Sunshine act payments verification process may be even more cumbersome than you think

The American Medical Association (AMA) is doing a full court press to get every member to verify his or her industry payments well before the August 27 deadline to dispute reported data because the process is turning out to be longer and more glitch prone than many anticipated.

Under the Physician Payments Sunshine Act that was voted into law as part of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) was charged with implementing a system for collecting data on pharmaceutical and medical device manufacturers’ payments to physicians and then making that data publicly available in order to uncover whether certain physicians were influenced in their practice of medicine by gifts from companies whose products’ success relies in large part on physician prescribing practices and device choices.

The AMA fought hard for the creation of a process that would allow physicians to check the data manufacturers reported about them and get mistakes corrected before that data became available to the public. However, the three-step online process for doing so that CMS rolled out in July is turning out to be quite tricky.

Among major issues noted by the AMA in its guidance to physicians are:

1. When using the Open Payments enterprise system portal, physicians may need to allow as long as 24 hours between step one (identity verification) and steps two and three (registration and information review) for identity information to process. Don’t assume you can take care of this all in one day.
2. Steps two and three of the Sunshine Act registration review process should only be done using Internet Explorer 8 or higher, CMS cautioned — quite a challenge for Mac users as Internet Explorer is no longer supported for Macs. (The AMA noted that a few physicians have reported being able to complete the process on a Mac using the Safari browser.) How many physicians attempting to use the system will be stopped by using the wrong browser?  Just looking at website traffic data for the largest site for healthcare media company TriMedia — publisher of HealthCXO — 52.57% of readers use Internet Explorer and the other half use other browsers with the most popular being Chrome, Safari and Firefox. If this data holds true for physicians trying to check the industry data reported about them through the CMS Open Payments Enterprise Portal, around half may be stopped at step two for having the wrong browser.
3. Step two takes about 30 minutes to complete and must be completed in one session. There is no auto-save for the data and if a physician pauses for longer than 15 minutes, the system times out and he or she has to start over from the beginning.
4. Step two requires logging out and then logging back in, but don’t do this too quickly. The AMA recommends waiting two minutes before trying to log back in.
5. Step two will ask for a physician’s specialty identification code, but this really the physicians’s provider taxonomy code. Physicians who don’t know their provider taxonomy code by heart can look it up in a 21-page single-spaced small type PDF document. Read fast because if you take too long to enter the code, the system will log you out and you have to start over.
6. Try not to use browser navigation buttons — the back and forward buttons in Internet Explorer — as this can erase entered data, CMS cautioned.
7. Step three of the process where information can be reviewed and disputed will give physicians without data reported about them an error message saying no records can be found instead of a straight-forward confirmation that there is no data. In some cases, physicians without data reported about them simply did not show up in the list of physicians in the system, the AMA noted.

“The process is complex and cumbersome, but it’s crucial to make sure your data is correct,” AMA president Robert M. Wah, M.D., urged members in a statement.

Wrong information that is not caught and corrected now will be up publicly for a whole year because CMS will only refresh the data on an annual basis. In addition, the AMA cautioned physicians that payments made through third parties are reported so that even if they think nothing was reported about them, they should still go through the effort of checking.

The AMA has set up a Twitter hashtag #SunshineTips to share information on the types of issues with the system encountered by physicians and how to avoid them.

CMS also has an Open Payments Help Desk email openpayments@cms.hhs.gov and phone number (855) 326-8366.