Physician Payments Sunshine Act (Open Payments Program)
The Physician Payments Sunshine Act established the Open Payments Program which is administered by the Centers for Medicare & Medicaid Services (CMS). The program is designed to provide greater transparency around the financial relationships of manufacturers, physicians and teaching hospitals.
This webpage is devoted to providing the most up-to-date information about the Physicians Payments Sunshine Act, Open Payments Program, administered by the CMS.
Please visit regularly to obtain the latest news and updated information. The information on this page is subject to revision.
CMS Submits Report to Congress on First Year of Open PaymentsOn April 6, CMS opened the review and dispute period, during which healthcare providers can log-in to Open Payments and review the payments attributed to them. Now CMS has clarified that the 45 day period ends on May 20, 2015. Payments that are disputed but not resolved within 15 days after the review period (June 3) will be made public on June 30. Learn more.
Sunshine Act Update: Explore the Data
Learn about financial relationships between industry and physicians using new CMS Data Exploration Tools
SIR Update: Sunshine Act Open Payments Database
As required by the Sunshine Act, the Centers for Medicare and Medicaid Services (CMS) recently launched its Open Payments Database, which lists any transfer of value from drug and device companies to physicians or teaching hospitals. The data included payments made to physicians from the 2013 reporting period, totaling $3.5 billion. Although the launch of this database has been in the planning stages since the implementation of the Affordable Care Act, opponents of the act claim the payment database has its faults. Critics, including the AMA, contend that the database is misleading because it does not put into context the reasons for the payments and did not allow physicians enough time to properly review reports. CMS plans to release the second round of payment data in June 2015.
SIR will continue to update members on the Sunshine Act.
Read a related article: CMS publishes Sunshine Act data amid controversy
SIR, Other Specialties Submit Concerns to CMSSIR and other medical specialties have registered concerns With CMS over the implementation of the Physician Payments Sunshine Act
Register With the Physician Open Payments ProgramPhase I
- Happening Now—Register with CMS in order to receive notification and information submitted by industry. Go to the CMS Enterprise Portal.
- Register in the Open Payments System: Begins mid-July and extends for 45-days. Track reportable transfers by downloading a free app through the iTunes App Store or the Google Play Store (search for “Physician Open Payment”)
Dispute Resolution Pushed to August/September
Physician Payments Sunshine Act: CMS Pushes Dispute Resolution to August/September; Still Plans to Post Public Database in September
A Letter From the Executive Director
Here Comes the Sun. (Sunshine Act, that is.)
By now, you have likely read or heard something about the Physician Payments Sunshine Act. Passed as part of the Patient Protection and Affordable Care Act in 2010, the Sunshine Act is designed to bring transparency to financial relationships that the drug and device industry have with physicians and teaching hospitals.
The burden of this law falls mainly to the manufacturers of drugs, devices, and biologicals that participate in U.S. federal health care programs and to group purchasing organizations (GPOs), who are now required to collect and report on selected financial interactions (like research funding, meals, honoraria, or travel reimbursement) between the company and individual physicians. The Act requires manufacturers and GPOs to report ownership interests held by physicians and their immediate family members. The Centers for Medicare and Medicaid Services (CMS) have developed an Open Payments system for gathering and posting most of this information on a public website. And while there have been numerous delays in implementation, the annual cycle has officially begun, with the first public reports scheduled to be posted by September 30, 2014, and annually after that. Physicians are guaranteed a 45-day window of opportunity to review the reported data and an additional 15 days to dispute inaccuracies.
While neither you, nor SIR, are required to make reports to the government, SIR is committed to helping everyone navigate this law and how it will affect you. SIR has developed this webpage to help you stay informed about the Sunshine Act, which contains links to additional resources from the AMA and from CMS. As physicians, you should prepare yourself by understanding what interactions could appear on the public website. You also need to take advantage of the window that will be offered to you to review reported payments before they are posted publically, and be prepared to dispute any errors.
