How The Sunshine Act Affects Health Care


An ACR session focused on the Sunshine Act and health care transparency.

Technology has transformed the health care industry in unimaginable ways. Now, patients can look up information about a physician prior to receiving care to make sure that this physician and their costs are the right choice.

The implementation of the Affordable Care Act also came with the passage of the Sunshine Act, which is a law designed to increase transparency measures requirements about disclosing the relationship between providers and drug manufacturers. Additionally, more information about providers is readily available online.

In the session Is Your Patient Googling You? How the Sunshine Act and Public Websites Allow Patients to Learn About Their Doctors, experts will discuss the changes that have come about from the implementation of the Affordable Care Act and technology advancement.

This transparency trend will likely continue, and be utilized more in the future. Understanding these measures and what information is available will assist providers with making informed decisions.

The Open Payments program is the part of the Sunshine Act, which gathers data about payments from drug and device manufacturers to physicians and hospitals. During the session, Shantanu Agrawal, MD, director of the Center for Program Integrity at the Centers for Medicare and Medicaid Services (CMS), will discuss the Open Payments program.

Dr Agrawal will present information about what types of data are disclosed, who is included, and the payment types that are required. He will also discuss time requirements for data collection, submission, review and dispute, and various other issues as well as the registration process, and resources available.

“The objective of the Open Payments program is to make financial relationships transparent on a national scale and give consumers the information needed to ask questions and make informed decisions about their healthcare professionals,” Dr Agrawal said. “The role of CMS is to remain neutral and to present the data on a public website, as well as to ensure reporting and disclosure are complete, accurate, and timely.”

K. Nikki Reeves, JD, a partner at King & Spalding’s FDA & Life Sciences practice group will also be discussing legal issues that face drug manufacturers, funding institutions, providers, and hospitals during the session.

“The law requires certain manufacturers and group purchasing organizations to report ownership or investment interests in their organizations held by physicians,” Reeves said.

The CMS is then required to group the information reported by manufacturers and group purchasing organizations. This information will then be accessible to the public through the internet.

With new information readily available from the CMS and other organizations, some wonder who will be using this data. In the session, Jane S. Kang, MD, MS, of Columbia University Medical Center and program director of the Rheumatology Fellowship will discuss patient review sites and how individuals use them.

Dr Kang will also review ethical implications of using these sites for patients and physicians.

With the surge of new information stemming from the Sunshine Act, it is important that stakeholders have an expansive understanding of the law, and how individuals use this information.

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