– The highest single transaction for physician meal in 2015 reported to CMS is: $15,000 (even).
– The highest single transaction for physician meal in 2014 reported to CMS is: $17,176.
How is this possible? How can a single physician eat a single meal worth $10k or more?
Is this data for real?
I asked a couple of my close friends who are knee-deep in analyzing transparency data before submission on what it could possibly be. One of them, “Sunshine” M, said she is 99.9% sure these are miscoded transactions. The second, “Sunshine” C. agreed – it is either misclassified or an aggregated total of meals across a period of time.
Both of them, however, expressed shock that nothing has been written about these outrageous meals, and the manufacturers themselves haven’t expressed concern or rectified data after submission.
So what is the lowdown on meals?
With almost 23 million transactions just for the “Food and Beverages” nature of payments category reported for covered recipient physicians, meals represent 87% of all submitted transactions.
Even though Food and Beverage Constitute the largest volume of transactions by count, they only represent 11% of the total $ amount spent as reported to CMS.
How expensive are these meals really?
I grouped the transactions into various amount buckets to get a sense. It turns out that 90% of all meal transactions are under $60 per transaction. Not exactly McDonalds or Dunkin Donuts, but that is still a reasonable meal for an HCP! And only 0.03% of transactions exceed the $500 mark. I mean, you know, you got to have a good bottle of wine every once in a while, right?
So what to make of the several $2k plus meals?
There are 480 food and beverage transactions that exceed $2,000 per transaction amount. For the record, this represents 0.002% of the total transactions. When I asked another compliance director on what he thought of the $15k meal transaction in 2015, his immediate response was “I hope it’s not us”!
So, without much forethought, I let out a cheesy sales line, “Of course it’s not you! You have been using our Aggregate spend reporting solution.”
But then I got to thinking. If sifting through these 23 million food and beverage transactions is so hard, why not make it our guarantee? How about I tell you something along the lines of, “If you are using an Aggregate spend reporting solution on your pre-submission data and you submit a single misclassified transaction, we will make it free for the year!”
There. I said it. It is a guarantee. It is qordata’s guarantee! Add that to the reasons why you should use our Aggregate spend reporting solution!
For the $15k meal transaction, I will update you once we speak to the compliance team at that manufacturer.
Other Relevant Reads:
