Physician Payment Sunshine Act: CMS Submits Report to Congress on First Year of Open Payments

Over the weekend, the Centers for Medicare and Medicaid Services (CMS) submitted their annual report to Congress on the first year of Open Payments. Each year, CMS is required to submit a report to Congress summarizing the payments made by applicable manufacturers and group purchasing organizations to physicians and teaching hospitals, as well as any penalties CMS assessed based on noncompliance with the program. The document is an interesting “inside-look” into CMS’s activity, and offers the industry an idea of where the agency is headed with Open Payments, including program implementation improvements, and, perhaps more importantly, where CMS is focusing their enforcement efforts.  The report, available here, first provides a high level overview of the Open Payments reporting requirements, as well as highlights from the first year of the program. CMS includes a number of familiar summary statistics, including an aggregate payment chart as well as a 50+ page appendix that lists every reporting entity and the dollar amounts attributed to that company (Appendix B, p. 33). Penalties The report is most interesting where CMS provides insight into its auditing process and its plans for the future. Since companies first began instituting aggregate spend systems to comply with the Sunshine Act, the question has always been, how will CMS interpret the complicated law for enforcement purposes? For now, it seems like the agency is focusing on c...
Source: Policy and Medicine - Category: American Health Authors: Source Type: blogs