On February 1, 2013, the Centers for Medicare and Medicaid Services (CMS) issued its long-awaited final rule regarding the implementation of the physician payment sunshine provisions of the Affordable Care Act. Significantly, the final rule sets out new dates for manufacturers and other entities’ initial collection of data and submissions to CMS. Specifically, CMS states that applicable manufacturers and group purchasing organizations (GPOs) must begin to collect the required data on August 1, 2013 and report the data to CMS by March 31, 2014. CMS will publish the data on a searchable website by September 30, 2014. In addition, the rule provides details, clarifications and definitions for key aspects of the reporting scheme, responding to the 337 public comments CMS received in connection with the proposed rule.
The rule finalizes requirements for applicable manufacturers to report annually certain payments or other transfers of value to covered recipients, namely physicians and teaching hospitals. The rule defines key terms, such as “applicable manufacturer” and “covered drug, device, biological and medical supply.” It also clarifies how certain types of payments ─ including research payments and payments provided to a covered recipient through a third party ─ should be reported and finalizes which transfers of value should be excluded from the reporting requirements.
This chart [http://www.arnoldporter.com/public_document.cfm?id=21900&key=1A0] provides more detailed information on key aspects of the rule, including comparisons between the proposed and final rules and brief summaries of CMS’ stated rationale for its decisions. We hope the attached chart is useful to our clients and friends as they evaluate the rule’s requirements and implement their physician payment tracking systems.