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CMS Issues Final Rule Interpreting The Physician Payment Sunshine Act

May 08, 2013

By PHILLIP STREET, W. CRAIG SMITH, & MATT BROHM

The Centers for Medicare & Medicaid Services (“CMS”) recently released its final rule (the “Final Rule”) interpreting the physician payment “sunshine” provisions of the Patient Protection and Affordable Care Act (the “Sunshine Act”). The Sunshine Act contains two (2) main requirements:

  1. “Applicable manufacturers” of a “covered drug, device, biological, or medical supply” must report annually certain information to CMS regarding “payments and other transfers of value” provided to physicians and teaching hospitals.

  2. Applicable manufacturers and group purchasing organizations (“GPOs”) must report annually certain information to CMS regarding “ownership or investment interests” held by physicians and their immediate family members during the preceding calendar year.

Applicable manufacturers and GPOs must begin data collection in connection with these two requirements on August 1, 2013. The first reports must be filed with CMS by March 31, 2014. CMS will release the responsive data to the public through a CMS website by September 30, 2014.