PPACA “Sunshine” Rule Increases Transparency in Health Care
On February 1, the Centers for Medicare & Medicaid Services (CMS) announced the “Sunshine” final rule, also known as the “National Physician Payment Transparency Program: Open Payments” from the Patient Protection and Affordable Care Act (PPACA). The “Sunshine” Rule finalizes transparency and physician ownership provisions described in the PPACA.
The Rule’s purpose is to create greater transparency in the health care market, particularly by increasing the public’s awareness of financial relationships between medical manufacturers and health care providers. Increased transparency may help reduce possible conflicts of interest that physicians or teaching hospitals could face because of their relationships with manufacturers.
The provisions of the final rule require manufacturers of drugs, devices, and biological and medical supplies covered by Medicare, Medicaid, or the Children’s Health Insurance Program to disclose to CMS any payments or other valuable transfers made to physicians and teaching hospitals. Manufacturers and group purchasing organizations (GPOs) must also report physician ownership to CMS. Failure to report this information can result in CMS imposing a civil monetary penalty on the manufacturer or GPO.
The PPACA “Sunshine” Rule is available at: PPACA “Sunshine” Rule details
The CMS news release on the “Sunshine” Rule is available at: CMS “Sunshine” Rule Press Release
The CMS fact sheet on the “Sunshine” Rule is available at: CMS “Sunshine” Rule Fact Sheet
Medicare, Medicaid, Children’s Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership or Investment Interests; Final Rule, 78 Fed. Reg. 27 9458, 9528 (Feb. 8, 2013).
Centers for Medicare & Medicaid Services. “Affordable Care Act ‘Sunshine Rule’ Increases Transparency in Health Care.” Press Release. 1 Feb. 2013.
Centers for Medicare & Medicaid Services. “CMS Implements Certain Disclosure Provisions of the Affordable Care Act.” Fact Sheet. 1 Feb. 2013.