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Topic: Transparency

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CMS releases Open Payments data refresh

This week, the Centers for Medicare and Medicaid Services (CMS) published a refresh of its Open Payments dataset, which includes new data to account for the result of disputes and other data corrections since the last refresh in June 2016. Note that this release does not yet include 2016 data, which should be published in … Continue reading

Stay tuned – CMS plans to consider public comments received on the Sunshine Act

CMS announced that the agency “will consider the public  comments received [on the Open Payments / Sunshine Act program] in the future through possible rulemaking or publication of subregulatory guidance” in the recently released “Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2017.” But for now, CMS … Continue reading

2015 CMS “Open Payments” data released

Last week, CMS posted the 2015 Open Payments data to its website, as well as updated payment records for 2013 and 2014.  Overall, manufacturers reported $7.52 billion in payments and ownership interests to 618,931 physicians and 1,116 teaching hospitals in 2015.  Nearly 1,500 companies reported making payments in 2015, comprising a total 11.9 million records.  … Continue reading

Healthcare leaders offer insights into US and Australia transparency

Pharma in Focus recently interviewed Rick Robinson, Norton Rose Fulbright’s global co-head of life science and healthcare, and his Australian colleague and Norton Rose Fulbright partner Bernard O’Shea. According to Robinson, greater transparency in reporting – just arrived in Australia – will likely have a “dampening” effect on payments and transfers of value to healthcare practitioners.  O’Shea … Continue reading

Not just physicians? Bill seeks to expand Sunshine Act to PAs and NPs

A bipartisan Senate bill (S. 2153) introduced this week would expand reporting obligations under the Sunshine Act / Open Payments program to cover payments or other transfers of value provided to physician assistants and nurse practitioners.   Right now, pharmaceutical and device manufacturers report on only their physician financial relationships, which could give rise to … Continue reading

CMS releases 2014 Sunshine Act data

On schedule, CMS released the 2014 Sunshine Act data, which shows $6.49 billion in transfers of value by pharmaceutical and medical-device manufacturers to physicians and teaching hospitals.  The data covers 11.4 million financial transactions attributed to over 600,000 physicians and more than 1,100 teaching hospitals. Join us on July 8 or July 14 for a … Continue reading

Government gears up: Sunshine data informs investigations and inquiries

This week at an enforcement panel, government representatives discussed using the Sunshine Act data to delve into allegations of kickbacks to doctors and detect industry trends of improper behavior. During the American Conference Institute’s 7th Annual Forum on Sunshine Act Compliance & Aggregate Spend Reporting, government representatives recognized that industry payments to physicians may be … Continue reading

Data refresh: CMS releases 2013 hospital and physician payment information

CMS has released data sets showing payments to hospitals and physicians for calendar year 2013: the same calendar year as the Sunshine Act data released last fall.  As a result, various sources will have contemporaneous data that could be used to suggest links between industry payments to healthcare providers and their practices, or to otherwise … Continue reading

Pharmaceutical Cost Transparency Act of 2015 introduced in the New York State Senate

Under the auspices of increased transparency, on May 13, 2015, state senator Ruben Diaz (D-NY) introduced the “Pharmaceutical Cost Transparency Act of 2015” [Bill 5338] to the New York State Senate. The legislative intent is “to make pharmaceutical pricing as transparent as the pricing in other sectors of the health care industry.” If passed, the … Continue reading

CMS releases data on nationwide drug prescribing patterns

Yet another set of data for your risk analysis: on April 30, 2015, the CMS released a 23-million record data set from Medicare’s Part D Prescriber Public Use File. While other CMS data sets have focused on provider remuneration (whether paid by manufacturers or Medicare itself), the Part D data focuses on physicians’ and other practitioners’ prescribing … Continue reading

Broad interpretation of France’s Sunshine Act continues global trend toward transparency

Beyond the United States’ Physician Payments Sunshine Act reporting requirements, international pharmaceutical and device companies must account for a growing number of transparency requirements related to their interactions with healthcare professionals. For example, in France, the Bertrand Act requires transparency related to: (1) the agreements between companies and healthcare professionals (HCPs) and (2) any benefits, … Continue reading

