Physician Payments Sunshine Act (Open Payments Program)

By Susan E. Sedory Holzer, MA, CAE
SIR Executive Director

Here Comes the Sun. (Sunshine Act, that is.)

By now, you have likely read or heard something about the Physician Payments Sunshine Act. Passed as part of the Patient Protection and Affordable Care Act in 2010, the Sunshine Act is designed to bring transparency to financial relationships that the drug and device industry have with physicians and teaching hospitals.

The burden of this law falls mainly to the manufacturers of drugs, devices, and biologicals that participate in U.S. federal health care programs and to group purchasing organizations (GPOs), who are now required to collect and report on selected financial interactions (like research funding, meals, honoraria, or travel reimbursement) between the company and individual physicians. The Act requires manufacturers and GPOs to report ownership interests held by physicians and their immediate family members. The Centers for Medicare and Medicaid Services (CMS) have developed an Open Payments system for gathering and posting most of this information on a public website. And while there have been numerous delays in implementation, the annual cycle has officially begun, with the first public reports scheduled to be posted by September 30, 2014, and annually after that. Physicians are guaranteed a 45-day window of opportunity to review the reported data and an additional 15 days to dispute inaccuracies.

While neither you, nor SIR, are required to make reports to the government, SIR is committed to helping everyone navigate this law and how it will affect you. SIR has developed this webpage to help you stay informed about the Sunshine Act, which contains links to additional resources from the AMA and from CMS. As physicians, you should prepare yourself by understanding what interactions could appear on the public website. You also need to take advantage of the window that will be offered to you to review reported payments before they are posted publically, and be prepared to dispute any errors.

In some cases, payments made from manufacturers to physicians come indirectly through a professional organization like SIR or the SIR Foundation and will require reporting by the manufacturers. SIR and the SIR Foundation are committed to letting our members and attendees know in advance whenever an SIR or SIR Foundation activity could result in a report, so you have the opportunity to decide for yourself whether to participate. To some extent, though, all SIR educational meetings, involving applicable manufacturers or GPOs are impacted by the Sunshine Act.

SIR has also chosen to accommodate manufacturers exhibiting at the Annual Scientific Meeting by assisting in the data collection process. The bar coded badge system we have used for several years was expanded in 2013 to also include the National Provider Identification (NPI) number for meeting attendees who voluntarily submitted their numbers as part of the registration process. This allows companies who provide payments or other reportable items of value to obtain the data they need for accurate reporting. Our belief is that facilitating the accuracy of data reported is of significant benefit to our members and attendees. SIR will continue this process at SIR 2014 in San Diego.

Realistically, it will very rare for any physician to not have been the recipient of some monetary or in-kind support of $10 or greater from some company. For many, consultation and speaking fees, research grants, meeting support, etc. exceed the threshold by substantial amounts. Thus, the extent to which this kind of transparency will shed meaningful light on appropriate physician-industry relationships, or merely contributes to information overload, remains to be seen.

In the meantime, SIR is committed to updating you on any changes, clarifications and pending deadlines. Please feel free to contact us directly with your questions and concerns.