A blog by attorneys for anyone interested in or affected by The Sunshine Act.

CMS Delivers Sunshine Act Annual Report to Congress

June 25, 2015
Ruselle W. Robinson

The Secretary of the Department of Health and Human Services has delivered the agency’s 2014 Annual Report on the Sunshine Act/Open Payments Program to Congress.  The Report, which is required under the Affordable Care Act, describes highlights of the first year of Sunshine Act data gathering and reporting.  The Report focuses on CMS’ successful publication of 2013 data submitted by applicable manufacturers and applicable group purchasing organizations (GPOs), and pays scant attention to the difficulties CMS encountered during the months leading up to publication.

Here are a few of the highlights the Secretary references in the Report:

  • Publication on September 30, 2014 of data records containing payments valued at nearly $3.5 billion in payments and transfers of value made to physicians and teaching hospitals during the 2013 reporting year (which included only the last five months of calendar year 2013).
  • Development of the Validated Physician List, which CMS made available on October 30, 2014 to applicable manufacturers and applicable GPOs. The Validated Physician List is a non-public list of physician identifier information for physicians named in 2013 reported data.
  • Publication on December 19, 2014 of a data refresh which included an additional 68,000 data records from the 2013 reporting year.

CMS developed the Validated Physician List to correct a problem that surfaced during the reporting period for 2013 data—mismatches of physician identifiers between the payment data submitted by reporting entities and CMS sources of physician information.  In order to maintain the published data’s integrity, CMS posted many 2013 data records as de-identified, which meant the reporting entity (applicable manufacturer or applicable GPO) and the payment value were published, but the physician recipient was not identified because the physician’s identity could not be confirmed.

Appendix B takes up more than half of the Report.  Appendix B lists, in alphabetical order, applicable manufacturers and applicable GPOs that submitted data reports for the 2013 reporting year.  Appendix B also includes, for each reporting entity, the aggregate dollar amount reported (broken down into reporting categories (e.g., research payments)), the number of transactions, the number of physician recipients and the number of teaching hospital recipients.

You can access the report here:  http://www.cms.gov/OpenPayments/Downloads/Open-Payments-April-2015-Report-to-Congress.pdf

CMS will publish 2014 data on June 30, 2015.  I will report on the 2014 data in my next post.

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