Becker's ASC Review

94 HEALTHCARE NEWS CMS' Open Payments updates to boost transparency, data analysis: What surgeons need to know By Alan Condon C MS' Open Payments program requires drug and devicemakers to report payments or transfers of value to physicians, teaching hospitals and other providers to increase the transparency of these relationships. e agency refers to drug and devicemakers and group-purchasing organizations as "re- porting entities" while providers are referred to as "covered recipients." Orthopedic devicemakers are among the big- gest spenders in the medtech industry when it comes to payments made to physicians. Under CMS' 2022 Physician Fee Schedule proposal, issued July 13, the agency pro- posed changes to support the usability and integrity of this data for the public, research- ers and CMS. Six notes and updates for surgeons to know: 1. Open Payments reports three types of records: • General payments (includes categories such as food and travel) • Research • Ownership interest 2. Reporting entities flag thousands of general payments for publication delay each year to keep a record from being publicly available because it contains sensitive research and devel- opment information. Only payments associated with research should be delayed for publication. To address this, the agency is "proposing lan- guage that will clarify the impermissibility of delaying general payments, and that research- related payments do not need to have been specifically outlined in the original research agreement to be reported as research pay- ments," according to a July 13 news release. 3. Open Payments requires reporting entities to disclose payment to teaching hospitals, but stakeholders argue that teaching hospital records oen don't have enough information to verify that the record was properly reported. is can lead to disputes, with covered entities request- ing more information from the reporting entity, which creates more work for both parties. CMS plans to add a required field to teach- ing hospital records to combat this. e field would only be available to the teaching hospital disputing the information. 4. Physician-owned distributorships are a subset of group-purchasing organizations but are not specifically defined in Open Payments. CMS proposes to include a definition for these entities and require them to "self-report and identify" to combat potential conflicts of inter- ests between providers and reporting entities. 5. CMS also plans to address an overlap between general and ownership payments. Currently, there is a nature-of-payment category for ownership that is separate from ownership and investment interest, which is another separate record. An entity can submit one or both types of record for ownership. e proposal aims to eradicate confusion around these two types of records and facilitate data analysis by having one type of ownership record. 6. Reporting entities undergo an annual recertification when they submit records, so companies can update their system informa- tion, but this is unavailable for companies that do not have any records to report. To address this, CMS plans to give compa- nies the option to recertify and declare that they do not have any records to submit for a reporting year. CMS said this will simplify communication about compliance between the agency and reporting entities. n HCA New Hampshire hospital loses 12 primary care physicians as new CEO takes helm By Kelly Gooch T welve of 14 primary care physicians on staff had left or were in the process of leaving practices affiliated with Frisbie Memorial Hospital as of July 15, accord- ing to Foster's Daily Democrat. The exodus came after Nashville, Tenn.-based HCA Health- care completed its acquisition of the Rochester, N.H., hospi- tal in March 2020. It also came as Matt Larkin took the helm of Frisbie Memorial as interim CEO. He was replaced when the hospital named Tim Jones permanent CEO on Sept. 1. "Yes, this has happened, and we are working to assure we can support the hospital with local coverage while we are actively recruiting new staff," Mr. Larkin told the Daily Democrat. "It is not a [reduction in force]. Sometimes when an organization changes administration, we can see attrition. Those physicians who left are fantastic, and we hope as we reorganize some may come back." Mr. Larkin, who previously was COO of HCA's Portsmouth (N.H.) Regional Hospital, served as interim CEO of Frisbie Memorial after Jeff Scionti retired. He said as the hospital is rebuilds practices, its aim is that some of the physicians leaving will want to return, according to the July 15 Daily Democrat report. He also told the newspaper that the hospital is recruit- ing physicians in various areas, including hematology and oncology, and obstetrics and gynecology. He added that "HCA made no direct changes to account for the attrition" and that the physician exodus is "a perfect storm of events that just happened. We have a really posi- tive feel for our emergency and other services, and we want people to know we are here to handle any situation." As part of HCA's purchase, the for-profit hospital operator agreed to make multiple investments in Frisbie Memorial, Current investments include in rooms, boiler systems and the pharmacy, Mr. Larkin said. n

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