No Free Lunch With the Affordable Care Act


Gifts to healthcare providers, including lunches, are now required to be tracked and reported.

The pendulum has swung again. There was a time not that long ago, when drug and product manufacturers bestowed lofty consulting honorariums and elaborate vacations upon physicians who used and/or supported their products. Then things tightened up and educational dinner meetings were a no-no. Now, the pendulum has swung even further. On August 1, 2013, a provision in the Affordable Care Act (ACA), called the “Physician Payments Sunshine Act," went into effect. From now on, drug and product manufacturers must keep track of payments and gifts to healthcare providers and report them to the Centers for Medicare & Medicaid Services (CMS), which will then make the data publicly available.

The purpose of the Act is to expose the financial dealings between and physicians and discourage conflicts of interest. There is underlying concern that gifts may influence prescribing patterns and product selection. Under the Physician Payments Sunshine Act, drug and product manufacturers must report any "transfer of value" of $10 or more made to physicians. Transfers of value under $10 aren't reportable unless they add up to more than $100 in a year. Drug and product manufacturers also must disclose whether physicians have any ownership stake in the companies. The Sunshine Act requires CMS to post the totals for each physician online by September 30, 2014. Physicians have no legal duty to keep a tally of industry payments and gifts; however, they may choose to because to because the Sunshine Act allows them to contest the dollar amounts that drug and product manufacturers submit to CMS. CMS released a free mobile app in July 2013 that physicians can use to record cash and in-kind payments from drug and product manufacturers (search “Open Payments” and the “Open Payments Mobile for Industry” app will appear). More information on the Sunshine Act and the mobile apps is available on the CMS Web site.

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