In September, Keith Chamberlin, MD, MBA, reported on the Sunshine Act and its implications for anesthesiologists. In this blog I continue the discussion with a report on a survey sent to District 4 CSA members in September 2014.
The Physician Payment Sunshine Act, part of the health care reform bill, was enacted in March 2010. However, final implementation by the Centers for Medicare & Medicaid Services (CMS) only began in February 2013.
The act mandates that medical device and pharmaceutical companies make available on a searchable federal database, data on payments and gifts to physicians and teaching hospitals as of September 2014. All companies must now report on the Open Payment website all direct and indirect payments made to physicians. Under the act the following information must be reported:
- Name and address of physician
- The amount and date of payment.
- The form of payment, such as cash or stocks
- The nature of the payment, such as consulting fees, gifts or entertainment expenses.
So if you attend a dinner meeting sponsored by a pharmaceutical or a medical device company, your name will be recorded and your share of the dinner (usually about $50 to $100 per person) will be attributed to you in the database. If the cost is less than $10 per person, the companies do not have to report the meal as a payment.
What should you do?
I encourage you to go online to see what is reported about you. To do this, you must sign into the CMS Identity and Access Management System. Your username and password for this website are the same ones used for the National Plan & Provider Enumeration System website (NPPES, also known as NPI). If you do not have your username and/or password, you can use the "Forgot Password and/or Retrieve Forgotten User ID" links on the site. If you need login assistance, call the NPPES help line at 1-800-465-3203 (6 a.m. to 2 p.m. PST).
You have an opportunity to dispute the information for 45 days after it is posted on the website. The company will have 15 days to correct the information. If the dispute between you and the company is not resolved, then the information will be stay on the website but will be marked "disputed."
Results of recent surveys
A recent survey of orthopedic surgeons (AAOS, April 2014) found that 63 percent of those who replied were “deeply concerned” about this new searchable website.
- A survey of CSA District 4 members, conducted by the author in September 2014, asked just one question:
Will you continue to attend sponsored educational dinner meetings despite the fact that the Sunshine Act requires the host to report your presence?
The reply options were “yes” and “no.”
There are 521 members in District 4: 386 active, nine affiliate, eight life, 36 residents and 82 retired. Only active members and residents were surveyed (386 + 36 = 422). There were a total of 139 replies, a 33 percent response rate. Ninety-six members replied “yes” (69 percent), while 43 replied “no” (31 percent).
Comments from the survey takers included:
- Many of the responders said they had no idea about the Sunshine Act.
- Those who said “no” stated that the Sunshine Act was the reason they would not attend any future dinner meeting.
- Many of the “no's" stated they did not like to be on any government list, nor would they like to explain their presence on the list to their patients.
- Two of the “no's" said that they would not attend, as the dinner would be coercion.
Of note: At a dinner meeting two months before the survey, when few knew the implications of the Sunshine Act, 58 attended. A dinner meeting held on Sept. 30, after the survey, had an attendance of 22 members. It will be interesting to monitor attendance at future dinner meetings.
Is there any solution?
There are several possible solutions to the problems posed by the Sunshine Act:
- You can attend the dinner meeting but pay for the dinner from your own funds.
- You can attend only lunch or dinner meetings where the cost per person is less than $10.00
- You can attend meetings for which some pharmaceutical companies will not report your participation. At such meetings all of the following must be true:
- No CME is given.
- The meal is a buffet.
- More than 50 people attend.
- The cost per person is less than $10.
So is the Sunshine Act a deathblow to industry-sponsored local dinner meetings? I would think not, but there could be a significant decrease in attendance, which may mean that sponsors will be reluctant to get involved. If that happens, then it is all over — a previous survey of District 4 CSA members showed that 99 percent would not attend any District 4 dinner/meeting unless it was sponsored.
This would be a great pity. District meetings can provide networking, help members learn how to get involved with grassroots political activities, increase recruitment to the CSA and offer information-sharing opportunities. Although the CSA has some modest funding to sponsor district meetings, it may not be enough to make up the difference that industry sponsorship provides.
What should you do?
I would recommend that you learn more about the Sunshine Act. You should go on the Open Payments website to find out what is being reported about you. Consider whether being on a government list is something that matters to you. If not, then support your society’s attempt to provide education, political involvement, networking and information-sharing opportunities