What is the Open Payments Act (or Sunshine Act)?

In order to increase transparency of financial relationships between industry and providers, a law, known as the Open Payments Act or Sunshine Act, was enacted. The law requires “Applicable Manufacturers” and “Group Purchasing Organizations” to collect and report payments made to physicians beginning to Centers for Medicare and Medicaid Services (CMS). The law also requires that CMS make this information available on a public website.

What kinds of payments will be reported to CMS and for what period?

Per the Act, direct and indirect payments and transfers of value in the form of cash, in-kind items or services, stock, stock options or any other ownership interest, dividend, profit, or other return on investment must be reported.  The nature of the payment will also be reported based on the following categories:  

  •   Consulting fees

 

  • Compensation for services other than consulting
  •   Honoraria

 

  •    Gift
  •   Entertainment
  •    Food
  •    Travel (including destination)
  •   Education
  •    Research
  •   Charitable Contribution 
  •   Royalty or License
  •    Current or prospective ownership or investment
  •   Direct compensation for service as faculty or as a   speaker for a medical education program
  •    Grant
  •  Any other nature of the payment or other transfer   of value

What will be reported to CMS about me?

  •   Name
  •   Business Address
  •    NPI

 

  •   Date of Payments
  •  Context of Payments
  •  Related Covered Product
  • Form of Payment and Nature of Payment (see above)

 

 

 Why should I care about what is reported about me?

This information will be posted for public viewing and CMS is encouraging patients to discuss these relationships with these physicians.  Your patients may have questions that have been made to you about your research, speaking engagements, consulting etc. with industry and you should know what was reported and posted.

In addition to the possibility that the information reported could simply be erroneous (not made to you, wrong amounts, etc.), there may be unintended consequences as a result of this information being gathered such as third-party scrutiny by patient advocacy groups and the press.  

What do I need to do to see the reported payments?

Physicians and authorized representatives for teaching hospitals must register both with the CMS Enterprise Portal and then with Open Payments. A couple of key points:

  • You do not need to wait for April 1st to register in the system. CMS encourages physicians and authorized representatives for teaching hospitals to register now, so that you can go directly to the Open Payments review and dispute page April 1.
  • If you have previously registered in these systems but have not logged in within 180 days, the account will be inactivated and you should call the support desk to reinstate the account.
  • Here is the contact information for the Help Desk: For live assistance, call Help Desk Support at 1.855.326.8366, Monday through Friday, from 8:30 a.m. to 7:30 p.m. (EST), excluding Federal holidays, or send an email to Openpayments@cms.hhs.gov

What should I do if a reported payment is inaccurate? 

  • You must note the dispute directly in the Open Payments system, which will alert the manufacturer of the dispute.
  • As a result of feedback from many of you, CMS has revised the dispute display to show contact information for the person at the company who is responsible for resolving the disputed payment. When disputing a payment, or if you have questions about a reported payment you should note this contact information.
  • CMS strongly encourages individuals to include their own contact information in the comments with the disputes to facilitate rapid resolution of the dispute. 

Information on how to access the Open Payments Portal can be found on the CMS Open Payments Physician Page or by using the EVMS Open Payments Portal Quick Access Page.

Additional questions should be directed to the EVMS Medical Group Compliance Office at 757.451.6200.