Physician Payment Sunshine Act

The Physician Payments Sunshine Act (Sunshine Act), which is part of the Affordable Care Act (ACA), requires manufacturers of drugs, medical devices, and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. Manufacturers submit the reports to the Centers for Medicare & Medicaid Services (CMS) on an annual basis. In addition, manufacturers and group purchasing organizations (GPOs) must report certain ownership interests held by physicians and their immediate family members.

The majority of the information contained in the reports are available on a public, searchable website. Physicians have the right to review their reports and to challenge data that are false, inaccurate, or misleading.

Key Dates

APR 1, 2017

Physician and Teaching Hospitals Review and Dispute Period Begins

MAY 15, 2017

Final Day for Physicians to Initiate Disputes

Final day for physicians to initiate disputes of erroneous data from calendar year 2016 reported for transfers made and ownerships held. If a physician waits until after data have been made public to initiate a dispute, the data will not be flagged as disputed in the public database until CMS updates the information.

JUN 30, 2017

CMS will publish 2016 payment data and any updates to the 2013, 2014, and 2015 data

DEC 31, 2017

All disputes of erroneous data from calendar year 2016 must be submitted to receive consideration by CMS.

Early 2018

Data will be refreshed and updated for the full calendar year of 2016 financial data.

Three-Step Verification and Registration Process To Review Data

  • Step 1

    CMS E-Verification Process

    CMS requires a two-phase registration process. In phase one, physicians are required to complete CMS' e-verification process via the CMS Enterprise Portal (EIDM). (Step-by-step instructions)

    1. Visit the CMS Enterprise Portal and select “New user registration”
    2. Accept the terms and conditions, being sure to read the “Consent to monitoring” and “Collection of personal identifiable information” sections.
    3. Identity verification is required for all users requesting access to any CMS application.
    4. Enter your personal information. You’ll speed up the verification process by completing all fields, including those that aren’t required.
    5. Select your user ID, password and security questions.
    6. Complete registration and wait for your confirmation email.

    CMS has contracted with Experian, a respected credit-reporting company that also specializes in identity theft protection, to verify your identity. Experian cross-references your registration information to the financial information it already has on file but that only you would know, such as your mortgage amount. CMS does not access or retain this information. This process involves a soft credit check that does not affect your credit score.

  • Step 2

    Register with CMS’ Open Payments

    Registration is rather cumbersome, so make sure to follow the directions closely and allow enough time to complete it in one session:

    1. Log in to the CMS Enterprise Portal
    2. Click the button on the far right that says “Request access now,” then click “Request new system access
    3. Select “Open Payments” from the drop-down menu and input your personal information
    4. Log out of the system and wait two minutes, then log back in
    5. Select “Create my profile”
    6. Select “Start profile” at the bottom of the next screen
    7. Select the profile type “Physician” and then select “Continue”
    8. Enter your personal information, making sure to fill in the required fields that are marked with an asterisk. When you are done, select “Continue”
    9. Do not choose “Cancel” unless you want to start over; canceling will erase all data
    10. Enter your details, making sure to fill in the required fields that are marked with an asterisk
      • When the system asks for your specialty identification code, what it really requires is your provider taxonomy code. The following list captures codes reserved for psychiatrists. Enter the proper taxonomy code in the Open Payments system.
      • Physicians are required to enter at least one license number by selecting “Add license” and entering the state in which the license is held and the license number. When you are finished, select “Continue.”
    11. If desired, choose an individual to represent you within the Open Payments system by entering the required information and the access level. You do not need to designate an authorized representative during this initial registration and may choose to do so later.
    12. Review the information you’ve entered. Select “Back” to edit any information. If the information is correct, select “Submit.”

    The entire registration process must be finished in a single session, according to CMS. Users cannot save entries or complete their profiles at later times. In addition, the system times out after 15 minutes of inactivity, and it does not have an auto-save feature.

    Note: If a provider has not accessed the CMS Enterprise Portal in the past 180 days, their password must be reactivated. Please call the CMS Open Payments Help Desk to initiate this process at 1-855-326-8366, Monday through Friday, from 8:30 a.m. to 7:30 p.m. (EST).

    CMS recommends using only Internet Explorer version 8 or later to register for the Open Payments system. CMS also cautions users against using their browser’s navigation buttons, which can delete registration data.

    If you experience any difficulties while attempting to use the Open Payments system, you can contact the CMS help desk via email or phone at (855) 326-8366.

  • Step 3

    Review and Dispute 2015 Data by May 16, 2016

    In Step 3, for 45 days immediately following the initial availability of the Open Payments System, physicians can request their individual report, review it and dispute inaccuracies in data submitted. CMS has indicated that it will not resolve disputes, but errors can be reported to manufacturers through the Open Payments System or directly through Open Payments contacts listed on most manufacturer websites.

    Physicians who have no data reported by industry should receive the following message when clicking on the review/affirm/dispute tab:

    "You have the following errors on the page: There are no results that match the specified search criteria."

Additional Resources