Tucked away deep within the 2,000-plus pages of the recently upheld Affordable Care Act is a tiny section of the law that could have a sizable impact on emergency physicians.
Explore This IssueACEP News: Vol 31 – No 09 – September 2012
Section 6002 – a mere seven pages – details what is known as the Physician Payment Sunshine Act, a statute designed to give the public access to information regarding payments made to doctors from manufacturers of drugs, medical devices, and medical supplies through a searchable website.
And that intent is a good one, said ACEP President Dr. David Seaberg. But good intentions don’t guarantee good results.
“Surely the need for transparency is a good concept, especially if [a payment] is significant in value and could sway a physician’s judgment in terms of using drugs or devices,” Dr. Seaberg said. “That’s been shown in the past. But this rule really overreaches in terms of the bureaucracy it will create. It’s going to present a real problem for physicians.
“It’s a real bureaucratic overreach in what they’re trying to do. The basic concept is good, but this particular ‘sunshine rule’ is not where it should be.”
Exactly how the law will work is still something of a mystery. At press time, the Centers for Medicare and Medicaid Services (CMS) still had not released a final version, and it has postponed the collection of data until at least the beginning of 2013.
One thing that is known, however, is that the threshold for reporting payments or gifts is a mere $10 ($100 per payer during the calendar year).
As ridiculous as that sounds – “Two lattes and you’re up to 10 bucks,” ACEP Federal Affairs Director Barbara Tomar said – it’s written into the statute itself and is not open to interpretation by CMS.
And that, Dr. Seaberg and Ms. Tomar said, could quickly become problematic even though the physicians are not required to report anything themselves.
ACEP is trying to help members stay one step ahead by collecting their National Provider Identifier (NPI) numbers at this year’s Scientific Assembly held Oct. 8-11 in Denver. Providing NPIs to health care service providers, device manufacturers, and pharmaceutical companies puts the burden of making the reports on those companies giving the cash, stock, or in-kind items or services.
However, physicians also will need to keep their own detailed and accurate records in order to be able to dispute any erroneous reports. With such a low threshold, those records will be many.