Open Payments Program
The Physician Payments Sunshine Act created the Open Payments Program, administered by the Centers for Medicare & Medicaid Services (CMS). The program is designed to create greater transparency around the financial relationships of manufacturers, physicians, and teaching hospitals.
The Sunshine Act requires certain pharmaceutical and device manufacturers to report payments or other transfers of value given to U.S. physicians and teaching hospitals. Reports are made once a year and posted on a public website via the Open Payments Program. Data collection for reporting began on August 1, 2013.
Manufacturers must report payments or transfer of value for the following:
- Funding for research
- Speaking fees
- Educational items like textbooks and journal reprints—whether made directly to a physician or teaching hospital or indirectly through a third party
The Sunshine Act applies to all physician specialties, as well as general practitioners.
Have you used the Open Payments Program? Please let us know by e-mailing ASCO with your feedback.
What is the Sunshine Act?
The Physician Payments Sunshine Act, or “Sunshine Act,” passed as part of the Patient Protection and Affordable Care Act (health care reform) in 2010. The law is designed to bring transparency to financial relationships between physicians, teaching hospitals, and the pharmaceutical industry.
The Sunshine Act requires manufacturers of pharmaceutical drugs and devices, as well as group purchasing organizations, to report payments or transfers of value (such as meals, honoraria, or travel reimbursements) made to U.S. physicians and teaching hospitals. The law also requires manufacturers and GPOs to report physicians who have an ownership interest in the company. Reports are made to the Centers for Medicare and Medicaid Services (CMS), a government agency.
Please see the questions and answers below or visit the CMS website for more detailed information.
FAQs About the Sunshine Act
How can I find more information on the CMS website?
CMS has created a comprehensive website for information related to the Sunshine Act and the Open Payments Program. The website includes:
- Frequently asked questions and answers
- Information on how to download the CMS payment tracking app.
For any questions relating to the program, physicians can contact the CMS Help Desk at OpenPayments@cms.hhs.gov. Physicians can register for periodic updates from CMS on their website.
How can I register?
Information about registration can be found on the registration page of the CMS Open Payments website.
Physicians can make sure that their National Provider Identification (NPI) number is correct, or can apply for an NPI number if they do not have one. The NPI is a unique identification number for covered health care providers and is used as an identifier for reporting in the Open Payments program. Click here to learn more about NPI numbers.
Questions about Reports
How can I be notified when reports are posted about my practice?
There are several ways physicians can be notified about reports:
- Physicians can register on the CMS website to receive notice that reports are available for review.
- Physicians employed in teaching hospitals can ask their institution about any new reporting requirements.
- Physicians can download the app developed by CMS to keep track of payments or transfers made to them.
- Physicians can ask their contacts within manufacturing companies about the company’s plans to keep physicians informed when reports are planned.
What kinds of payments are reported?
Payments for the following must be reported:
- Research funding, such as grants
- Speakers’ honoraria
- Travel expenses
- Educational materials like text books or journal reprints
- Participating in a paid advisory board
- Writing manuscripts
Reports are only required for physicians licensed to practice in the United States. This excludes medical students, residents, support and office staff, nurses, advance practice nurses, physician assistants, and others.
What information must be reported by manufacturers?
Manufacturers are required to report identifying information about the physician to whom the payment was made, including the physician’s:
- Business address
- NPI and license number
- The nature and amount of the payment or transfer, and any explanatory details.
- Where applicable, the name of the manufacturer’s product(s) related to the payment or transfer will also be reported.
Do physicians have to do any reporting?
Physicians will not be responsible for reporting any information to CMS, but may be asked to provide the information to a manufacturer or a third party so that it can be included in a report.
How will I find out if a report is made about me? Can I dispute a report?
CMS must provide physicians with the reports before the reports are made public. CMS makes this information available to physicians online, with time to review and dispute reports before the reports are posted publicly. CMS will not alert all physicians that the reports are available. Physicians must register on the CMS website to receive alerts.
CMS is not responsible for resolving disputes between physicians and manufacturers and will not hold public reporting until disputed are resolved. Disputes that are not resolved within a 45 day period will be flagged as disputed on the public website.
