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Physician Payments Sunshine Act

Note: The information on this web page is based on our understanding, as of May 2014, of the Physician Payments Sunshine Act of the Patient Protection and Affordable Care Act of 2010. More detailed information about the Sunshine Act is available on the Centers for Medicare and Medicaid Services website at: http://www.cms.gov/Regulations-and-Guidance/Legislation/National-Physician-Payment-Transparency-Program/index.html

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 JHM Physicians

Among the many implications of the Sunshine Act is that if, acting in a private capacity, a JHM 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.

On June 1, 2014, physicians will be able to register with CMS so they are able to gain access to the data that will be reported publicly.  We encourage JHM physicians to register promptly so that they can review this data as soon as it becomes available.

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

We anticipate that CMS will soon announce the date on which physicians can review the payment data submitted by manufacturers. Once the data are available for review, there will be a 45-day period of time during which physicians can dispute the data. Information about the review and dispute process is not yet available, but we anticipate that CMS will announce details soon.

In order to assess the accuracy of the payment data, JHM physicians should maintain records of the payments they receive.

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 JHM, 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, Suburban Hospital, and All Children's Hospital.

Resources

More information regarding 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 through the American Medical Association at: http://www.ama-assn.org/ama/pub/advocacy/topics/sunshine-act-and-physician-financial-transparency-reports.page?linkid=popularlinksbox-1

Faculty physicians who have questions may contact the Office of Policy Coordination at policy@jhmi.edu. Non-faculty physicians who have questions may contact Mary Ann Dunlay

Updated May 30, 2014.

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Posted May 20, 2013

 

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