Physician Financial Transparency Reports (Sunshine Act)
Key steps physicians need to take
The Physician Payments Sunshine Act (Sunshine Act) requires manufacturers of drugs, medical devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. The Centers for Medicare & Medicaid Services (CMS) has been charged with implementing the Sunshine Act and has called it the Open Payments Program.
As part of this program, manufacturers are now required to submit reports on payment, transfer and ownership information. Physicians have the right to review their reports and challenge reports that are false, inaccurate or misleading. However, the timeframe for initiating disputes and having data corrected or publicly marked as disputed is extremely limited. Key steps and dates are below. Access the AMA's full Sunshine Act toolkit for additional information.
Questions? E-mail CMS' Open Payments Help Desk at firstname.lastname@example.org or call (855) 326-8366
Step 1: Complete CMS e-verification process today
CMS requires a two-phase registration process. In phase 1, which is now open, physicians complete CMS' e-verification process via the CMS Enterprise Portal (EIDM). Access detailed instructions at AMA Wire®.
Step 2: Register with CMS' Open Payments system
Once physicians have completed Step 1 and gained access to EIDM, physicians can move onto phase two and register in CMS' Open Payments System via EIDM. Access detailed instructions at AMA Wire.
Step 3: Review and dispute data by Aug. 27*
Physicians can request their individual report, review it and flag disputes after completing Step 2. CMS has indicated that it will not resolve disputes, but errors can be reported to manufacturers through the Open Payments System or directly through Open Payments contacts listed on most manufacturer websites. Access detailed instructions at AMA Wire.
*Physicians must initiate disputes by Aug. 27 to have potentially erroneous data flagged in the initial public release. Physicians can still initiate disputes on 2013 data until Dec. 31, 2014, but it will not be flagged in the public database until 2015.
Other important dates:
Sept. 30: Data released publicly
CMS publishes majority of data including physician-specific information
Dec. 31: Last day to file dispute for 2013 report data
This is the deadline for initiating a dispute of incorrect data reported for transfers made and ownerships held in 2013. If a physician waits until after data has been made public to initiate a dispute, the data will not be marked as disputed in the public database until the agency updates the information, which could be six months to a year later.
To learn more about what is being reported, who has to report, what categories are being reported and more, visit the AMA's Sunshine Act Frequently Asked Questions Web page. The AMA's full Sunshine Act toolkit also provides more in-depth information. You can also access a printer-friendly Sunshine Act brochure.
Access the AMA's full Sunshine Act toolkit for information on the AMA's position on the Sunshine Act and related advocacy.
Download a free smartphone app to track reportable transfers. Compatible with Apple® and Android platforms, "Open Payments Mobile for Physicians" is available through the Apple Store and Google Play® Store. A number of security features protect the privacy of the captured data, which will be stored on one device and cannot be backed up to a cloud or other devices. Physicians should also urge their industry contacts to use the app so they will be able to capture the necessary information to ensure accurate reporting.