School of Dentistry Compliance is working to provide accurate and up-to-date information for faculty and researchers about the Sunshine Act Open Payment system. There may be times when the most recent information is only available on the CMS website.
The Sunshine Act Open Payment review and dispute period for 2014 began on April 6, 2015 and ended May 20, 2015. The review, dispute and correction process allows physicians/dentists and teaching hospitals to review and initiate any disputes regarding the data reported about them by applicable manufacturers and applicable GPOs before CMS makes the information public on June 30, 2015.
There will be a 45-day period “following initial availability of the Open Payments system [to] review, dispute, and correct data submitted by industry.”
What is the Sunshine Act Open Payments Program?
Physician Payment Sunshine Act (“Sunshine Act”) is a provision of the Affordable Care Act. By law, starting in 2014 a publicly available federal website, “Open Payments” will display information about payments and other “transfers of value” (defined below) from manufacturers to individual doctors (defined as MD, DO, DD/DDM, DDS, DPM, OD and DCP 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/dentists, as defined above.)
According to CMS: “Open Payments is a national disclosure program that promotes transparency by publishing the financial relationships between the medical industry and healthcare providers (physicians/dentists and hospitals) on a publicly accessible website developed by CMS.”
Individual physicians/dentists will be responsible for checking their information posted on the site and for contacting manufacturers to address any discrepancies.
What Should School of Dentistry Faculty do?
We strongly encourage all of our physicians/dentists to register with CMS so as to receive notifications when CMS receives a payment report on the individual. Physicians/dentists will need to register to review their data.
Individuals will be identified using their NPI number, so this information is needed for registration. Please be advised that during registration it is our understanding that you need to have your NPI as well as your taxonomy code(s) (which CMS is calling a specialty code).
Individual physicians/dentists will be responsible for reviewing the accuracy of reported data and addressing any discrepancies.
We advise all of our physicians/dentists to keep thorough documentation for all outside activities involving industry in case you need it to dispute information posted in the Enterprise Portal. It is unclear for how long CMS will keep open any disputes, so we recommend that you maintain records for at least five years.
After registration, individual physicians/dentists can appoint one delegate to monitor records on the CMS website. According to the AAMC, “physicians/dentists can appoint a delegate and those delegates must also register and accept their role before they can review a physician’s/dentists’ data.”
Whose Information Does it list?
Only MDs and other providers, such as those with a DO or DDS. Posting will NOT include residents, fellows or other providers, such as NPs.
Reviewing: Physicians/dentists will need to register with the site to preview their own information and, if needed, work with manufacturers to correct payment information.
Disputes: Physicians/dentists are responsible for correcting their own information, if needed. See below.
Please note, there have been reports of problems reviewing individual’s information. Open Payments portal website is managed by CMS. For problems, please reach out to CMS directly by email to firstname.lastname@example.org or by phone at 855-326-8366.
What Information will the Federal Website Contain?
Payments to individuals will be listed by the physician’s/dentist’s name. Payments will not be listed by the physician’s/dentist’s place of employment or appointment. Sponsored research will be listed by institution and will name individual PIs, also possibly investigators (TBD).
Reporting: Payments must be reported by industry to the Centers for Medicare and Medicaid Services (CMS). Information posted will include detailed information about payments and other “transfers of value” worth over $10 from manufacturers to physicians/dentists at teaching hospitals.
Categories of Payment and Transfers of Value: Manufacturers will cover companies that manufacture drugs, devices, biologicals or medical supplies and are required to provide a category for the services rendered. There are 14 categories of payment and transfers of value to physicians/dentists including: consulting fees, compensation for speaking or other services, travel, food, entertainment, gifts, honoraria, royalties or licenses, charitable contributions, education, current or prospective ownership or investment interest, etc. (Information about research grant reporting is available below.) According to AAMC, “any payment or transfer of value that does not fit into one of the other categories noted above is considered a gift… Examples might include office supplies, journal reprints, textbooks, editorial services, and scientific posters, if they did not fit into another category.”
Types of Payment: Manufacturers are required to categorize how the recipient received the payment (such as cash or cash equivalent, in-kind items or services, or stock, stock option(s), or any other ownership interest, dividend, profit, or other return on investment).
Indirect Payments: Manufacturers must collect and provide information about indirect payments as well as payments made directly to physicians/dentists. For example, if a physician/dentist 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/dentist.
Research support: Physicians/dentists who are investigators on research supported by manufacturers will be listed in connection with the research payments to the institution, even if payments for research are made to the institution. These payments will be reported on a separate research reporting section of the web site.
Ownership: Manufacturers as well as GPOs are required to report on interests held by physicians/dentists and their immediate family members. Ownership or investment interests in publicly traded security and mutual funds are excluded.
What Information will be Excluded?
Payments to physicians/dentists for serving as faculty or speakers for accredited Continuing Medical Education activities are generally not included. Exclusions also include, buffet meals, product samples, educational materials for patients, short-term loaned medical devices, items worth less than $10.
Additional exclusions are listed in the FAQs in the AMA Toolkit for Physician Financial Transparency Reports (Sunshine Act).
How to Pre-review Your Information?
Physicians/dentists will need to register with the site to preview their information and, if needed, work with manufacturers to correct payment information.
Please note, you must register before you can review your information. According to the AAMC, “physicians/dentists have no reporting obligations under this regulation but should consider reviewing the reported information before it becomes public.”
You will only be able to view what has been reported about you if you have registered. If you haven’t already registered, gaining access to your information is a two-step process. You can register at the CMS website.
How to Dispute Your Previewed Information?
Individual physicians/dentists will be responsible for contacting manufacturers to address any discrepancies.
CMS has established specific deadlines for the processes of reviewing, disputing and correcting individuals’ information.
Information about and dates for the review, dispute and correction processes are available at the CMS website
According to CMS, “applicable manufacturers and applicable GPOs should work with the disputing physician or teaching hospital to correct disputed data. Applicable manufacturers or applicable [business] must send CMS a revised report to make the corrections and re-attest to the updated data.”
CMS has stated that it “will not mediate any dispute.”
Once CMS establishes the online portal, physicians/dentists will be encouraged to sign-up to receive direct notice when the reports are made available to physicians/dentists prior to CMS posting on the public website.
Want More Information?
To receive updates from CMS, you may register for the listserv by emailing OPENPAYMENTS@cms.hhs.gov
Faculty providers who have questions about faculty disclosure requirements may contact School of Dentistry Compliance at email@example.com or 206-543-5331.
The information listed here was obtained from CMS (accessed 6/4/2015).