The Next Wave of Physicians’ Financial Information to Go Public on Horizon; Are You Prepared?


On April 9, the Centers for Medicaid and Medicare Services (CMS) began releasing payment data for services provided by physicians.  On September 30 physicians’ financials relationships with drug and medical device manufacturers will be made public as part of the Open Payments Programs (also known as the Sunshine Act).

The 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 program.

As part of this program, manufacturers are now required to submit reports on payment, transfer and ownership information. That information covers “payments or other transfers of value,” which include the transfer of anything value at $10 or more/$100 or more aggregate annual. Certain educational materials and in-kind items for charity care are excluded. The information includes the name and address of the physician; the amount and date of the payment; the form of the payment, such as cash or stocks; and the nature of the payment, such as consulting fees, gifts, or entertainment expenses. In addition, the companies and group purchasing organizations must provide information about ownership or investments interest held by physician owners or investors and members of their immediate families.

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.

Physicians already should have registered with the Centers for Medicare & Medicaid Services’ (CMS) Enterprise Portal; the first phase in a three-step process for data review. If you haven’t completed this step, do so NOW

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