Billing Compliance
Industry Gifts to Providers to be Made Public
As of July, pharmaceutical and medical device manufacturing companies are subject to a new set of sales and marketing regulations in Massachusetts, entitled the Pharmaceutical and Medical Device Manufacturer Code of Conduct. This code is designed to limit the interactions companies may have with health care providers. The code also increases transparency in health care-industry relationships by requiring the companies to report payments for sales and marketing activities to the Department of Public Health (DPH), which will then post the name of the recipient, as well as the value, nature and purpose of the payment, on a searchable public Web site.
Members of the Partners community who will be affected by the code are physicians, APNs, CNMs, psychiatric nurse specialists, physician assistants and podiatrists, partnerships or corporations of individuals in these roles, such as an office practice, and employees of office practices, all of whom are considered health care practitioners under the new law. Payments given to hospitals, nursing homes and pharmacists will also be reported to DPH.
Companies will report each payment, fee, compensation, subsidy or other economic benefit that is valued at $50 or more. The companies will identify the name of the recipient, the amount paid and the nature and purpose of the payment. Some examples of reportable payments include reimbursement for expenses in connection with product training, speaking on behalf of a company if the company pays you directly and compensation for bona fide services, such as consulting arrangements. Donations given to covered recipients also will be reported.
Companies will not have to report to DPH money given for genuine research projects, prescription drug samples or demonstration units that are exclusively for patient use, or items used for the provision of charity care.
Companies have to start tracking these payments as of July 1, 2009. The first report of these payments is due to DPH by July 1, 2010, and each July 1 thereafter. DPH is still evaluating how this information will be made available to the public.
The new code has several other provisions relating to company marketing activities and sponsorship of continuing medical education programs. However, Partners policies related to these areas are currently under review and may change in the coming months.
The code, frequently asked questions and other reference materials are available on the Massachusetts Department of Health and Human Services Web site at mass.gov/eohhs under “For Provider” and “Certification, Licensure, and Registration.”
If you have additional questions about these regulations, please contact Jim Bryant, chief compliance officer, at 617-525-8534 or jbryant3@partners.org