As we have covered numerous times on this website, in 2009, the State of Massachusetts enacted the Massachusetts Pharmaceutical and Medical Device Manufacturer Code of Conduct (PCOC).
After going into effect on July 1, 2009, the PCOC requires the reporting of payments of more than $50 made to any health care practitioner by industry. Payments for 2009 were then published on the states website in late November, 2010. The legislation is very similar to the Physician Payment Sunshine Act.
For a better understanding of Massachusetts’s law and basic definitions of terms, click here.
More recently, the Massachusetts Department of Public Health approved final amendments to the PCOC in November of last year. The amendments, among other things, allow companies to provide “modest meals” for healthcare providers for product education (non-CME) outside of the office or hospital setting. You can find the current version of the law here.
Consequently, the Massachusetts Department of Public Health recently posted its transparency data—manufacturer payment data to physicians and hospitals—for 2011. You can download the full 2011 data here. Between 2010 and 2011 payments decreased approximately 3%, from about $64.4 million to $62.4 million. The number of transactions between manufacturers and physicians, hospitals, and entities also decreased almost 10% (from 42,497 to just over 38,500). There were also a number of other significant changes:
- Payments for charitable donations decreased 62% (over $1.8 million less)
- Compensation for bona fide services decreased 7% (over $2.4 million less)
- Payments for education and training remained unchanged
- Payments for food decreased 6%
- Payments for marketing studies decreased 42% ; and
Payments for CME, third-party conferences or meetings increased 16% (over $1.2 million less) . This category includes payments to covered recipients for accredited CME activities and for sponsoring a covered recipient’s scientific or professional conference/meeting, where the sponsorship is promotional (e.g., booths/exhibits).
Payments for grants/educational gifts also increased, 2%. This category includes fellowships, scholarships grants for local events, and provision of anatomical models or other such practice-related items. In addition “other” types of payments increased 60%, a little over $1.4 million.
Payments to specific individuals and entities broke down as follows:
- 46% of payments were to physicians (over $28.8 million) (28,844 payments)
- 20% were for acute hospitals (over $12.6 million) (889 payments)
- 11% to clinical laboratories (over $6.7 million) (949 payments)
- 9% for stem cell research (over $5.7 million) (153 payments)
- 6% to clinics (over $3.6 million) (134 payments)
- 2% to dentists ($1.5 million) (494 payments)
- 2% to registered nurses (under $1 million) (3,322 payments)
- 2% to pharmacists (under $1 million (1,263 payments)
- 1% clinical nurse specialist (~$312K) (302 payments)
- Less than .05% to nurse practitioners (~$261K) (749 payments)
- ~.3% to physician assistants (~$202K) (639 payments)
- ~.15% to podiatrists (~$96K) (165 payments)
- ~.05% to optometrists (~$34K) (18 payments)
The payment reports are in a similar format as those posted in previous years (see our story from 2010 payments). Thus, the posted data includes:
- Top 20 Manufacturers Summary (2011), which includes 509 pages of payments.
- Top 50 Physicians Summary, including 17 pages of payments
- Top 50 Hospitals, Summary, including 29 pages of payments
- Top 100 Covered Recipients, Non Hospital, Detail, including 46 pages of payments
In general, you can search for payments by category type:
- Compensation for Bona Fide Services
- CMEs, Third-party Conferences, or Meetings
- Grants/Educational Gifts
- Food
- Education/Training
- Marketing Studies
- Charitable Donation
- Other
Given the immense expense that went into collecting this data, it is hard to imagine that less than $62 million was spent on compliance, which means that it was more expensive to collect the data than the actual dollars spent.
States considering expanding transparency to NP’s and PA’s, should consider that in Massachusetts they amounted to less than 1.5% of all payments. With state resources strapped for cash there are significantly better ways to control spending than to force companies to spend more on needless additional transparency.