For more than a year, the Centers for Medicare and Medicaid Services (CMS) has been preparing to post information about certain financial interactions between drug/device manufacturers and physicians and teaching hospitals to a public website. Referred to as the Open Payments Program, this disclosure is part of a national transparency initiative intended to shed "sunshine" on such financial relationships.
Manufacturers' reports detailing 2013 activity have been submitted to CMS. Physicians should review these reports to:
- Determine whether they are identified as having received anything of value from a manufacturer
- Determine whether information reported is accurate
- Challenge false, inaccurate or misleading information
CMS intends to relate the data publicly on September 30, 2014. In order to have potentially erroneous information corrected or flagged before the data is released, physicians must initiate disputes by August 27, 2014. To view the data, physicians must complete a two-phase registration process. Although is process is voluntary, it is required if a physician wants to review data reported by the industry relating to financial interactions the industry has had with physicians.
Phase 1 includes user registration in the CMS Enterprise Portal to request access to the Open Payments system.
Phase 2 includes registration in the Open Payments system, where physicians will be able to review and dispute data submitted by manufacturers and group purchasing organizations (GPOs) prior to public posting of the data.
Because this process and identity verification can take some time, CMS recommends completing the registration process as soon as possible. Both CMS and the American Medical Association have tools to help physicians through this process. Visit the Physicians web page of the Open Payments website or ama-assn.org/go/sunshine, respectively, for more information.
As background, the Physician Payments Sunshine Act (Sunshine), which was part of the Affordable Care Act (ACA), requires manufacturers of drugs, medical devices, and biologicals that participate in U.S. federal health care programs to track and report certain payments and items of value given to physicians and teaching hospitals. Manufacturers are required to submit the reports to CMS annually. Additionally, manufacturers and group purchasing organizations (GPOs) must report certain ownership interests held by physicians and their close family members.
MSMS recently joined with the AMA and other associations in sending a joint letter to CMS Administrator Tavenner regarding implementation of the Sunshine Act that outlines problems with language in the proposed Medicare Physician Fee Schedule for 2015, as well as concerns with how the Open Payments System has been implemented, including the condensed registration time frame and the complicated and incomplete guidance from the agency.
If you have additional questions please feel free to contact Stacey Hettiger at (517) 336-5766 or shettiger@msms.org.
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