Sunshine Act

Clinical Faculty Meeting

August 14, 2014

What is the Sunshine Act?

• The Physician Payment Sunshine Act is part of the Affordable Care Act.

• It does not prohibit anything; rather it is simply a reporting statute.

• Goal: Increase awareness of financial relationships between manufacturers and health care providers

https://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Downloads/Phys-Teaching-Hosp-Phase-1-EIDM-Registration-Steps-%5bJune-2014%5d.pdf

https://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Downloads/Phys-Teaching-Hosp-Phase-1-EIDM-Registration-Steps-%5bJune-2014%5d.pdf

Office for Interactions with Industry

What is Reportable?

POTV: Any payment or transfer of value of $10 or more, or greater than

$100 in aggregate Different reporting structure for research payments versus general

payments “General” payments will be categorized into one of these:

Consulting fees Compensation for speaking Honoraria Gifts Food Entertainment Travel and lodging Education Royalty or license fees Grants Charitable contributions and donations

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Office for Interactions with Industry

“Indirect Payment” Reporting For “general” (i.e., non-research) payments, payments

will be reported both as direct payments to the immediate recipient (in our case, the institution), and as indirect payments to the individuals providing services

Examples: Institutional service agreements Society awards Company-supported fellowship programs (funding, textbooks,

travel grants)

Indirect payment reporting does not apply to payments for research

Also – third party payments – e.g., donations

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https://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Downloads/Phys-Teaching-Hosp-Phase-1-EIDM-Registration-Steps-%5bJune-2014%5d.pdf

Process

• Step 1: Complete CMS e-verification process todayCMS requires a two-phase registration process. In phase 1, which is now open, physicians complete CMS' e-verification process via the CMS Enterprise Portal (EIDM) .

• Step 2: Register with CMS' Open Payments system (Note: The system is temporarily offline. Check back no later than Aug. 20, 2014, to determine if it is back online.)** Once physicians have completed Step 1 and gained access to EIDM, physicians can move onto phase two and register in CMS' Open Payments System via EIDM.

• *Physicians must initiate disputes by Aug. 27 to have potentially erroneous data flagged in the initial public release. Physicians can still initiate disputes on 2013 data until Dec. 31, 2014, but it will not be flagged in the public database until 2015.

8http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page?

Process

• Step 3: Review and dispute data by Aug. 27* (Note: The system is temporarily offline. Check back no later than Aug. 20, 2014, to determine if it is back online.)**Physicians can request their individual report, review it and flag disputes after completing Step 2. CMS has indicated that it will not resolve disputes, but errors can be reported to manufacturers through the Open Payments System or directly through Open Payments contacts listed on most manufacturer websites.

http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page?

Questions?