A key deadline for the Physician Payments Sunshine Act is fast approaching. As part of the Affordable Care Act (ACA), the Sunshine Act requires the makers of drugs, medical devices, medical supplies and biologicals to annually report payments or other transfers of value to physicians and teaching hospitals. The Centers for Medicare & Medicaid Services (CMS) is responsible for administering this reporting process and manufacturers have been required to collect and track this data as of August 2013.
The next major deadline is scheduled for Sept. 30, 2014. CMS’s goal is to have all the collected data be made publically available on a new website by this date. When this repository is open and fully searchable, consumers will be able to see all information collected for physicians. Prior to the site’s debut, physicians will be able to challenge any reports they consider false, inaccurate or misleading.
It sounds straightforward enough, and few would argue with the desire to create greater transparency around the financial relationships of manufacturers, physicians and teaching hospitals. Many consumers are unaware of the payments physicians receive for helping develop new drugs or medical devices, but on the flip side, many consumers do not know the great value of having physicians contribute to drug or device development. Thus, the CMS effort to collect, aggregate and publish data is expected to shed light on things that should be known but may not be placed in right context by consumers.
More importantly, the Sunshine Act, which created the Open Payments program of data reporting, has not been well understood by the physicians whose financial relationships will be disclosed. Last year a 1,000-person survey found that 63 percent of physician respondents were “deeply concerned” about the searchable CMS website. In addition, respondents said they did not know that payments and gifts given to physicians and teaching hospitals by medical device and pharma companies must be included in all Open Payments reporting.
And while many physicians have learned more over the last year, some details still may not be clear. For example, CMS is required to provide physicians with reports before they are made public. Online physician access will allow for time to review and dispute before the consumer site goes live. However, CMS will not alert all physicians that reports are ready for viewing. Physicians must register on the CMS website to receive notifications of reports that include them. Registration opened on June 1; physicians and teaching hospitals will be able to begin reviewing reports in July.
Reporting requirements remain an area that’s not well understood. In addition to reporting things such as travel expenses, meals, entertainment and educational materials, manufacturers also must report speaker honoraria even if the physicians receiving them donate the funds to charity. A charitable donation does not negate the reporting requirement.
Physicians also may not be aware of how detailed the reporting will be. The Open Payments program requires the name and address of the physician, the amount and date of a payment, the forms of payment (cash, stock, etc.), and the nature of the payment (consulting fees, gifts, entertainment, etc.). Most physicians are accustomed to maintaining disclosure statements for their speaking engagements, but this level of reporting for public scrutiny will be new.
There’s much more to know about the details of the Sunshine Act and the CMS website debut for both physicians and vendor representatives. Reptrax UniversityTM offers an online compliance training package with a course specific to the Sunshine Act. The course, called “The Sunshine Act: A Guide for Healthcare Providers,” reviews the major components of the Act.
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