Sunshine Act/CMS Reports

Physician Payments Sunshine Act ("Open Payments")

The Physicians Payments Sunshine Act ("Open Payments") was implemented in 2013 as part of the Affordable Care Act to ensure transparency between physicians and industry. Manufacturers of drugs, medical devices, and biologicals track and report to the Centers for Medicare & Medicaid (CMS) payments and items of value (>$10) given to physician and teaching hospitals. In addition, manufacturers and group purchasing organizations must report certain ownership interests held by physicians and their immediate family members. The industry reports is available to the public on a searchable, public website provided by CMS. Reports become available by the end of June every year.

The Sunshine Act Defines Physicians as the Following Types of Professionals:

• PHYSICIANS*
  • Doctor of Medicine (MD)*
  • Doctor of Osteopathy (DO)
  • Doctor of Dentistry (DMD/DDS)
  • Doctor of Dental Surgery
  • Doctor of Podiatry
  • Doctor of Optometry
  • Doctor of Chiropractic Medicine
• Physician Assistants
• Nurse Practitioners
• Clinical Nurse Specialists
• Certified Registered Nurse Anesthetists
• Anesthesiologist Assistants
• Certified Nurse Midwives

*Medical residents are excluded from the definition of physicians for the purpose of the Sunshine Act.

Applicable Manufacturers are Required to Categorize All Reportable Payments as the Following:

• Consulting fees
• Honoraria
• Education
• Research
• Royalty or license
• Compensation for services other than consulting, including serving as faculty or as a speaker at an event other than through a continuing education program
• Compensation for serving as faculty or as a speaker for an unaccredited or non-certified continuing education program
• Compensation for serving as faculty or as a speaker for an accredited or certified continuing education program
• Gifts
• Entertainment
• Food and beverage
• Travel and lodging
• Charitable contributions
• Current or prospective ownership or investment interest
• Grants
• Space rental or facility fees (teaching hospitals only)

What UNM Physicians Need to Do:

• Register in the CMS website in order to view and potentially correct your payment records prior to publication
• Ensure that your Conflicts of Interest Disclosures are accurate and up-to-date. Check your status here. 
• Discuss with and acquire written approval from your department chair when considering outside consulting relationships with pharmaceutical/biomedical/device companies
• Be sure to read any email updates sent by the HSC COI Office that have the subject "Sunshine Act"

Sunshine Act Reporting

The CMS website provides a report once per year at the end of June. Data collected from the previous year (January through December) is published in the annual reports. HSC personnel can review their information and dispute reporting errors, but this can only occur in a specific time frame. Disputes may be submitted from April 1 – May 15 to request corrections prior to publication of reports. Industry entities will have until May 30 to submit corrections prior to publication. Information which is still under dispute at the time of publication will still be listed in the report. Disputes may also be submitted from May 15 – December 31 of the calendar year in which the data was first published and any changes will be published during the data refresh the following January.

Important Links

• The Open Payments - Centers for Medicare & Medicaid Services website will keep you informed of the latest developments. You can also sign up for email updates about Open Payments from this web page.
• The Physician Fact Sheet and the Physician Publication provide additional information about Open Payments.
• You can submit dispute requests for data on the Review and Dispute page on the CMS site.
• Questions concerning Open Payments can be emailed to CMS here.

Free Mobile Apps

Free mobile apps are available to track your own payments from the healthcare industry. They can be downloaded from the Google Play or the Apple app store. Search for Open Payments Mobile for Physicians. This does not interact with the CMS systems or CMS contractors but it allows you to compare this information with information about you provided to CMS. Additional information regarding the Open Payments app is available here.