gov launch. Perhaps the words of caution that many orginazations had suggested during the recent comment period for dispute resolution should have been taken.

Update:  

According to “Mired in Med Ed,” CMS released the following email communication about the website’s outage:

The Open Payments rollout has not been smooth thus far. We will be interested to follow the next few weeks of the process to see whether CMS extends the dispute process, pushes back the data release, or keeps chugging along with the current timeline.