The civil monetary penalties for violations of countless healthcare laws are on the rise. A few months back, we discussed the sharp increase in penalties under the Federal False Claims ACT (FCA). With the initiation of an interim final rule, the per-claim FCA penalty was nearly doubled by the Department of Justice. The reason behind this increase is that the Federal Civil Penalties Inflation Adjustment Act of 2015 deemed it necessary for Federal agencies to update civil monetary penalties {CMPs) within their jurisdiction by the 1st of August, 2015 in order to catch up with inflation.
In addition to the FCA, several other CMPs recently have increased or likely will increase in times to come because of the 2015 Adjustment Act. For the record, CMPs for violations of the Anti-Kickback Statute have also increased. Previously, the CMPs stood at about $50,000 and have now been raised to $73,588. What must be mentioned here is that these CMPs are in addition to potential criminal fines that stand at about $25,000 per violation.
Do You Really Know Your Spend Data?
The steep rise in CMPs for violations of the complex regulatory landscape in which the pharma
industry operates has led to the need for robust compliance programs. If anything, reporting entities need to get their data right.
What this means is that their data needs to be complete, accurate, and even supported by appropriate documentation.
What’s most important is that they understand what their data is saying about them and their practices pertaining to interactions with physicians and teaching hospitals – and this is where Open Payments Analytics comes in.
There are many different aspects of their data that pharma manufacturers should be aware of:
What is the breakdown of payments by payment type and dollar volume?
Who are the highest-paid physicians?
Are physicians receiving both promotional payments (such as speaker or consulting fees) and research payments?
Dedicated to helping pharma companies inspect their spend for accuracy and completeness, Open Payments Analytics assists in understanding what is in the data, including how budgets are being spent from a promotional, research, and investment standpoint. All of these elements are critical to ensuring that appropriate resources are being allocated by the company to address risks and conflicts.
Don’t Let Your Data Surprise You!
Pharma companies often get surprised by what’s in their data. However, this is often not evident without significant digging with the help of an analytics tool like Open Payments Analytics. Some actually get surprised when their reported payments are brought to light publicly by a third party. How might this data be used by individuals to initiate lawsuits against your company? How will this data be used by law enforcement agencies together with investigative inquiries or enforcement actions? Know your data better than anyone else – don’t let it surprise you later on!
The best thing for you to do, as a pharma company, is to start off by performing a high-level analysis of your data so as to gain a better understanding of your baseline payment patterns and identify potential outliers.
This can easily be done with a data analytics solution like Open Payments Analytics. With Open Payments Analytics, not only will you be able to identify payment trends but also spot outliers on your pre-submission data that might later require additional follow-up. With this information at hand, you will have the potential to further investigate your data anomalies and be prepared to respond to external inquiries regarding your company’s spend information.
