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Designed to increase the transparency of financial relationships in the healthcare industry, the Sunshine Act requires the collection and reporting of certain financial transactions to the Centers for Medicare and Medicaid Services.
The Physician Payment Sunshine Act (The Sunshine Act) was enacted as part of the Patient Protection and Affordable Care Act. Designed to increase the transparency of financial relationships in the healthcare industry, the Sunshine Act requires the collection and reporting of certain financial transactions to the Centers for Medicare and Medicaid Services (CMS).
Physicians are not required to register with CMS or to send them any information.
Generally, manufacturers and applicable group purchasing organizations (GPOs) are required to submit annual reports to CMS on or before March 31.
For 2013 only, CMS has announced that it would collect data in two phases. Phase I began February 18, 2014, and ends March 31, 2014. During this time, manufacturers and GPOs will submit corporate profile information and aggregate payment data.
Phase II begins in May 2014. Manufacturers and GPOs will register for the Open Payments system, submit “detailed 2013 payment data,” and attest to the accuracy of the data. Both phases will be completed by August 1, 2014, at which time physicians will be able to review the data and correct inaccuracies.
After the data has been reported to CMS, but before it is made public, physicians will have 45 days to review the information and work with the applicable manufacturers and GPOs to make corrections. After the initial 45-day period, applicable manufacturers and GPOs will have an additional 15 days to submit corrections based on any disputes. If the dispute cannot be resolved, CMS will publish the information and mark it as disputed. The parties should continue to try resolving the dispute.
Physicians should keep track of payments received from applicable manufacturers and GPOs, and dispute inaccurate data promptly. Consumers are becoming increasingly savvy about researching their healthcare providers, and it is important that physicians ensure the accuracy of any information that could potentially affect their practice.
Gregory R. Smith, JD, is a partner at Garfunkel Wild, P.C. in Great Neck, New York. Send your legal and practice management questions to firstname.lastname@example.org.