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‘Sun­shine’ set to cost teach­ing hos­pi­tals $650 apiece

Modern Healthcare - - NEWS - Jaimy Lee

Physi­cians, hos­pi­tals will share in price of Sun­shine Act

Physi­cians, teach­ing hos­pi­tals, group pur­chas­ing or­ga­ni­za­tions and drug and de­vice com­pa­nies will bear some fi­nan­cial bur­den when the CMS be­gins to ask for in­for­ma­tion about their fi­nan­cial re­la­tion­ships.

The 121-page pro­posed guid­ance is­sued last week es­ti­mates those costs and pro­vides clar­i­fi­ca­tion about how the CMS ex­pects drug, de­vice, bi­o­logic and med­i­cal sup­ply man­u­fac­tur­ers and GPOS to col­lect and re­port data about pay­ments and “trans­fers of value” made to physi­cians and teach­ing hos­pi­tals, as well as man­u­fac­tur­ers’ and GPOS’ in­vest­ment in­ter­ests and physi­cian own­er­ship.

Un­der the Physi­cian Pay­ments Sun­shine Act pro­vi­sions in the Pa­tient Pro­tec­tion and Af­ford­able Care Act, the CMS will an­nu­ally pub­lish the data online. A list of cov­ered teach- ing hos­pi­tals, which are de­fined in the pro­posed rule as fa­cil­i­ties that re­ceive Medi­care grad­u­ate med­i­cal ed­u­ca­tion pay­ments, will also be pub­lished online by the CMS each year.

“While some col­lab­o­ra­tion is ben­e­fi­cial to the con­tin­ued in­no­va­tion and im­prove­ment of our health­care sys­tem, pay­ments from man­u­fac­tur­ers to physi­cians and teach­ing hos­pi­tals can also in­tro­duce con­flicts of in­ter­ests that may in­flu­ence re­search, ed­u­ca­tion and clin­i­cal de­ci­sion­mak­ing in ways that com­pro­mise clin­i­cal in­tegrity and pa­tient care, and may lead to in­creased health­care costs,” the CMS said in the pro­posed rule.

The CMS es­ti­mates that about 334,500 physi­cians will have a fi­nan­cial bur­den of $24.3 mil­lion and 1,100 teach­ing hos­pi­tals of $715,000 dur­ing the first year of com­pli­ance with the law. The agency based the es­ti­mates on la­bor costs for physi­cians’ of­fices and teach­ing hos­pi­tals. Physi­cians who re­ceive pay­ments and trans­fers of value from drug and de­vice man­u­fac­tur­ers will each pay an es­ti­mated $75 to re­view the in­for­ma­tion sub­mit­ted by GPOS and man­u­fac­tur­ers, while the es­ti­mated av­er­age to­tal cost for each teach­ing hos­pi­tal is $650.

The CMS said in the pro­posed rule that “teach­ing hos­pi­tals would have to re­view more pay­ments or other trans­fers of value and have more com­plex re­la­tion­ships,” not­ing that it would take a rep­re­sen­ta­tive at a teach­ing hos­pi­tal an es­ti­mated 10 hours on av­er­age to re­view sub­mit­ted data and up to 60 hours

The new rules re­quire de­vice­mak­ers to dis­close pay­ments to doc­tors.

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