Reporting Of Pharma Payments To APRNs To Start In 2017

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A state initiative that would have required drug companies and device manufacturers to start reporting their payments to advance practice registered nurses (APRNs) this year has been delayed to 2017.

The original APRN legislation, passed in 2014, called for quarterly reporting beginning in July 2015. That law was amended this spring to push back the start date and require only annual reporting, after urging from the pharmaceutical industry, state officials said.

The delay comes as an APRN at a pain clinic in Derby, Heather Alfonso, awaits sentencing on charges that she received kickbacks from the drug company Insys Therapeutics in exchange for prescribing a potent painkiller intended for cancer patients. The payments to Alfonso for promoting the drug were not reported publicly under federal rules because APRNs are not included in the Physician Payment Sunshine Act, which requires public reporting of drug company payments only to physicians and teaching hospitals.

The revised state legislation, signed into law by Gov. Dannel P. Malloy, requires drug and device companies to report gifts, meals and other payments to APRNs who are practicing independently of physicians. Under a state law passed in 2014, APRNs who have been licensed for at least three years are now allowed to practice and prescribe independently of physicians. The amended reporting legislation does not cover APRNs who practice with physicians.

The original legislation, proposed by state Senate President Pro Tem Martin Looney, D-New Haven, called for drug and device companies to report gifts and payments to APRNs quarterly to the state Department of Consumer Protection.

Looney said the legislation was changed this year after pharmaceutical industry representatives argued that quarterly reporting was more rigorous than the annual federal reporting requirements for physicians, and that they needed more time. The law also was amended to apply only to those APRNs practicing independently.

Looney said that while some provisions have changed, the original intent of the legislation remains the same: To make sure that independent APRNs, with prescribing authority, are “subject to the same disclosure requirements and transparency” as physicians. Connecticut is one of a handful of states that requires APRN disclosures.

In testimony to the legislature, the Pharmaceutical Research and Manufacturers of America, which represents biopharmaceutical researchers and biotechnology companies, said the original law did not align with federal reporting requirements and argued for more time to begin reporting. The 2017 reports will cover the 2016 calendar year. DCP Commissioner Jonathan Harris testified that after the original bill was passed, his office “heard concerns from industry” about the quarterly reporting and start date, and said he supported the changes.

DCP spokeswoman Claudette Carveth said this week that the APRN disclosures will be made available to the public, as physician disclosures are.

“DCP supports transparency and will make this information available on its website” starting in 2017, she said.

Alfonso’s payments from Insys would not be covered by the amended legislation because she worked in collaboration with a physician at the Comprehensive Pain and Headache Treatment Center in Derby, not independently.

Alfonso, who no longer works at the center, has admitted receiving $83,000 in kickbacks from January 2013 until March 2015 from the company and has acknowledged that those payments influenced her prescribing of a potent painkiller called Subsys.

The charge of receipt of kickbacks in relation to a federal healthcare program carries a maximum term of imprisonment of five years and a fine of up to $250,000.  Alfonso’s sentencing, originally scheduled for Sept. 17, has been postponed.


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