Sunshine data submitted; 45-day review-and-dispute period begins April 6

Physicians and teaching hospitals can begin reviewing the Sunshine Act data attributed to them by applicable manufacturers on Monday, April 6. The 2014 data – the first full year of reported data –  was due on March 31.  Physicians and teaching hospitals can register in both the CMS Enterprise Portal and the Open Payments system to review … Continue reading

Sunshine Act data submission / correction begins today

Starting today, applicable manufacturers and GPOs can begin submitting data about Sunshine Act payments and transfers of value for the 2014 calendar year, according to a listserv email from CMS. Applicable manufacturers and GPOs can also submit corrected 2013 data, as needed, until the March 31, 2015 deadline for data submission. Physicians and teaching hospitals … Continue reading

Top things you should know about the Sunshine Act database

The shifting guidance on whether the industry should report mere funding of educational events, the likely enforcement ahead by federal and state agencies, and maps showing the “hotspots” of consulting, food and beverage, and travel and lodging payments: here’s what you should know now about the Sunshine Act / Open Payments database. The indirect-payment exclusion … Continue reading

Although CME exclusion no longer available, broader approach may apply for Sunshine Act reports

CMS has finalized four revisions to the Sunshine Act (Open Payments) regulations as part of the 2015 Medicare Physician Fee Schedule Final Rule. These revisions are effective as of October 31, 2014, and will be implemented for the 2016 program year, with reporting to CMS in 2017. Importantly, CMS has removed the exclusion for continuing … Continue reading

CMS returns payment records for review and correction

Entities that submitted Sunshine Act reports are now able to review and correct the 2013 “Open Payments” records returned from the intermingled data fix that resulted in CMS withholding a significant portion of the data.  The agency expects the corrected intermingled data—which accounts for approximately a third of the Open Payments database – to be … Continue reading

Healthcare leaders talk transparency in the US and Australia

Pharma in Focus recently interviewed Rick Robinson, Norton Rose Fulbright’s global co-head of life science and healthcare and his Australian colleague  and Norton Rose Fulbright partner Richard Fogl. Discussing Australia’s drive for more transparency in the medical systems, both Robinson and Fogl caution within the article that “Australia should not ‘rush’ into a system of … Continue reading

Sunshine around the world

In the United States, the healthcare industry is familiar with the Sunshine Act’s tracking and reporting requirements related to payments and transfers of value to physicians, as well as to physician ownership and investment interests. And around the world, new rules and policies are seeking to increase transparency. For example, the Norton Rose Fulbright’s UK briefing, … Continue reading

Sunshine Act data now available

The “Open Payments” database of transactions reported under the Physician Payments Sunshine Act has launched on its scheduled release date of September 30 and is now available for public review. Pharmaceutical and medical-device manufacturers reported information about their financial relationships with physicians and teaching hospitals for the second half of 2013 to the Centers for … Continue reading

Sunshine data 33 percent unpublishable, penalties next?

Despite extending the dispute-and-resolution deadline to account for the days that the Centers for Medicare & Medicaid Services (CMS) pulled down the reporting system, the public Physician Payments Sunshine Act website is still expected to go live in a matter of weeks. It now seems, however, that CMS will publish only two-thirds of the reported … Continue reading

Changes proposed to Sunshine Act reporting would remove CME exclusion, may broaden availability of “indirect-payments” exclusion

On Friday, July 11, the Centers for Medicare & Medicaid Services (CMS) proposed potentially significant revisions to the federal Sunshine Act rules. Among other changes, CMS suggested eliminating the rule section that explicitly excludes certain continuing medical education (CME) speaker compensation from manufacturers’ transparency reports. The life-sciences industry had pushed hard for this exclusion prior to the … Continue reading

Phase 2 reporting opens June 1

By listserv message, CMS announced that applicable manufacturers and applicable group purchasing organizations (“GPOs”) can start Phase 2 of Open Payments registration and detailed data submission process on June 1. Phase 2 itself has two steps and Phase 2 closes on June 30, 2014: Step 1: Starting June 1 Applicable manufacturers and applicable GPOs must complete system registration and confirm … Continue reading
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