The federal Physician Payment Sunshine Act (Section 6002 of the Patient Protection and Affordable Care Act) requires applicable manufacturers of drugs, devices, biologics or medical supplies and applicable group purchasing organizations to report to the Centers for Medicare & Medicaid Services (“CMS”) certain payments and transfers of value to physicians or teaching hospitals. CMS recently concluded its initial collection of disclosures from applicable manufacturers and GPOs and is preparing to make those disclosures public on September 30, 2014 through an on-line database. The on-line database is part of CMS’s Open Payments system.
Before the Open Payments database is made public, the Sunshine Act grants physicians and teaching hospitals (referred to as “Covered Recipients”) the opportunity to review, dispute and submit corrections to the information submitted about them by applicable manufacturers and GPOs. CMS recently opened the Open Payments registration process for Covered Recipients, and the review and dispute period runs through August 27, 2014.
In order to register for this purpose, physicians and teaching hospitals must establish an account in the CMS Enterprise Portal (the Enterprise Identification Management system, or “EIDM”) and register with the Open Payments system. CMS warns that the establishment of an EIDM account can take some time, as it involves an extensive identification verification component. As such, physicians and teaching hospitals are encouraged to start the process well before the August 27, 2014 close of the review and dispute period. Information about registration can be found here for physicians and here for teaching hospitals. Registration is voluntary, but it is required if a Covered Recipient wants to review and possibly dispute the data.
Given the public nature of the Open Payments database, reviewing and, where appropriate, disputing information is extremely important. Once a dispute is logged, the Covered Recipient can work cooperatively with the reporting manufacturer or GPO to resolve the dispute and correct the information. However, if the cooperative resolution process is not successful, the Open Payments database will publicly identify that the report is disputed.