On February 1, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited final rule implementing the physician payment transparency provisions, commonly referred to as the Physician Payment Sunshine Act, in the Obama administration’s 2010 health care reform legislation. The Sunshine Act joins the list of significant federal laws addressing potential conflicts of interest in health care, including the Anti-Kickback Statute and the Stark Law. With implementation of the Sunshine Act now in sight, stakeholders face the real challenge of complying with, and practicing under the shadow of, the Sunshine Act and its complex and detailed regulations.
The Basics
The Sunshine Act requires "applicable manufacturers" of drugs, devices, biologicals or medical supplies covered under Medicare, Medicaid or CHIP to report annually to the CMS certain payments or other transfers of value to "covered recipients," namely physicians and teaching hospitals. Additionally, applicable manufacturers and applicable group purchasing organizations (GPOs) must report certain information regarding the ownership or investment interests in them that are held by physicians or their immediate family members. The CMS will make the data submitted publicly available via a website.
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