With kickback and other allegations pending against physicians and executives associated with Insys Therapeutics Inc., compliance officers may want to use the CMS open payments program to determine if any of their physicians accepted payments from the pharmaceutical company and, if so, whether they were disclosed on conflicts-of-interest forms. It’s a more targeted application of the open payments program, which some hospitals use to validate the information that physicians disclose on conflicts-of-interest forms in the quest to manage and mitigate potential conflicts and identify hints of Stark Law and Anti-Kickback Statute violations.

The open payments program is helpful both for routine monitoring of conflicts-of-interest forms and spot-checking potentially high-risk payments from companies under investigation, says Shannon Sumner, a principal of PYA in Brentwood, Tennessee. ”There are so many layers of this to pull back and analyze,” she notes.

For example, in the Insys case, the U.S. Attorney’s Office for the Southern District of New York charged five physicians in March with allegedly accepting kickbacks and bribes for prescribing a Fentanyl-based spray in the form of “sham” education programs. The New York City area physicians prescribed millions of dollars’ worth of the Fentanyl spray, which is a treatment for intractable cancer pain. They were compensated for participating in a speakers’ bureau about the Fentanyl spray, but “they were predominantly social affairs where no educational presentation about the Fentanyl Spray occurred,” the U.S. attorney’s office alleges.