Centers for Medicare & Medicaid Services (CMS) Conducts First Call on Physician Payments Sunshine Act Implementation

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In anticipation of the start of data collection under the Physician Payments Sunshine Act, the Centers for Medicare & Medicaid Services (“CMS”) continues to issue guidance on data collection and reporting in an effort to address the many questions being asked by affected parties.  As discussed in previous posts, applicable manufactures (“Manufacturers”) and group purchasing organizations (“GPOs”) must begin collecting data on payments and other transfers of value given to physicians and teaching hospitals as of August 1, 2013, and initial reports are due to CMS by March 31, 2014.

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To educate affected parties about the Open Payments Program, CMS is holding a series of National Provider Calls.  The first call took place last week.  Those who missed the call can access the slide presentation on CMS’ website, and CMS plans to post an audio recording and transcript at a later date.

Although the intended audience for the call was physicians and teaching hospitals, CMS addressed a number of issues of interest to Manufacturers and GPOs.  The presentation consisted mostly of a summary of the Sunshine Act’s requirements, but CMS also provided high-level guidance on issues such as indirect payments and offered a series of examples of how transfers of value might flow between a Manufacturer and a physician or teaching hospital.

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CMS fielded questions at the end of the call.  Some concerned issues that are currently vexing many Manufacturers, such as whether reprints of material provided to physicians have any value and, if so, what that value might be.  And one participant asked CMS to address whether medical devices used to conduct a covered test or procedure (e.g., an x-ray machine) are considered covered products.  CMS declined to answer these and a number of other questions but noted that it is developing guidance on these and other issues that will be published on the Open Payments website.

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Afftected parties also should be aware that CMS recently issued the list of teaching hospitals for 2013 and published answers to some frequently asked questions.  Currently posted questions and answers provide guidance on speaking fees at CME programs, transfer of value to group physician practices, and indirect payments, among other topics.

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