In some cases, payments made from manufacturers to physicians come indirectly through a professional organization like SIR or the SIR Foundation and will require reporting by the manufacturers. SIR and the SIR Foundation are committed to letting our members and attendees know in advance whenever an SIR or SIR Foundation activity could result in a report, so you have the opportunity to decide for yourself whether to participate. To some extent, though, all SIR educational meetings, involving applicable manufacturers or GPOs are impacted by the Sunshine Act.
SIR has also chosen to accommodate manufacturers exhibiting at the Annual Scientific Meeting by assisting in the data collection process. The bar coded badge system we have used for several years was expanded in 2013 to also include the National Provider Identification (NPI) number for meeting attendees who voluntarily submitted their numbers as part of the registration process. This allows companies who provide payments or other reportable items of value to obtain the data they need for accurate reporting. Our belief is that facilitating the accuracy of data reported is of significant benefit to our members and attendees. SIR will continue this process at SIR 2015 in Atlanta.
Realistically, it will very rare for any physician to not have been the recipient of some monetary or in-kind support of $10 or greater from some company. For many, consultation and speaking fees, research grants, meeting support, etc. exceed the threshold by substantial amounts. Thus, the extent to which this kind of transparency will shed meaningful light on appropriate physician-industry relationships, or merely contributes to information overload, remains to be seen.
In the meantime, SIR is committed to updating you on any changes, clarifications and pending deadlines. Please feel free to contact us directly with your questions and concerns.
—Susan Sedory Holzer, MA, CAE, SIR Executive Director
What is the Physician Payments Sunshine Act?
As mandated by the Affordable Care Act, the law now requires medical device and pharmaceutical companies to disclose any “transfers of value” made to physicians or teaching hospitals through a federal database starting in September 2014. Transfers of value include payments, gifts, and any ownership or investment interests. Specifically, the new federal transparency regulations require:
- Applicable drug and device manufacturers report payments or other transfers of value to physicians and teaching hospitals.
- Applicable drug and device manufacturers and group purchasing organizations (GPOs) report information regarding physician ownership or investment interests and payments or other transfers of value provided to such physicians.
It is important to note, however, that the regulation only applies to medical device and pharmaceutical companies and does not require any action on the part of the physician.
Data collection began on March 31, 2014 and the first reporting deadline will be September 30, 2014. Under the guidelines, the following information must be reported:
- name and address of the physician
- the amount and date of the payment
- the form of the payment, such as cash or stocks
- the nature of the payment, such as consulting fees, gifts, or entertainment expenses
Prior to publication, physicians will be given 45 days to review the information and make necessary corrections. The companies will then have 15 days to amend the report. If the dispute cannot be resolve within the specified time frame, CMS will publish the report with a notation that the information has been disputed. Payments under $10 will not be required to be reported unless those payments total $100 or more in any given year. Companies are not required to report payments made to a speaker at a CME program if certain conditions are met. See FAQs from CMS.gov.
SIR will continue to release information and provide resources to help interventional radiologists understand the program.
If you have any specific questions about how this program will impact interventional radiologists or SIR programs, please contact Susie Evenden at (703) 460-5586.
How to Protect Yourself under the Physician Payment Sunshine Act
December 30, 2013
Source: American Medical Association
By taking four easy steps now, you can make sure you are prepared when it's time to review your 2013 financial data before it's published online next year. Under the Physician Payments Sunshine Act (Open Payments Program), drug and medical device manufacturers started tracking their financial interactions with licensed physicians as of August 1, 2013. Any payments, ownership interests and other “transfers of value” will be reported to the Centers for Medicare & Medicaid Services (CMS) for publication in an online database to be launched in the fall of 2014.
Here are the steps you can take now to support the accuracy of this data:
- Make sure your disclosures are up to date. Financial and conflict-of-interest disclosures required by employers, advisory bodies and entities funding research should be updated regularly so it is consistent with the data that eventually will be publicly reported under the Sunshine Act.
- Confirm that your National Provider Identifier (NPI) information is current. The information tied to your NPI, including your specialty, must be accurate to help ensure appropriate attribution of payments and other transfers of value that will be listed in CMS's online database.
