Sunshine Act 101: The Physician Payments Sunshine Act, also known as the PPSA, Sunshine Act or Open Payments Program, has been abuzz over the last couple of years. This unprecedented law, passed in 2010 as part of the Affordable Care Act, requires manufacturers of medical products and group purchasing organizations (GPOs) to publicly report all payments or transfers of value to physicians and teaching hospitals, as well as ownership or investment interests held by physicians or immediate family members of physicians in such manufacturers and GPOs. It goes without saying that this law has a tremendous impact on physicians across the board and significantly changes the physician-industry relationship. All physicians (MDs, DOs, dentists, podiatrists and chiropractors), other than those who are bona fide employees of the manufacturer reporting the payment, are impacted by this law. This includes physicians who do not treat patients, such as medical researchers and physician administrators. It does not include other clinicians, such as nurses, nurse practitioners, physician assistants or pharmacists. Medical residents are excluded from this regulation.
What's in the Forecast for the Sunshine Act?
On Aug. 1, 2013, manufacturers began collecting data on payments made to physicians. Reports of industry payments made to physicians between Aug. 1, 2013, and Dec. 31, 2013, will be made public on Sept. 30. This summer is a crucial period for ensuring that your report is accurate ahead of the public release. From now until Aug. 27, you can review your report for accuracy and initiate any necessary disputes. After Aug. 27, there is an additional 15-day period that you can use to continue to work with industry to resolve disputes. To preview your report, you must first register by creating an account through the Centers for Medicare and Medicaid Services' Enterprise Portal
, a system designed to verify your identity. You must then register specifically with the Open Payments System. Learn more about the Sunshine Act and get tips for successfully registering on CardioSource.org
Personalized Medicine Hot Topic on the Hill: This week, ACC President Patrick T. O'Gara, MD, FACC, shared his perspective on how personalized medicine will impact the practice of cardiology in the future during a House Energy and Commerce Committee roundtable. This meeting provided an opportunity for key players in health care to have an open discussion about the advancements in and barriers to personalized medicine and its role in improving patient care. O'Gara underscored that shared decision making between clinicians and patients is essential to the successful development and application of personalized medicine. "This is an extraordinarily important and very exciting inflection point, but we cannot forget the educational piece and the shared decision making that has to be part and parcel of how we're going to get this out," he stressed. Furthermore, O'Gara called for harmonization across regulatory agencies; funding for information and science; and proper reimbursement for diagnostic tests and counseling of patients. Read more on CardioSource.org. This meeting is one of two the College has been invited to take part in this month. On July 31, health care experts will speak to the House Small Business Committee on the benefits and barriers to increased use of telemedicine. Stay tuned to the Advocate and CardioSource.org for full coverage. Additionally, ACC's SMARTCare pilot project was mentioned for its potential to reduce health care costs during a Senate Finance Committee hearing on chronic illness that took place last week.
Legislative Conference Lineup: During the 2014 Legislative Conference, which will take place Sept. 14-16 in Washington, DC, ACC members from across the spectrum of cardiology will share how the ACC is leading the transformation of care. Additionally, an impressive lineup of speakers from several government agencies will provide vital insight into the health care climate and the direction medicine is headed. Speakers will include Michael S. Lauer, MD, FACC, FAHA, director, division of cardiovascular sciences, National Heart, Lung, and Blood Institute; Mark Miller, executive director, Medicare Payment Advisory Commission; and Margaret A. Hamburg, MD, commissioner, Food and Drug Administration. Key congressional staff from the Senate Finance, House Ways and Means, and House Energy and Commerce committees will also be on hand to provide a view from the Hill. Don't miss your opportunity to hear what these influencers have to say – register now.
ACC Supports Elimination of Tobacco Price Discounting for Military: Your ACC has signed onto a letter of support for a provision in an appropriations bill that eliminates price discounting for tobacco products sold in military commissaries and exchanges. The provision garnered bipartisan support from Sens. Susan Collins (R-ME) and Barbara Mikulski (D-MD) who spoke in favor of the amendment during a Defense Appropriations Subcommittee meeting last week. Numerous economic studies have indicated that price has a significant impact on the number of people who start using tobacco products. In line with ACC policy on tobacco use, this is a small, but necessary step that should be taken to reduce tobacco use in the military – which is higher than the civilian population. The ACC endorsed the provision through its partnership with the Campaign for Tobacco Free Kids.
New Issues Emerging in the States: Throughout the year, the College's State Advocacy team works with ACC chapters to advance legislation that enhances patient care and defeat bills that threaten cardiovascular professionals and patients. While legislative efforts around issues such as cardiopulmonary resuscitation/automated external defibrillators, imaging and pulse oximetry continue to dominate in the states, a number of new issues are emerging across the country that are likely to have an impact on the cardiovascular field. Here's a look at a few issues on the radar:
- Intersection of clinical research, quality improvement and state health regulations: Increasingly, state health departments are relying on ACC's guidelines, appropriate use criteria and quality initiatives to set rules for state policies. The College has been involved in several states to ensure the ACC programs are used to guide as opposed to creating policy. To date, the ACC has been successful at having ACC chapter leaders appointed to state health policy panels.
- Energy drinks: State officials are proposing bills and regulations to ban marketing and sales to youth. Often these proposals are part of a broader effort to reform school nutrition programs.
- Naturopaths: Naturopaths are alternative medicine "practitioners" who are advocating to perform many of the services, tests and diagnoses physicians are licensed to perform. They market themselves as "naturopathic physicians," which many believe is misleading because they are not medical doctors or doctors of osteopathy. Currently, there are 17 states with boards that approve naturopathic licenses and set rules for their scope of practice.