Sunshine Thursday Morning

Open Payments, also known as the "Sunshine Act," relationship-data-collecting-period starts August 1, 2013, bright and early. Some of our customers are using CarePrecise data as the basis for the physician database underlying their Open Payments tracking process.

Starting August 1, manufacturers and suppliers have to start tracking payments and other transfers of value made to physicians and teaching hospitals, an certain ownership or investment interests held by physicians or their family members. Names, dates, values and other data must be captured, and will be required to be submitted to Centers for Medicare and Medicaid Services in early 2014. Submission files specifications are available for review.

Two New Beta Provider Data Releases

This summer has seen one spectacular new release of healthcare provider data from CarePrecise already, and a second is on the way. The first one, released just a week ago, is already finding its way into EMR pre-population, new web apps, OpenPayments and HIE applications.

The Extended Professional, Group & Hospital(TM) dataset extends CarePrecise's flagship master database, CarePrecise Access Complete (CPAC), with verified group practice data for physicians and other providers, their hospital affiliations, medical schools and graduation years. The EPGH's Extended Hospital table provides an unduplicated list of all U.S. acute care, VA, children's and critical access hospitals that bill Medicare (essentially all of these hospital types bill Medicare, so this list is nearly complete; link it to hospital data in the CPAC, and you've got everything -- a more complete, up-to-date and verified database of physicians than the American Medical Association's list at a small fraction of the cost... plus more than 3 million other healthcare providers not included in the AMA data.

The EPGH has only been released in beta so far, and in beta it is being distributed to all current CPAC subscribers free of charge through September 2013. The EPGH/CPAC bundle is the only commercially available merged database of NPPES, LEIE, PECOS, PhysicianCompare and HospitalCompare data, and it contains all of the "hooks" necessary to link to CMS hospital quality data and forthcoming physician quality data.

Coming next is the beta release of CP ProCase(TM), a proper-case version of the name, mailing address and practice address in CPAC, for all approximately 4 million records. Using CPAC data for marketing and other communications will be easier and more professional looking. As with the EPGH dataset, the ProCase add-on will be available bundled with CPAC, and not separately.

Planned beta release of CP ProCase will coincide with the August 2013 CPAC update release. As with EPGH, ProCase will be distributed as a free beta for evaluation to all current CPAC subscribers. (Betas are not available on single download purchasers.)

And, as if that weren't enough, our popular software, CP ListMaker, is undergoing a rebuild to add EPGH functionality. (Proper casing is already a feature of CP ListMaker.) The new version -- 4.01 -- will sport new output queries that include the new extended data linked to list outputs, completely configurable to use the new information. Release date for CP ListMaker v4.01 is scheduled to coincide with the August CPAC data release.

Questions about the new products? Call your CarePrecise sales representative at (877) 782-2294.

Doctors: Will Patients Misread Sunshine Info?

The Centers for Medicare and Medicaid Services (CMS) is reassuring physicians about Physician Payment Sunshine Act reporting, saying that reporting efforts involving connections between physicians and vendors will fall largely on the shoulders of the vendors, rather than on physicians. But that's not the only issue that worries docs. Once the Sunshine data becomes public, they are concerned that it may be incorrectly interpreted by consumers and the media, leading to unwarranted witch hunts. At the AMA's House of Delegates meeting in Chicago, pediatrician Lynda Young said "The media can really sensationalize this," worrying that when information goes public, "the media jumps on it."

The Sunshine Act (Section 6002 of the Patient Protection and Affordable Care Act) is being rebranded by CMS as the "Open Payment Program," according to a June 20 article in Modern Healthcare. Quoting Dr. Shantanu Agrawal, director of the CMS data-sharing and partnership group, the agency wants to create a national transparency program for payments to physicians and teaching hospitals by drug and medical-device manufacturers and group purchasing organizations. According to Agrawal, pharmaceutical companies spent $15.7 billion in 2011 on face-to-face sales and promotional activities. But companies like Pfizer and GlaxoSmithKline have reported reductions in spending to attract doctors.

The law kicks in August 1, requiring drug and device companies to start tracking transfers of anything valued at more than $10. Physicians will be able to see what has been reported about them in the second quarter of 2014, and reports will become public on Septenver 30 of that year.

CarePrecise.com supplies accurate physician databases used by drug and device manufacturers in their Sunshine Act tracking programs.