Bill seeks to add nurse practitioners, PAs to Sunshine Act reporting

Two U.S. senators introduced a bill last week meant to close a loophole in the Sunshine Act--and add a rapidly growing group of healthcare providers to the database of payments from pharma and device makers.

Sen. Charles Grassley

The bipartisan pair, Sen. Charles Grassley (R-IA) and Sen. Richard Blumenthal (D-CT), want to add "physician assistants, nurse practitioners, and other advance practice nurses" to the Open Payments database, which tracks pharma's gifts and other payments to doctors.

"We think that the void should be filled in order to have a complete record," Grassley said in an interview with NPR. "Transparency isn't an end to itself. Transparency is meant to bring accountability."

The bill would require reporting on money given by pharma directly or indirectly to nurse practitioners, in the form of meals, trips and speaking fees, beginning in 2017.

Sen. Richard Blumenthal

PAs and nurses wrote about 10% of the nearly 1.4 billion prescriptions in Medicare's prescription drug program in 2013, NPR has reported. That same year, an IMS Health study found that the two groups wrote 15% of all scripts nationwide during the first 5 months, NPR wrote. Finding it increasingly difficult to reach doctors themselves, some drugmakers have broadened their push into doctors' practices by specifically appealing to PAs and nurse practitioners.

Congress comes to the issue after several high profile criminal cases in which nurse practitioners pled or were found guilty of taking kickbacks. One Connecticut nurse pleaded guilty earlier this year to taking $83,000 worth of kickbacks from Insys, which markets a spray form of the high-powered painkiller Subsys. The nurse was one of the company's paid speakers; as part of her plea agreements, she admitted that speaking fees affected her prescribing decisions.

"It's an important step," Allan Coukell, senior director for health programs at the Pew Charitable Trusts said of the new bill (as quoted by NPR). "Nurse practitioners and physician assistants write a lot of prescriptions, and this creates a level playing field with the same kind of transparency as the original Sunshine Act created for physician payments."

- read the NPR story

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