OCMA Blog

Physician Financial Transparency Reports (Sunshine Act) Begins August 1, 2013



Tracking of Industry Gifts to Physicians Begins in August

Don't miss your chance to challenge false or misleading data before it goes public!

Beginning August 1, 2013, manufacturers of drugs, medical devices and biologics that participate in federal health care programs must begin tracking and reporting certain payments and items of value—including consulting fees, travel reimbursements, research grants and other gifts—given to physicians and teaching hospitals. The new law, known as the Sunshine Act, also requires manufacturers and group purchasing organizations (GPOs) to report certain ownership interests held by physicians and their close family members.

The intention of the law is to increase transparency and reduce the potential for conflicts of interest that can influence research, education and clinical decision making.

The reports will be submitted to the Centers for Medicare and Medicaid Services (CMS) on an annual basis. The majority of the information contained in the reports will be made available on a public, searchable website beginning in September 2014. Physicians will, however, have the right to review their reports and to challenge any information that is false, inaccurate or misleading. By statute, physicians are provided, at a minimum, 45 days to review the transparency reports and make corrections before they are made public.

“Data accuracy is the number one goal of our program,’’ said Anita Griner, CMS’s deputy director for the Data Sharing and Partnership Group, speaking to the American Medical Association's House of Delegates in June. “We do not want to perpetuate any false information about a physician or teaching hospital…. And that will come from you tracking your own transfers and checking the website before it goes public.’’

 

 

The Sunshine Act covers all physicians who have an active state license, even if they do not participate in federal health care programs, but excludes residents and medical students.

Payments of less than $10 do not need to be reported unless the aggregate amount exceeds $100 annually. The $10 threshold will increase every year, based on the Consumer Price Index.

How to challenge false, inaccurate or misleading reports

Physicians will have 45 days after the annual reports are completed to challenge the data before it is made public. The reports will be available to physicians for their review via an online portal sometime after the close of the calendar year. The portal will also facilitate contact between a physician with a dispute and the manufacturer/GPO that submitted the disputed information.

 

Manufacturers then have 15 days to correct any misinformation. If a resolution is not reached within the allotted time period, the disputed information will be flagged, but the report will be posted on a public webpage. Physicians will, however, have two full years to contest or seek corrections to data contained in the reports, even after it has been made public.

 

Physicians are encouraged to proactively check with any manufacturer from which they have received payments or any items of value to see what information they are tracking and intend to report. If you hold any ownership interests, you should also check to ascertain what they intend to report. (Ownership or investment interests in publicly traded securities and mutual funds are excluded from reporting.)

What you can do now to prepare for the Sunshine Act

Update your disclosures regularly. Ensure that all financial disclosures and conflict of interest disclosures required by employers, advisory bodies and entities funding research, for example, are current and updated regularly.

If you have an NPI, update the information and ensure your specialty is correctly designated. Physicians who have a National Provider Identifier (NPI) should ensure all information in the NPI enumerator database is current and regularly updated as needed. This information will be used by industry reporters, among other unique identifiers, to ensure that they have accurately identified you.

Inform your industry contacts that you want ongoing notice of what they report to the government. Ask all manufacturer and GPO representatives with whom you interact to provide you with notice and an opportunity to review and, if necessary, correct all information that they intend to report before it is submitted to the federal government.

For more information

 

Physicians are encouraged to register for the CMS Open Payments listserv to receive periodic email updates about the program. To register, visit http://go.cms.gov/openpayments. Questions about the program can be sent to openpayments@cms.hhs.gov.

Some information in this article was republished with permission from the American Medical Association. For more information, visit www.ama-assn.org/go/sunshine.

 

Sidebars

Key Dates

August 1, 2013: Manufacturers begin collecting and tracking payment, transfer and ownership information.

January 1, 2014: CMS is expected to launch the physician portal that allows physicians to sign up to receive notice when their individual consolidated report is available for review. This portal will also allow physicians to dispute the accuracy of a report.

March 31, 2014: Manufacturers/GPOs report 2013 data to CMS.

June 2014: CMS is expected to provide physicians with access to their individualized consolidated reports for the prior calendar year. Physicians will be able to access the reports online and will be able to seek correction or modification by contacting the manufacturer/GPO via the web portal.

September 30, 2014: CMS will release most of the data on a public website.

Exemptions

The Sunshine Act includes a number of exemptions from the reporting requirements; among them are:

  • Samples intended for patient use, including coupons and coupons to obtain samples
  • Certified and accredited continuing medical education activities funded by manufacturers
  • Educational materials ultimately intended to be used with patients (for example, wall models or anatomical models)
  • Buffet meals, snacks, soft drinks, or coffee generally available to all participants of large-scale conference or similar large-scale events
  • The loan of a medical device for a short-term trial period
  • Discounts (including rebates)
  • In-kind items used for the provision of charity care
  • A dividend or other profit distribution from a publicly traded security or mutual fund


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