Why You Need to Be Aware of the Physician Payment Sunshine Act

Your relationships with manufacturers and group purchasing organizations (GPOs) allow you to provide better care for your patients. After all, these relationships provide both you and your patients with more information about and greater accessibility to various drugs, medical devices, and treatments.

But in an effort to increase transparency—and prevent instances of inappropriate influence or conflicts of interest—the Centers for Medicare and Medicaid Services (CMS) established the National Physician Payment Transparency Program, also known as the Physician Payment Sunshine Act.

This act requires manufacturers and GPOs to report all payments or transfers of value to physicians and teaching hospitals, as well as any ownership or investment interests a physician may have, on an annual basis.

The reported data will include information about the physician (name, business address, national provider identifier (NPI), licensure information, and specialty) and the payments or transfers of value (the amount, date, form, and nature of the payment). Details about ownership and investment interests held by physicians or their immediate family members must also be reported.

CMS will then collect, aggregate, and publish the data (but not the physicians’ NPIs) on a public website. Manufacturers and GPOs can start reporting data as of August 1, 2013. All data for August through December 2013 must be reported to CMS by March 1, 2014, and then CMS will post the data by September 30, 2014.

The good news for you? The manufacturers and GPOs are responsible for reporting the information—and also subject to penalties for failure to report. So while the Sunshine Act is something physicians should be aware of, it doesn’t require you to take any action. Still, it’s important that you stay informed about the information that’s being provided about you.

If you have established relationships with manufacturers and GPOs, ask them if they are subject to reporting this type of data under the Sunshine Act. Then any time they offer you a form of payment or something of value, take a moment to confirm whether or not the payment will be reported and decide if you feel comfortable accepting it.

And not to worry—you’ll have the opportunity to review reported information and dispute any data that is inaccurate or misleading. Once CMS builds the online portal, physicians will be able to sign up for notifications of when reports are made public, so they can review the data and contact manufacturers or GPOs to discuss any discrepancies. Of course, in order to compare and confirm the accuracy of the data, you’ll have to keep your own personal records. So determine which details you’ll need to track and the best way to do so.

Keep in mind that your patients will have access to the reported data too. As such, they may form perceptions of you and your practice based on your relationships and the payments or items you’ve received. Maintaining trust with your patients is imperative; so in all of your interactions, be open to discussing your industry relationships, how you stay up to date on new developments, and how you form recommendations for prescriptions and treatments. The main purpose of the Sunshine Act is increased physician-patient transparency. So if you make that your goal when communicating with your patients, you’ll go a long way toward minimizing any potential concerns they may have and ensuring that their positive perceptions of your practice continue into the future.


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