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Physician Payments Sunshine Act

Note: The information on this site is provided to members of the Johns Hopkins Medicine Community as a resource for the Physician Payments Sunshine Act, which is also referred to as Open Payments. 

Overview

The Sunshine Act requires that detailed information about payments and other “transfers of value” worth over $10 from manufacturers of drugs, medical devices and biologics to physicians (defined as M.D., D.O., D.D./D.D.M., D.D.S., D.P.M., O.D. and D.C.P. who are licensed in any state in the U.S., whether or not they are practicing) and teaching hospitals be made available to the public.  The Act does not affect faculty and staff members who are not physicians (as defined above).

Manufacturers were required to collect and provide to CMS information about payments made from August 1 through December 31, 2013.  CMS will post that information on a publicly accessible website beginning September 30, 2014.   Thereafter, the data will cover full calendar years.

Implications for Johns Hopkins Physicians

Among the many implications of the Sunshine Act is that if, acting in a private capacity, a Johns Hopkins physician consults, serves on a scientific advisory board, or engages in other compensated activity for manufacturers of drugs, devices or biologics, details of the physician's compensation for that activity as well as other payments (such as travel reimbursement) from those companies and the purpose of the payment will be posted on a publicly accessible website.

Individual physicians -- not the physician's institution, such as the Johns Hopkins University School of Medicine -- will be responsible for reviewing the accuracy of reported data and addressing any discrepancies.

As of July 14, 2014, physicians can register in the CMS Open Payments system via the EIDM (Enterprise Identity Management System) to review reported data and dispute any inaccuracies. 

Registration information is available at cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/Physicians.html

For step-by-step instructions on the registration process, click here

Any payment data disputed by September 10 will be labeled as "disputed" when the data are made public on September 30, 2014 unless the dispute has been resolved with corrected data submitted by the manufacturer.  

September 10 is the end of a special 45-day window during the initial review period.  Payments not disputed by September 10 will be publicly reported but not flagged as disputed.

Information about the review and dispute process is available at http://www.cms.gov/Regulations-and-Guidlines/Legislation/National-Physician-Payment-Transparency-Program/Dispute-and-Resolution.html

After September 10, physicians can still initiate and resolve disputes about reported data, but the data will not be noted as disputed and will not be corrected on the CMS website until the following review cycle next year.

Johns Hopkins physicians are encouraged to register promptly, review the payment data as soon as possible and submit disputes if necessary.

In order to assess the accuracy of the payment data, JHM physicians are advised to maintain records of the payments they receive from manufacturers.

Key Elements

Below are some of the other key elements of the Sunshine Act:

  • Manufacturers must collect and provide information about indirect payments as well as payments made directly to physicians.  For example, if a physician is paid indirectly through a third party (e.g., contract research organization, travel agency), the payment will be listed as a transfer from the manufacturer to the physician. 
  • Payments to physicians for serving as speakers at accredited Continuing Medical Education activities are generally not included.
  • Manufacturers are responsible for reporting to CMS; physicians not responsible for reporting to CMS.
  • Manufacturers must identify physicians by their National Provider Identifier (NPI), so physicians may be asked to provide their NPI to a company that has made payments to them, whether directly or indirectly.
  • Categories of payment and transfers of value to physicians include, among others, consulting fees, compensation for speaking, travel, food, entertainment, gifts, honoraria, royalties, education, research, current or prospective ownership or investment interest, etc.
  • At Johns Hopkins, payments for research are made to the institution, not to individual physicians.  However, the Sunshine Act requires that physicians who are investigators on research supported by manufacturers be listed in connection with the research payments to the institution.  Payments made for research, whether to teaching hospitals, individuals or other organizations, such as medical schools, will be reported in a separate section of the CMS database.
  • Information about payments to teaching hospitals will be listed by hospital name.  The teaching hospitals that are part of Johns Hopkins Medicine are the Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Sibley Memorial Hospital, Suburban Hospital, and All Children's Hospital.

Resources

More information about the Sunshine Act is available on this CMS website.  Please note that CMS is still developing this process, so some implementation details may change. To receive updates from CMS, physicians may register for the listserv by emailing  OPENPAYMENTS@cms.hhs.gov.

Additional information is available on the American Medical Association website at: http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page?linkid=popularlinksbox-1

Questions?

  • For questions about registration and other technical assitance, contact the CMS Open Payments Help Line at 1-855-326-8366 or openpayments@cms.gov.  The Help Line is available Monday through Friday from 7:30 a.m.-6:30 p.m. (Central Time).  For step-by-step instructions on the registration process, click here.
  • For information about the review and dispute process, click here.  After noting a payment as disputed on the CMS Open Payments website, physicians must contact the manufacturer directly to resolve the dispute and correct any inaccuracy.
  • Faculty and investigators who have questions about Sunshine payment data and the School of Medicine disclosure requirements should contact policy@jhmi.edu
  • All other questions should be directed to the Office of Policy Coordination at sunshine@jhmi.edu or 410-516-5560.

​CMS procedures are subject to change and this site will be periodically updated.  Last update: August 28, 2014

 

 

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Posted May 20, 2013

 

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