Medicare eyes reporting of industry-physician relations

April 3, 2008

The Medicare Payment Advisory Commission (MedPAC) has been examining the feasibility of requiring hospitals and medical product manufacturers to report financial relationships with physicians on a national basis.

The Medicare Payment Advisory Commission (MedPAC) has been examining the feasibility of requiring hospitals and medical product manufacturers to report financial relationships with physicians on a national basis.

With Medicare now spending more than $50 billion a year on prescription drugs, policy makers are scrutinizing more closely how industry-doctor relationships may boost drug prescribing, particularly of expensive drugs.

Separately, Congress has raised concerns about the growing number of physician-owned specialty hospitals and ambulatory surgical centers. This development is prompting the Centers for Medicare and Medicaid Services (CMS) to extend its disclosure rules on hospital financial relationships to this increasingly prominent field.

These developments have generated interest in establishing a national system for physicians, hospitals and medical product manufacturers to publicly report financial relationships. This would include physician ownership positions in hospitals, as well as fees and gifts paid to physicians by manufacturers.

Such disclosure would reveal whether such financial relationships actually influence the use of drugs and medical devices and whether individual physicians have conflicts of interest that could affect their roles on advisory boards or formulary committees or the credibility of research articles and reports. Health plans also might find this data useful in constructing provider networks.

While hospitals, manufacturers and physicians are leery of detailed disclosure requirements, they could find it easier to comply with one uniform set of reporting rules, rather than increasingly diverse state and local requirements. A growing number of academic medical centers and physician groups are banning gifts or payments from drug companies to physicians, and several states are requiring pharmaceutical companies to report such interactions. MedPAC analysts say the data collected under current state reporting programs is too general to be useful for patients or payers, and that a national program could be of greater value to researchers and healthcare organizations.