A teleconference was held today by the Centers for Medicare & Medicaid Services (CMS) regarding the National Physician Payment Transparency Program, also known as Open Payments.  The CMS Open Payments system implements the requirements of the Physician Payments Sunshine Act, section 6002 of the Affordable Care Act.  The objective of the teleconference was to provide physicians and teaching hospitals with an update on program policy, focusing on third party payments, indirect payments, and the Physician Resource Toolkit.  The presentation used by CMS is available here.  CMS plans to make the transcript and audio from the meeting available on its website.

“Third party payments” were described by CMS as payments or other transfers of value provided to a third party at the request of or designated on behalf of a physician or teaching hospital.  CMS further described “indirect payments” as payments or other transfers of value made by a manufacturer or GPO to a physician or teaching hospital through an intermediary where the manufacturer or GPO requires, instructs, directs, or otherwise causes the third party to make the payment.  CMS then provided several examples of how these types of payments will be reported to CMS by manufacturers and GPOs.  CMS noted that information about the third party recipient will be reported, but information regarding the intermediary providing an indirect payment or transfer will not be reported.

CMS recommended that physicians and teaching hospitals register with CMS in order to receive notifications, review information submitted by manufacturers and GPOs, and dispute incorrect data.  This registration is voluntary and will start early in 2014.  Additionally, physicians and teaching hospitals should plan to review and, if necessary, dispute incorrect information beginning in the second quarter of 2014.  Disputes may be initiated anytime through the end of the calendar year.  Data that has been disputed but are unresolved will be posted on the CMS website, but noted as disputed.  

CMS further emphasized the significant resources that it is creating to assist physicians and teaching hospitals regarding the Sunshine Act.  For example, CMS has a webpage and fact sheets specific to physicians and teaching hospitals, two continuing medical education modules related to the Sunshine Act available through Medscape, and brochures for physicians and patients regarding Open Payments.  In addition, CMS has made mobile applications available for physicians and industry to assist with tracking payments and transfers of value.

During the teleconference question and answer session, CMS stated several times that additional frequently asked questions (FAQs) are forthcoming and encouraged participants to submit questions to CMS Help Desk (openpayments@cms.hss.gov).  CMS also stated that it is considering additional rulemaking to address a few issues related to the Final Rule, including the exclusion requirements related to accredited continuing medical education.

Posted by Cooley

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