- Request ongoing notification from your industry contacts about the data they report to CMS. Ask your representatives at the manufacturers and group purchasing organizations with which you interact to give you an opportunity to review and correct information they intend to submit before they transmit it to CMS. 2013 data is due March 31.
- Track your payments and financial transfers. Download a free smart phone app to track reportable transfers. Compatible with Apple® and Android platforms, "Open Payments Mobile for Physicians" is available through the Apple Store and Google Play® Store. A number of security features protect the privacy of the data you capture, which will be stored on one device and cannot be backed up to a cloud or other devices. Also urge your industry contacts to use the app so you will be able to capture the information you need to ensure accurate reporting.
Centers for Medicare & Medicaid Services (CMS) Resource Page on PhysicianPayments Sunshine Act (Open Payments Program)
American Medical Association’s Toolkit for Physician Financial Transparency Reports (Sunshine Act)
August 1 to December 31, 2013: Manufacturers required to begin collecting and tracking payment, transfer, and ownership information. Thereafter, they are required to report for each full calendar year.
January 1, 2014: It is anticipated that CMS will 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 contact manufacturers/GPOs if they want to dispute the accuracy of a report.
March 31, 2014: Manufacturers/GPOs will report the data for 2013 to CMS.
June-July 2014: It is anticipated that CMS will provide physicians access to their individualized consolidated version of all manufacturers/GPO reports for the prior calendar year in June 2014. Physicians may access the consolidated reports via an online website portal maintained by CMS and will be able to seek correction or modification by contacting the manufacturer/GPO through the portal. Sometime in July, physicians will actually be able to register in the Open Payments system, check their data, and potentially engage in dispute resolution.
September 30, 2014: CMS will release most of the data on a public website.
For any questions relating to the program, physicians can contact the CMS Help Desk at OpenPayments@cms.hhs.gov.
Physicians can register for periodic CMS updates on the CMS website.
Frequently Asked Questions
Who does the reporting?
The Sunshine Act requires that data on payments and gifts made to physicians and teaching hospitals by medical device and pharmaceutical companies (“manufacturers”) and group purchasing organizations (“GPOs“) be publicly available on a searchable federal database, called the Open Program” Web site, starting in September 2014.
While the burden of data collection and reporting requirements falls on manufacturers and GPOs – not physicians and teaching hospitals – physicians are encouraged to voluntarily review and dispute manufacturers ‘and GPOs’ data before it is submitted to the CMS, and, at the very least, before it is posted on the CMA national Web site.
What is to be reported?
Applicable manufacturers of at least one covered drug, device, biological, or medical supply must report all payments of $10 or more or other transfers of value provided to covered recipients, regardless of whether any particular payment or other transfer of value was related to a covered drug, device, biological, or medical supply. Applicable manufacturers will be required to categorize all reportable payments as falling within one of the following natures of payment:
- Consulting fees
- Compensation for services other than consulting, including serving as faculty or as a speaker at an event other than a continuing education program
- Food and beverage
- Travel and lodging
- Charitable contributions
- Royalty or license
- Current or prospective ownership or investment interest
- Compensation for serving as faculty or as a speaker for an unaccredited and non-certified continuing education program
- Compensation for serving as faculty or as a speaker for an accredited or certified continuing education program
- Space rental or facility fees (teaching hospital only)
At health care conferences, companies must report the per-person value of meals given to physicians who take the meals, but have no responsibility to report on buffet meals or other foods/beverages made available to all participants in a conference.
All SIR educational meetings, involving applicable manufacturers and applicable group purchasing organizations are affected by the Physician Payments Sunshine Act.
Accredited vs. non- accredited SIR programs - CMS believes "that since this type of education program does not require the same safeguards as an accredited and certified program, payments or transfers of value should be reported as required for any other payment or other transfer of value." If the payment or other transfer of value is made indirectly, it will be subject to the same reporting requirements for all indirect payments.
Learn more at PolicyMed.com.