Because CMS only requires reports annually, a lengthy gap could occur between when the payment is made and when the report becomes available to a physician from CMS. Physicians can ask companies to make them aware when the company plans to make a report and ask them to develop a mechanism for challenging a planned report.
Can I decline a payment from a manufacturer to avoid being reported?
Yes. For example, if a manufacturer’s representative brings lunch to your group practice, the manufacturer must report the value of the meal (if consumed by physicians) to CMS. You can avoid being reported by declining the meal.
Will directing or donating my honorarium to a charity avoid reporting?
It is important to note that redirecting payments or transfers to others or to charitable organizations does not negate the reporting requirement. For example, redirecting a speaker’s honorarium to a nonprofit charity will not preclude the sponsoring company from reporting you as the honorarium recipient.
Are there any exceptions from reporting?
Yes, some payments and transfers are exempt. For example:
- Payments for speakers and faculty at certain accredited CME events.
- Food and beverage provided to all attendees of a large scale conference or meeting.
- Product samples intended for use by patients.
- Educational materials for use by or with patients, such as anatomical models.
- Payments or transfers of less than $10 in value, unless they exceed $100 in annual aggregate.
Can I ever opt out of reporting?
The only way to opt out of reporting is to refuse to accept a payment or transfer of value.
What does the government do with the reports?
CMS accepts reports on an annual basis. CMS compiles the reports, and physicians and teaching hospitals can review the reports and initiate any disputes if they believe there is an error. After the review period, reports are placed on a public website. Research funding is shown on a different section of the public reporting website from all other types of payments. Visit the CMS website for more information.
I work in a teaching hospital. How will the Sunshine Act affect me?
Teaching hospitals might initiate specific rules on employee physicians related to accepting payments from manufacturers. Physicians employed by teaching hospitals may want to ask their institution for more information.
I work in private practice. How will the Sunshine Act affect me?
Payments or transfers of value for activities, such as speaking on behalf of a manufacturer, accepting food brought to a physician’s office by a manufacturer’s representative, or acting as a paid consultant, could result in a reportable payment. Physicians can ask manufacturers and companies if the payment or item would result in a report before accepting it. Physicians can ask the value of the transfer so they can keep track of reports.
Physicians in private practice also might receive research funding from a manufacturer that would be reported. Physicians can keep track of their research payments from manufacturers.
Physicians always have the option of refusing to accept a payment or transfer in order to avoid a report.
The Sunshine Act and ASCO Activities
How will the Sunshine Act affect my ASCO activities?
Most ASCO activities, such as attending the Annual Meeting, paying membership dues, subscribing to the Journal of Clinical Oncology or the Journal of Oncology Practice, and serving on committees, are not reportable.
However, some ASCO activities are reportable. These include:
- Accepting payment as a speaker for a non-CME meeting sponsored by ASCO,
- Receiving certain grants from the Conquer Cancer Foundation of ASCO (CCF),
- Attending a company-sponsored event, are reportable.
ASCO does not make any reports to the government as a result of the Sunshine Act. However, ASCO may be required to report the following:
- Certain payments made from manufacturer funding to U.S. physicians.
- Payments or transfers of value made to physicians indirectly through a professional organization like ASCO or a charitable organization like CCF, if the manufacturer knows that money will be paid to physicians or earmarks money to go to physicians.
ASCO and CCF have made a commitment to physician members to clearly communicate whenever an ASCO or CCF activity could result in a report. Members will have the opportunity to decline participating in an activity to avoid having ASCO report information back to a manufacturer.
How is ASCO responding to the sunshine act?
- During the long period of public comment before the Sunshine Act rules were released, ASCO successfully advocated to clarify the exclusion of payments for speakers and faculty of accredited CME programs from reporting.
- ASCO is monitoring developments from CMS.
- ASCO is working with other physician specialty societies through the Council of Medical Specialty Societies to understand how the rule will impact physicians.
ASCO has made a commitment to communicate with members in advance if any ASCO or CCF activity could result in a report. ASCO will continue to inform members about important information related to the Sunshine Act.