Medicare Advisers Weigh Open Payments Improvements

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By Michael D. Williamson

Sept. 11 — A Medicare advisory panel Sept. 11 discussed ways to improve the federal program designed to make drug and device company payments to physicians more transparent to the public, with one panelist suggesting disclosures to patients at the time a drug is prescribed.

Rita Redberg, a Medicare Payment Advisory Commission (MedPAC) member and a physician at the University of California, San Francisco, recommended the change during a session on the Centers for Medicare & Medicaid Services' Open Payments transparency initiative. Specifically, the Open Payments program could be improved if doctors disclosed to patients if they have a financial relationship with the maker of a drug or device they are prescribing, Redberg said.

The Open Payments program, created by a provision in the Affordable Care Act, requires manufacturers of drugs, devices and other medical supplies and group purchasing organizations to report certain payments made to physicians or teaching hospitals that are over $10.21.

MedPAC staff presented an analysis of Open Payments program data for 2013 and 2014 that showed the distribution of general payments to doctors from drug or device makers is highly concentrated. For example, the top five percent of physicians that received payments accounted for 86 percent of the total payments, staff said.

After hearing the staff presentation, Francis J. Crosson, the new MedPAC chairman, directed commissioners to recommend improvements the Open Payments program and additional analysis from MedPAC staff on the issue.

Patient Awareness

Redberg also stressed the importance of increasing patient awareness about financial relationships doctors and hospitals sometimes have with drug and device manufacturers. These relationships “don’t lead to the best medical decisions,” Redberg said.

Other commissioners supported Redberg's point about increasing patient awareness. In a related statement, commissioner Willis (Bill) Gradison, a former Republican member of Congress who now lives in McLean, Va., said the commission hasn't discussed what should be done to influence patient behavior about drug and device companies' payments to providers.

Likewise, commissioner Mary Naylor, a University of Pennsylvania gerontology professor, said the Open Payments database the CMS established is a very important tool, but, by in large, beneficiaries are still unaware of the payments drug and device manufacturers make to providers.

Exploring Drug Costs 

MedPAC held several discussions about drug pricing issues during its September round of meetings. Increasing drug costs are concerning and will be a priority area for Congress's Medicare advisers, Crosson declared Sept. 10. In addition, on Sept. 11, MedPAC devoted an entire session to Medicare drug spending trends.

Staff also presented Sept. 11 an analysis of emergency department services at stand-alone facilities.

To contact the reporter on this story: Michael D. Williamson in Washington at

To contact the editor responsible for this story: Kendra Casey Plank at

A summary of the Open Payments sessions is at

The Open Payments presentation is at

The presentation on emergency department services at stand-alone facilities is at


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