Published 3/1/2015
Melissa Young, JD

Open Payments Reporting Under Way

The second year of reporting under the Open Payments Program—established by the Centers for Medicare & Medicaid Services (CMS) as a result of the passage of the Physician Payments Sunshine Act—is now under way. Applicable manufacturers and group purchasing organizations (GPOs) have until March 31 to submit corrected data for 2013 and new data for 2014. Data submitted for the 2014 program year covers payments made to physicians during 2014.

Applicable manufacturers and GPOs report each form of payment or transfer of value made, including the following:

  • Anything of value (cash or cash equivalent form given by a company to a physician or teaching hospital)
  • The nature of each payment— consulting fees, compensation for services other than consulting, including serving as faculty or as a speaker at an event other than a continuing education program, honoraria, gifts, entertainment, food and beverage, travel and lodging, education, research charitable contributions, royalty or license, current or prospective ownership or investment interest, compensation for serving as faculty or as a speaker for unaccredited, noncertified continuing education programs as well as for accredited or certified continuing education programs; or grants

Small payments or other transfers of value, defined by the law as less than $10, don’t need to be reported. One exception to the law is when the total annual value of payments or other transfers of value provided to a physician or teaching hospital by a single applicable manufacturer or GPO is more than $100.

Additionally, the law applies to ownership or investment interests held by physicians or their immediate family members (spouse; natural or adoptive parent, child, or sibling; stepparent, stepchild, stepbrother, or stepsister; father-, mother-, daughter-, son-, brother-, or sister-in-law; grandparent or grandchild; and the spouse of a grandparent or grandchild).

Open Payments does not identify which financial relationships are beneficial or which may cause conflicts of interest. However, applicable manufacturers and GPOs may voluntarily report information that gives context to the payment or transfer of value when they submit payment records. For example, they must note whether the payment is for research or general purposes or due to an ownership or investment interest.

Physicians who have not already registered in the Open Payments program should do so prior to data publication (June 2015). For more information, visit www.cms.gov/openpayments

Melissa Young, JD, is the assistant general counsel for the AAOS. She can be reached at young@aaos.org