The medical industry paid $3.5 billion to physicians and hospitals in the last five months of 2013, leading some to question why payments were being made. The donors were manufacturers of medical devices, as well as pharmaceutical companies.

The Centers for Medicare and Medicaid Services (CMS) released the largest cache of documents about such payments ever made public. Included in the data were records of money provided for research grants, speaking fees, travel and meal expenses, and more. Recipients were named for 60 percent of the payments, while the remainder was redacted by the CMS over concerns of inconsistencies in the data.

A total of 4.4 million payments were detailed in the release, which named 546,000 physicians and 1,360 teaching hospitals as beneficiaries.

Records were made public under the 2010 health care reform law, requiring organizations to disclose any payment of $10 or more made during those five months to doctors, dentists, and other health care professionals, as well as teaching hospitals. This data was collected under the Open Payments program, managed by the CMS.

Data inconsistencies could cause people to believe that pharmaceutical companies have undue influence over physicians, according to the American Medical Association. They urged the CMS to wait six more months to release the data, in order for those problems to be resolved.

The Centers for Medicare and Medicaid Services offered affected physicians a 45-day window to review data and respond to any part with which they disagreed. The AMA, among other groups, claims that period was too short for an adequate response. The CMS produced a guidance document provided to the doctors, explaining how to register on the review system, look over records relevant to their office, and report any inconsistencies. The 360-page document was found to be incomplete, according to the AMA.

"Records that were disputed but not corrected by the end of the review and dispute period (September 11), aren't in the first data publication. This data will be published at a future date after physicians and teaching hospitals have had the opportunity to review and dispute it," CMS officials wrote in the Open Payments website.

The Physician Payments Sunshine provision, which required the release of these records, was supported by both Republican and Democratic lawmakers. Proponents claimed the regulation would make healthcare more transparent to Americans.

"Patients deserve to have access to accurate information. Publishing inaccurate data can lead to misinterpretations, harm reputations and cause patients to question their trust in their physicians... Unfortunately, the CMS' Open Payments program has to date been plagued by significant shortcomings that call into question the accuracy of information that will be published on September 30th," the American Medical Association wrote in a statement.