What Does the Federal Sunshine Act Mean for Massachusetts Physicians?

Vital Signs: November 2013

Mass. Law and New Federal Act Have Similar Goals

The federal Physician Payments Sunshine Act has now been in effect for several months. What does it mean for the average Massachusetts physician?

Under the Sunshine Act, part of the Affordable Care Act, the news rules are as follows: manufacturers of drugs, devices, biologics, or medical supplies that participate in federal health care programs must report to the Centers for Medicare and Medicaid Services (CMS) any payments or “transfers of value” to physicians.

Those transfers include consulting and speaker fees, food, beverage, entertainment, travel, and lodging. Additionally, manufacturers and group purchasing organizations must disclose direct and indirect ownership and investment interests held by physicians and close family members. There are no gift bans or limits to the value of gifts that individuals can accept.

Exemptions to the federal reporting rule include educational materials and items used directly with patients; payments of less than $10 (unless the cumulative amount for an individual physician exceeds $100 per year); and samples intended for patient use.

Manufacturers do not have to track items such as pens, notepads, or meals that are provided at largescale events, so Massachusetts physicians will not see signs admonishing them to refrain from eating bagels ― a common sight at conferences before the state’s 2008 gift ban and disclosure act was relaxed.

Physicians don’t have to do any reporting; however in January 2014, CMS will launch an online portal for physicians to sign up to receive alerts when their financial disclosures are ready for review and correction.

At some time between April and August 2014, physicians’ personal reports will be ready to review. They have 45 days for review and another 15 days to resolve any disputes before the information is made public. The majority of the information in the disclosure reports will be available on a public, searchable website.

How to Ensure Your Report Is Accurate

If you have reason to expect that you may show up in the reports, the AMA suggests you take several steps to ensure accurate reporting. They include:

  • If you have a National Provider Identifier (NPI) number, make sure that the information in the NPI enumerator database is current because it will be used by manufacturers to confirm they have identified you correctly. You want to guard against being assigned payments made to another doctor ― something that could happen especially if you have a common name.
  • Make sure that financial and conflict-of-interest disclosures required by your employer or other entities that provide your funding are updated regularly. These entities may compare their information to what is posted on the public website.
  • Learn what financial transfers and ownership interest must be reported. Understand what exemptions apply and when indirect transfers (those not made directly to a physician) are reportable.
  • Ask industry representatives to allow you to review reportable transfers before they report them to catch errors early.

Public Access to Information

Massachusetts law and the federal Sunshine Act have similar goals: providing the public with information about the financial interactions between physicians and the industry. Where the two laws overlap, the more stringent one applies. Does the federal law alter anything in the Massachusetts law? “There has been no indication that the state plans to change its reporting program in light of the new federal law,” according to MMS General Counsel Charles Alagero.

For some physicians though, there will be new considerations. “If you think, for example, that you’ re going to be speaking at many events and accrue a lot of speakers’ fees, then you should consider familiarizing yourself with the nature of the data that is being reported and then tracking your payments,” said Alagero. “But remember that the onus of complying with the new law is on the drug and medical devices industries.”

― Vicki Ritterband

More resources on the Sunshine Act are available at www.massmed.org/sunshine.

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