What is the “Sunshine Act”?
The Physician Payment Sunshine Act, section 6002 of the Affordable Care Act, consists of new federal regulations requiring manufacturers and distributors of drugs, medical devices, and biologicals to record and report any “transfer of value” to doctors or teaching hospitals in the United States and U.S. Territories. The official name of the government program is National Physician Payment Transparency Program: Open Payments.
What is the intent of the Sunshine Act?
The intent of the federal Sunshine Act and state sunshine laws are to promote transparency of financial interactions between physicians and manufacturers to patients. It is not designed to interfere with interactions that benefit patients and the betterment of medicine and health care services, but is intended to ensure that the physician and manufacturer relationships are transparent.
How does this affect me?
A “covered recipient” under the Sunshine Act, is defined as 1. A doctor licensed to practice in the United States or 2. A teaching hospital receiving GME funds (Open Payments List of Teaching Hospitals 2020).
Certain “transfers of value” made to covered recipients by A dec, Inc. or other manufacturers or distributors of dental care products will need to be reported to the Centers for Medicare & Medicaid Services (CMS). This information will then be made public in September 2014 when CMS posts it on their public website. Doctors will be able to register on cms.gov (anticipated January 2014) to gain access from CMS to view their consolidated industry report using an online portal in April 2014. At that time physicians will have 45 days to view, dispute, and resolve any submission that seems inaccurate.
*Note: The federal Sunshine Act does not apply to dental students, dental hygienists, dental assistants, receptionists, office managers, nurses, lab technicians, etc.
What is a “Transfer of Value”?
A “Transfer of Value” is anything of value that is given to a covered recipient, their spouse or immediate family members by a manufacturer or distributor. For example: meals, gifts, travel, entertainment, education, and charitable donations made on their behalf.
Are there notable exceptions that are not reportable for the Sunshine Act?
1. Repairs, recalls, replacements of warranty items.
2. Discounts, rebates, and promotions.
How is A-dec, Inc. complying with the Sunshine Act?
A-dec, Inc. is making their best effort to be in full compliance with the Sunshine Act rules and regulations. It is the goal of each A-dec employee who interacts with a doctor or a teaching hospital to have open communication about Sunshine Act reporting requirements. Before a transfer of value is initiated, an A-dec employee will notify the recipient and explain reporting requirements. Any doctor or teaching hospital is welcome to opt-out of any transfer of value from A-dec, Inc.
When does this law go into effect?
CMS required data collection for the Sunshine Act to begin on August 1, 2013. The data for August-December 2013 will be reported by March 31, 2014 to CMS. CMS will post the data on their public website in September 2014.
Do I need to do anything?
If you have an NPI number (National Provider Identifier), update the information on the NPPES NPI Registry. CMS has identified the NPI number as the one unique identifier that they and industry will use to accurately report and aggregate information on individual doctors.
*Physicians receive an NPI number when they request reimbursement from Centers for Medicare and Medicaid Services (CMS). Manufacturers and distributors are required by law to submit this number when reporting a transfer of value.
Will information be reported to the IRS?
No. Manufacturers and distributors are required to submit reports directly to CMS annually (and select state government departments).
CMS will then aggregate the information on each physician and post it on a public. Please consult your tax advisor with any additional tax-related questions.
Who should I contact if I have more questions?
Talk to your local dealer, A dec Territory Manager, or email us at firstname.lastname@example.org.
OPEN PAYMENTS (Physician Payments Sunshine Act) official website