Navigating the Physician Payments Sunshine Rule

Background

The Physician Payments Sunshine Act, also referred to as the PPSA, Sunshine Act or Open Payments Program, requires public reporting by manufacturers of medical products and group purchasing organizations (GPOs) of all payments or transfers of value to physicians and teaching hospitals, as well as ownership or investment interests held by physicians or immediate family members of physicians in such manufacturers and GPOs. Data collection began on Aug. 1, 2013 and will be conducted annually going forward. Although the Centers for Medicare and Medicaid Services (CMS) was required by Congress to implement the law and begin data collection by Jan. 1, 2012, lengthy delays in the release of the proposed and final regulations by CMS meant that data collection did not actually begin until Aug. 1, 2013, delaying reporting by applicable manufacturers and GPOs to CMS and public reporting until Sept. 30, 2014.

Latest Developments

Physicians and teaching hospitals have the opportunity to review their reports prior to publication. CMS on Sept. 9 announced that because of “scheduled maintenance upgrades” the review period has been extended until Sept. 11, giving physicians and teaching hospitals one extra day to review and dispute their data. CMS also confirmed that physicians and teaching hospitals will have at least 15 days starting Sept. 15 to continue to work with industry to resolve disputes. Reports will still be made public on Sept. 30 and a notation will be made for any payments under dispute.  

Physicians and teaching hospitals must register through CMS' Enterprise Identity Management system (EIDM) first. The registration system opened on June 1 and is now available at portal.cms.gov

While many CMS systems allow administrative staff to perform tasks on behalf of physicians, the EIDM does not. Because of the types of questions that it asks, physicians will need to first register themselves before granting administrative staff access to their report. Teaching hospital administrators will also need to register and provide access to appropriate staff after the provision of personal information. Specifically, the EIDM will verify physician and other users' identities through the provision of personal information. The EIDM will match information provided by physicians and other users with information provided by Experian, a company that performs credit monitoring services.

Early registration is critical to ensure easy access to pre-publication reports. From July 14 to Aug. 27, physicians and teaching hospitals can preview reports of the payments they received from industry from Aug. 1 through Dec. 31, 2013 and dispute information contained within the reports. After the close of the 45-day period, there is an additional 15-day period that physicians and teaching hospitals can use to continue to work with industry to resolve disputes. The reports will be made available to the public on Sept. 30.

Upcoming Sunshine Dates:

  • June 1: Registration begins for physicians and teaching hospitals
  • July 14: Report preview period begins, along with dispute initiation period
  • Sept. 30: Reports published

If you encounter difficulties with the registration process, email openpayments@cms.hhs.gov and copy to AdvocacyDiv@acc.org.

Keywords: Physicians, Hospital Administrators, Medicaid, Sunlight, Centers for Medicare and Medicaid Services (U.S.), Medicare, United States, Hospitals, Teaching


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