A bill proposed yesterday would require drug and device makers to report payments to nurse practitioners and physician assistants. The legislation  is designed to close what critics call a loophole in the federal government’s Open Payments database, which was created under the 2010 Affordable Care Act in response to concerns that industry payments to doctors unduly influence medical practice and research.
The Centers for Medicare and Medicaid Services debuted the database last year in order to identify payments or gifts from industry to doctors. And so, it lists companies making payments; names of doctor and the amount of money paid; the reason for the payment (such as speaking fee, research, meals, entertainment); as well as the drug or device product linked to the payment.
Notably, the database does not include such information about another important category of health care providers – nurse practitioners and physician assistants. Although nurses do not often conduct research into new treatments, they are responsible for a sizable portion of medicines that Americans take each year.
“We think that the void should be filled in order to have a complete record,” US Senator Chuck Grassley (R-Iowa), who co-sponsored the bill US Senator Richard Blumenthal (D-Conn.) told ProPublica , which first reported the bill. Grassley’s investigation into industry payments to physicians several years ago led to the creation of the database. “Transparency isn’t an end to itself,” he continued. “Transparency is meant to bring accountability.”
For instance, nurse practitioners and physician assistants wrote about 10 percent of almost 1.4 billion prescriptions in the Medicare Part D program in 2013, according to a ProPublica analysis . And during the first five months of this year, nurse practitioners and physician assistants wrote 15 percent of all prescriptions nationwide, not just in the Medicare program, according to IMS Health, a research firm.
“These providers are recipients of substantial marketing efforts by the manufacturers,” said Allan Coukell, senior director for health programs at The Pew Charitable Trusts. “This law will help put them on an even playing field.”
Whether the bill  will become law and expand the database is uncertain. But the Senate is expected to pursue its own version of the 21st Century Cures Act , which addresses an array of health care issues. The House passed the bill, but it doesn’t include language that would expand the database to include other health care providers, such as nurse practitioners or physician assistants.