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Thomas Sullivan - Policy & Medicine Writing Staff
Columbia, Maryland
Former political consultant who founded Rockpointe, Inc. a bio-medical education company in 1995.
Interests: marketing, politics, baseball, cycling, medicine, university of florida sports, medical education, track and cross country, driving kids to various practices
Recent Activity
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As we previously covered, in July CMS released its annual proposed updates to the Physician Fee Schedule. There are a number of potentially important areas of this proposal to our readers, including a section on Open Payments. The proposed rule... Continue reading
Posted 7 hours ago at Policy and Medicine
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In early July 2016, a three-judge panel of the Federal Circuit Court of Appeals issued a unanimous decision in Amgen v. Apotex interpreting a provision of the Biologics Price Competition and Innovation Act (BPCIA) that requires biosimilar applicants to give... Continue reading
Posted yesterday at Policy and Medicine
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As part of a series on the Average Manufacturer Price (AMP), this month’s article explores the of AMP from the beginning of the Medicaid Drug Rebate Program (MDRP) to where it is today and why there is so much public... Continue reading
Posted yesterday at Policy and Medicine
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The Centers for Medicare & Medicaid Services recently announced a new way to pay for the care of patients who have had a heart attack or need coronary artery bypass graft surgery. CMS is seeking comment on the five-year demonstration,... Continue reading
Posted 2 days ago at Policy and Medicine
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The United States Department of Health and Human Services (HHS) issued a proposed rule intended to address the significant backlog resulting from an “unprecedented and sustained increase” in Medicare appeals. According to HHS, the Office of Medicare Hearings and Appeals... Continue reading
Posted 3 days ago at Policy and Medicine
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On June 30, 2016, transparency efforts around the world released numbers on financial interactions between industry and physicians. This article goes through recent releases in Germany and the United Kingdom, including analysis on where the money is coming from, and... Continue reading
Posted 3 days ago at Policy and Medicine
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NJ Spotlight, a website that highlights “news issues and insight for New Jersey” recently created an interactive map of New Jersey doctors who received transfers of value from industry in 2015. The map, which can be found here, allows interested... Continue reading
Posted 6 days ago at Policy and Medicine
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While the goals of Open Payments and transparency are arguably good public policy, the usefulness of Open Payments depends entirely on the quality of the underlying data. This paper explores some of challenges found in the 2015 data set that... Continue reading
Posted 6 days ago at Policy and Medicine
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The Department of Labor (DOL) Office of Workers’ Compensation Program (OWCP) administers the Federal Employees’ Compensation Act for the Postal Service and the federal government, including costs for medical treatment and prescriptions. The Postal Service then reimburses the DOL for... Continue reading
Posted 7 days ago at Policy and Medicine
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We have known for awhile that the European Federation of Pharmaceutical Industries and Associations (EFPIA) tracks and assesses industry events for compliance with the EFPIA code. We have also known about Eucomed’s Ethical MedTech, which has a similar system in... Continue reading
Posted Aug 17, 2016 at Policy and Medicine
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On June 30th, 2016 CMS published the third year of Open Payments data. With more than two full years of transaction level spend data publicly available, an opportunity exists for Life Sciences companies to utilize Open Payments data as an... Continue reading
Posted Aug 17, 2016 at Policy and Medicine
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The Stark Law has become increasingly convoluted over the years due to complicated regulations, restrictions on historically acceptable professional practices, and the inability in many instances for physicians, healthcare facilities, and other healthcare providers to know whether they are actually... Continue reading
Posted Aug 16, 2016 at Policy and Medicine
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The Biotechnology Innovation Organization (BIO) held an International Convention in San Francisco June 6 – 9, 2016. This year, the organization held two fireside chats, one of which was with Dr. Robert Califf, the Commissioner of the Food and Drug... Continue reading
Posted Aug 15, 2016 at Policy and Medicine
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As we have repeatedly reported, the proposed MACRA regulation offers what appears to be one of the most significant changes in federal health care policy in years. CMS is expected to announce its final MACRA rule on November 1, 2016,... Continue reading
Posted Aug 12, 2016 at Policy and Medicine
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We frequently write about the transparency requirements found in the United States Physician Payments Sunshine Act and the resulting statistics; however, the United States is not the only country with recently-enacted transparency laws. Germany recently released their first transparency numbers,... Continue reading
Posted Aug 11, 2016 at Policy and Medicine
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Recently, we were treated to a series of articles by ProPublica promoting the nefarious physician and hospital ties with industry. The organization behind the Dollars for Docs website, wrote an article for the Boston Globe about how the data behind... Continue reading
Posted Aug 10, 2016 at Policy and Medicine
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(Picture from ProPublica Dollars for Doctors) The release in late June of the Open Payments data for 2015, received very little media coverage but earlier that week Dollars for Doctors dropped a media bomb on the open payments data from... Continue reading
Posted Aug 10, 2016 at Policy and Medicine
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In July 2016, California Insurance Commissioner Dave Jones reached a $30 million settlement with pharmaceutical company Bristol-Myers Squibb over allegations of drug marketing fraud and physician kickbacks. As we have seen often as of late, the allegations stemmed from whistleblowers... Continue reading
Posted Aug 9, 2016 at Policy and Medicine
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The American Academy of Family Physicians recently approved measures that will simplify CME requirements for Academy members. Previously, AAFP physicians could claim a maximum number of credits for self-directed individual activities (i.e., published research, clinical research, paper presentations, exhibit presentations,... Continue reading
Posted Aug 8, 2016 at Policy and Medicine
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Last month, the cover of BusinessWeek featured an article, How Big Pharma Uses Charity Programs to Cover for Drug Price Hikes, focused on co-pay charities for Medicare patients. I of course had heard about such co-pay charities before, and even... Continue reading
Posted Aug 5, 2016 at Policy and Medicine
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On Tuesday, August 2, 2016, The Centers for Medicare & Medicaid Services (CMS) hosted a Special Open Door Forum. The Special Open Door Forum was hosted for the CMS to obtain input from Open Payments stakeholders to inform future rulemaking... Continue reading
Posted Aug 4, 2016 at Policy and Medicine
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CMS wants to pay practices a monthly fee to manage care for as many as 25 million patients in the agency's largest-ever plan to transform and improve how primary care is delivered and reimbursed. The Comprehensive Primary Care Plus (CPC+)... Continue reading
Posted Aug 3, 2016 at Policy and Medicine
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The Department of Justice (DOJ) recently announced that it is charging hundreds of individuals across the country with committing Medicare fraud worth hundreds of millions of dollars. The takedown – being called the "largest takedown in history" both in terms... Continue reading
Posted Aug 2, 2016 at Policy and Medicine
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Since the US Government uses AMP to set Medicaid rebates, as well as the Medicaid Federal Upper Limit (FUL), it is vital the pharmaceutical manufacturers, and their compliance teams understand the concept to prevent possible missteps. This article is Part... Continue reading
Posted Aug 2, 2016 at Policy and Medicine
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On Wednesday, July 27, 2016, the Pharmaceutical Research and Manufacturers of America (PhRMA) and the Biotechnology Innovation Organization (BIO) released guidelines for drug makers’ communications with other health care professionals about their products. The guidelines encompassed nine principles aimed at... Continue reading
Posted Aug 1, 2016 at Policy and Medicine