Sunshine Act: Payment Data to be Published September 30; MSNJ Objects to Timing & Dispute Resolution Process

The Sunshine Act requires that transfers of value in the amount of $10 or more from the pharmaceutical industry to physicians be tracked and reported by the industry in a database that will soon be made public. MSNJ supports transparency but has a long history of objecting to this requirement believing that the administrative burden on physicians of tracking and verifying the di minimis value of a lunch outweighs the usefulness of this reported data to the public. MSNJ’s delegation to the AMA will advocate that the threshold reporting amount be increased to $100 at the AMA Annual Meeting in Chicago this week. Meanwhile, implementation of the program dubbed the “Open Payments Program” continues:

  • Step 1: Beginning June 1 physicians were able to register in CMS’s Enterprise Portal;
  • Step 2: Beginning in July physicians must take the second registration step to register in the Open Payments system (via the CMS Enterprise Portal)
  • Step 3: Once the information is available, physicians will have a 45 day period to review and dispute the payment information
  • Step 4: On September 30 the public will be granted access to the database.

Physicians will only have 45 days to review and to attempt correction of any reporting errors. Under the final rule on plan implementation, physicians and the industry would then have an additional 15 days to resolve disputes or the payment at issue would be flagged as “disputed.”  However, CMS and the Office of Management & Budget (OMB) have proposed that industry be allowed to unilaterally dismiss physician disputes; the payment amounts at issue would be reported without a dispute flag. MSNJ objects to the proposal that would allow industry to unilaterally dismiss a dispute. On June 2 MSNJ filed comments with CMS asserting that the proposal contradicts the final implementation rule and violates physicians’ due process rights. We further urged CMS to delay release of the database to the public for at least six months to give physicians more time review the reported payments.

Physicians are urged to take the above two registration steps and to begin reviewing payments attributed to them as soon as possible. This will be a challenge because physicians will be seeing this data for the first time. Physicians are urged to participate in CMS’s webinar on June 12 that will further explain the process. Register online. MSNJ has developed a webinar with Jennifer Searfoss, Esq., a nationally recognized healthcare attorney and practice management consultant, who will describe the program, and its pitfalls, on June 19. Register online.

View more resources on Open Payments.

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About MSNJ

Founded in 1766, the Medical Society of New Jersey is the oldest professional society in the United States. The organization and its dues-paying members are dedicated to a healthy New Jersey, working to ensure the sanctity of the physician–patient relationship. In representing all medical disciplines, MSNJ advocates for the rights of patients and physicians alike, for the delivery of the highest quality medical care. This allows response to the patients’ individual, varied needs, in an ethical and compassionate environment, in order to create a healthy Garden State and healthy citizens.

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