Physician Payments Sunshine Law


What is the Physician Payments Sunshine Act? Signed into law in 2010 as part of the Affordable Care Act, the Physician Payments Sunshine Act (the “Sunshine Law”) requires manufacturers, including certain distributors, of medical devices, drugs, biologicals, and medical supplies to track and report certain payments made to and transfers of value provided to physicians and teaching hospitals. The Sunshine Law also requires manufacturers and Group Purchasing Organizations (GPOs) to report certain ownership and investment interests held by physicians and their immediate family members.
Purpose The main purpose of the Sunshine Law is to provide patients with enhanced transparency into the relationships their health care providers have with life science manufacturers, including medical technology companies. It’s important to note that the Sunshine Law does not restrict industry-physician collaboration or interactions, or prohibit payments or transfers of value. Rather, it requires tracking and reporting of Value of Industry-Provider Collaborations
Value of
Industry-Provider Collaborations
 Collaboration and interactions between medical technology companies and health care providers is essential to advancing new, safe and effective medical technologies that benefit patients. AdvaMed recognizes that this goal must be balanced against the obligation of health care providers to make independent decisions regarding the care and treatment of their patients. AdvaMed and its member medical technology companies are committed to transparency with patients about interactions between providers and industry. For this reason, AdvaMed supports the Physician Payments Sunshine Law. Many AdvaMed member companies have certified to compliance with the AdvaMed Code of Ethics on Interactions with Health Care Professionals which also supports ethical collaborations. It is by driving ethical collaborations that we help protect patients. To see the companies that have certified to the Code, and for more information about the value of interacting with a company that has certified to the AdvaMed Code of Ethics visit:  www.AdvaMed.org/CodeCertification
Timing -
Key Dates




 
Aug. 1, 2013Manufacturers and GPOs are required to begin collecting information about payments, transfers of value, and ownership interests.
Feb. 18, 2014 through Mar. 31, 2014Phase 1 Data Submission Period - Submission of corporate profile information and aggregate 2013 payment data (covering August – December 2013 payments/transfers of value and ownership interests).
May 2014Phase 2 Data Submission Begins (extends for no fewer than 30 days) - includes detailed 2013 payment data (covering August – December 2013 payments/transfers of value and ownership interests), and legal attestation to the accuracy of the data.  Subsequent reports will cover an entire calendar year and be due the 90th day of the following year.
Aug. 2014(in subsequent years, during the month of May) Physicians and teaching hospitals may access their own data via secure online portal for review and correction. - 45 Days to Review and Initiate Disputes - 15 Days to Resolve Disputes
Sept. 30, 20142013 data published on a public website by CMS. In subsequent years, information will be published on June 30.
Sept. 30, 2014(in subsequent years by June 30) – CMS submits reports to states that include a summary of payments made to covered recipients in each state.
April 1, 2015CMS submits first annual report to Congress that will include aggregated information submitted during the previous calendar year (data collected in CY 2013 and submitted March 2014), as well as any enforcement actions taken and any penalties paid.






Highlights

 02.10.14 U.S. Physician Payments Sunshine Act FAQs for oUS Companies [View] [Download]
 11.05.13 Partners for Healthy Dialogues Newest Partner AdvaMed Sits Down with Dialogues+ [LINK]
 10.30.13 New CMS FAQs posted - scroll to bottom [LINK]
New! Sunshine Brochure for Teaching Hospitals [Link]
updated!
Sunshine Brochure for Physicians [Link]
  


Quick Links

Final Rule Medicare, Medicaid, Children's Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests [LINK] [PDF]
 04.09.13 AdvaMed Sunshine Comments on Final Rules and Data Templates [view] [PDF]
CMS Website The Official CMS Website for the Sunshine Law, also referred to as the National Physician Payment Transparency Program: OPEN PAYMENTS [LINK]
CMS FAQs CMS Open Payments Frequently Asked Questions [Link]
AMA  Information from the American Medical Association (AMA) [LINK]
CMS User Guide for Industry
Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity - User Guide for Industry - Open Payments - Creating Public Transparency into Industry-Physician Financial Relationships [Link]



AdvaMed Sunshine Advocacy
Information about AdvaMed's Sunshine Advocacy [link]
State Sunshine Laws Information about state sunshine legislation [link]
AdvaMed Code AdvaMed Code of Ethics on Interactions with Health Care Professionals [LINK]