BY THE NUMBERSMoney paid to doctors by drug companies since 2009• Tennessee -- $20.8 million• Georgia -- $20 millionSource: ProPublicaWHO'S PAIDTop 10 doctors receiving payments in Chattanooga region:• Timothy Jennings -- $185,666• James Sizemore -- $87,608• Allen Solomon -- $70,832• Kevin Ferguson -- $49,768• Dianne Roland -- $43,648• Robert Younger -- $37,000• Mark Jennings -- $33,939• Daniel Smith -- $31,050• Stephen Dreskin -- $30,391• David Huffman -- $30,762Source: ProPublica
A new federal law requiring drug and medical device companies to disclose what they pay doctors for research, consulting, speaking, travel and entertainment has hit a few snags.
But despite missed deadlines and reporting delays, officials say they are still on track to begin releasing some information in the first quarter of 2013.
Known as the Physician Payment Sunshine Act, the law was part of broader health care reform implemented in 2009. The administration was required to establish payment-reporting procedures by Oct. 1 but didn't actually issue them until December.
The public will have until Feb. 17 to comment on the proposed guidelines before the Centers for Medicare and Medicaid Services comes out with the final rules.
It's important that the new law go into effect as soon as possible, said Allan Coukell, director of medical programs for the Pew Health Group, a division of the nonprofit Pew Charitable Trusts.
"This is a provision that has very broad stakeholder support -- it's the uncertainty that is a problem," Coukell said. "They need to move forward quickly to get back on track."
The federal requirement -- with an online, searchable database -- will offer the first comprehensive look at the money, gifts, drugs and medical products that change hands, with implications for everything from patient care to rising medical costs.
Pro and con
Payments and gifts long have been a controversial part of the relationship between doctors and pharmaceutical and medical device companies.
Consumer advocates say the exchange makes doctors less likely to make decisions based on patients' best interests, but some proponents say it allows doctors to be compensated for the time they put into research.
ProPublica, an investigative news group, has tracked some payments from drug companies for the last three years. Its figures show the companies paid doctors $761.3 million from 2009 through the first quarter of 2011.
Tennessee and Georgia rank 12th and 13th in the nation in payments reported so far, with doctors in each state receiving more than $20 million from 2009 to the first half of 2011.
Coukell called the numbers ProPublica has reported "the tip of the iceberg." Several of the large drug companies have reported their numbers, either voluntarily or because of court orders, but no medical device companies have done so, he said.
Who's covered
Under the new guidelines, officials hope to begin collecting data later this year and report it by the end of March 2013. Companies must begin collecting information until the final guidelines are released.
Even though the rules are behind schedule, partial reporting in 2012 would be "meaningfully important" and give everyone a chance to test the system, Coukell said.
Under the proposed guidelines, if a company has even one product covered by Medicare or Medicaid, it must report all payments. Companies will face a penalty of up to $10,000 for each unreported payment, and knowingly failing to report a payment can generate fines up to $100,000.
The 120-page guidelines provide extensive details of what to report and how the reporting takes place.
"We recognize that disclosure alone is not sufficient to differentiate beneficial, legitimate financial relationships from those that create conflicts of interest or are otherwise improper," the guidelines state. "However, transparency can shed light on the nature and extent of relationships, and may dissuade inappropriate conflicts of interest from developing."
The requirements will cost companies about $224 million the first year and $163 million annually after that, the report states.