The Physician Payment Sunshine Act

The Department of Health and Human Services (DHHS) and the Centers for Medicare and Medicaid Services (CMS) were notified by the Senate Finance Committee about the possible failure of physician-owned distributorships (PODs) to disclose physician ownership interests under the Physician Payment Sunshine Act.  The Committee noticed that some PODs may not be following the requirements of the Sunshine Act.  This raises concerns for the senators because they believe it could encourage physicians to perform unnecessary medical procedures to generate more profit.

The Sunshine Act was passed on August 1, 2013 to promote transparency between physicians and the makers of drugs and medical devices. “The Act requires manufacturers of pharmaceuticals, biologics, medical devices and medical supplies that participate in Federal health care programs to report to the CMS any transfer of value to physicians or teaching hospitals.”  A covered entity is subject to pay civil monetary payments if they knowingly fail to submit the required information. Senators hope to modify the Sunshine Act to ensure noncomplying physicians are penalized.

By April 15, 2019, the Committee would like the DHHS to respond to a list of questions regarding the quality of data and reporting and wants to know what steps the HHS Office of the Inspector General (OIG) has taken to prevent fraud and how they can improve.  The Committee plans to follow up with HHS OIG to figure out the best way to keep the Sunshine Act up to date and to ensure penalties for those who fail to disclose ownership of an entity and leverage ownership interests at the expense of patients and the federal health care entitlement programs.

Written by Heather Lynn Gillman Director of Healthcare Communications Problem Solver. Designer. Wine Maker. Writer. Connect with Heather on LinkedIn