Letter Supporting Transparent Physician Payments

December 23, 2009

Support for a strong Physician Payments Sunshine provision in final health care reform legislation

[Individualized for Mr. Reid, Mr. Baucus, Mrs. Pelosi, and Mr. Waxman]

The undersigned organizations commend members in both House and Senate for including Physician Payment Sunshine provisions in health care reform legislation.

The Sunshine provision reflects the recommendation by major medical, consumer and industry groups, as well as MedPAC and the Institute of Medicine (IOM), that Congress pass legislation to bring transparency to the financial relationships between pharmaceutical or medical device companies and health professionals and organizations.

We urge that the final health reform bill produced by the Conference Committee include the following key elements, which are found in the Senate or House bills, or both:

Broad inclusion of covered recipients. We strongly support the recommendations of both MedPAC and the IOM that manufacturers should publicly report financial relationships with physicians and also with other health-care providers and institutions, as in the House provision, including payments to nurse practitioners and professional medical organizations; pharmacies and pharmacists; medical schools; continuing medical education (CME) providers; biomedical researchers; advocacy and disease groups; and professional medical organizations.

Capture of payments made through third parties. In many instances, industry funds may travel through third parties, such as marketing agencies, before reaching doctors or other covered recipients. The final Sunshine provision should capture these payments to the greatest extent possible, which would also protect against potential future shifts of funds to third parties that would undermine the intent of the bill.

Relation to state laws. Both House and Senate currently include commendable language on preemption that will remove a potential compliance burden for companies while still preserving the right of states to collect information that is not collected under the federal bill.

Samples reporting. Industry reporting of pharmaceutical samples disbursement should be included in the Sunshine provision to ensure comprehensive data collection and to facilitate analysis. Both House and Senate require samples reporting to HHS, although through different mechanisms. Neither bill requires public disclosure of which physicians accept samples.

Maintain comprehensive reporting threshold. Both House and Senate provisions include reporting thresholds that will help ensure comprehensive reporting by industry of all transfers of value, including small gifts and payments that studies show can influence prescribing. In no case should final legislation include a higher threshold than those established in current House and Senate provisions ($5 and $10, respectively).

We thank you for your attention to this important transparency initiative, which has support from diverse stakeholders. We believe that its passage will protect patients and help restore trust in our health care system.


Allan Coukell
Director Pew Prescription Project
The Pew Charitable Trusts

Marcia Hams
Director Prescription Access and Quality
Community Catalyst

AFSCME - District Council 37 (NY)
American Federation of State, County and Municipal Employees (AFSCME)
American Medical Student Association
Center for Medical Consumers
Central New York Citizens in Action, Inc
Citizen Action of Wisconsin
Coalition of Wisconsin Aging Groups
Committee of Interns and Residents / SEIU
Commonwealth Care Alliance (MA)
Connecticut Center for Patient Safety
Consumers Union
DES Action
The Everett Clinic
Families USA
Florida CHAIN (Community Health Action Information Network)
Government Accountability Project
Health Action New Mexico
Health Care for All (MA)
Health Partners Medical Group (MN)
HealthPartners Health Plan (MN)
Hennepin Faculty Associates
Labor / Management Health Care Coalition of the Upper Midwest (MN)
Long Island Health Access Monitoring Project
Maryland Citizens' Health Initiative
Medical Accountability Network
Minnesota Nurses Association
Mississippi Human Services Coalition
National Committee to Preserve Social Security and Medicare
National Health Law Program
National Partnership for Women & Families
National Physicians Alliance
National Research Center for Women & Families
National Senior Citizen’s Law Center
New Jersey Citizen Action
National Legislative Association on Prescription Drug Prices (NLARx)
No Free Lunch
Oregon Health Action Campaign
Patients not Patents
Pharmacist Planning Services
Progressive Research and Action Center (NY)
Service Employees International Union (SEIU)
South Carolina Appleseed Legal Justice Center
Teamsters 25 HS&IP (MA)
Tennessee Health Care Campaign
The Everett Clinic (WA)
Union of Concerned Scientists
United Senior Action of Indiana
Universal Health Care Action Network of Ohio
Wisconsin Alliance for Retired Americans 

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