Physician Payment Sunshine Act—Important Information and Relevant Dates

On August 1, 2013, manufacturers of drugs, medical devices, biological agents, and medical supplies will begin tracking payments and transfers of value to physicians and teaching hospitals as required under the National Physician Payment Transparency Program. Please read this important update on the Sunshine Act.

On August 1, 2013, manufacturers of drugs, medical devices, biological agents, and medical supplies will begin tracking payments and transfers of value to physicians and teaching hospitals as required under the National Physician Payment Transparency Program.  This legislation is often referred to as the “Physician Sunshine Act” and is part of the Affordable Care Act. Manufacturers and group purchasing organizations also must report certain ownership interests of physicians and immediate family members. Applicable Manufacturers will report the information annually to the Centers for Medicare & Medicaid (CMS), and CMS will post the aggregated information on its Open Payments website.

The following categories of remuneration received by physicians and teaching hospitals from manufacturers will be disclosed: consulting fees, compensation for services other than consulting, honoraria, gifts, entertainment, food, travel and lodging, education, research, charitable contribution, royalty or license, current or prospective ownership or investment interest, direct compensation for serving as faculty for a medical education program, grant. A comprehensive list of the types of financial information that will be made publically available on the website can be found here: http://cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/index.html

There is no reporting requirement on behalf of the physicians or the teaching hospitals; however, CMS will allow physicians and teaching hospitals a 60-day window of time to review the information for accuracy before it is made publically available on the Open Payments website. It is important that physicians register with CMS, once the portal is developed, to access this financial information during the 60-day review period. To the extent that any discrepancies in the figures remain after the 60-day period, the financial information will be listed on the Open Payments website as reported by the applicable manufacturer, with a notation that the figure is in dispute, and the information will not be updated until the next year.

Please take note of the following relevant dates:

  • August 1–December 31: Manufacturers must begin tracking payments to physicians and teaching hospitals, as well as physician and family ownership information.
  • January 1, 2014: Physicians will be able to register with CMS to view information reported about them by the manufacturers (note, you can only preview your own information prior to website publication, not the information of others).
    • March 31, 2014: Manufacturers submit reports to CMS.
    • CMS aggregates the information by physician’s NPI number and name of teaching hospital.
    • Review period:  physicians who register with CMS will be notified of the financial information reported by manufacturers. Physicians will have 60 days to review the data for accuracy. CMS will not be a party to any data disputes: Physicians must work directly with the manufacturers to solve any discrepancies.
      • September 30, 2014: Financial data is published on CMS’s Open Payments website.

Applicable Manufacturers are faced with severe financial penalties for failure to report the required financial information to CMS. It is often difficult to recall receipt of meals and other items of monetary value months later, so it is in the physicians’ best interests to track the relevant information as they receive the item, should they wish to compare against the information being submitted to CMS by the manufacturers. Visit the HCS/SOM’s Vendor Relations Acknowledgement Form to confirm your disclosures are up to date at: http://www.med.unc.edu/ois/vendor-relationship-conflict-of-interest-policy.

What physicians can do now:

(1) Ensure that all University financial disclosures and conflict of interests are current and regularly updated, (2) if you have a National Provider Identifier (NPI), be sure that the information is up-to-date and the specialty designation is correct. Manufacturers will use the NPI and other information to identify physicians, and (3) stay tuned for further updates in Vital Signs.

Helpful Resources:

 

For questions, contact Leeanne Walker (leeanne_walker@med.unc.edu), Lisa Apple (ldapple@unch.unc.edu), or John Hart (jhart@unch.unc.edu).