The CMS Open Payments Program, also called the “Sunshine Act”
Highlights:
- Each Open Payments cycle covers applicable payments from the prior calendar year.
- Payment data reported by manufacturers for the prior calendar year is generally available for review and dispute by recipients beginning on or about April 1.
- The deadline for submitting disputes is generally on or about May 15.
- Payment data for the prior calendar year is then made available to the public on the CMS Open Payments web site on or about June 30.
- View published payment data for prior years
- Any questions from journalists, other members of the media or any other outside organization regarding payments listed on the Open Payments web site should be referred to [email protected].
Note: The information on this site is provided to members of the Johns Hopkins Medicine Community as a resource for the Open Payments program, which is also referred to as the “Sunshine Act”.
- Overview of the Sunshine Act and Implications for Johns Hopkins Physicians
- Key Dates and Important Information
- Other Key Elements of Open Payments
- Resources
Overview of the Sunshine Act and Implications for Johns Hopkins Physicians and Certain Advanced Practice Providers
The Sunshine Act requires that detailed information about payments and other “transfers of value” worth over $10 from manufacturers of drugs, medical devices and biologics to physicians and teaching hospitals be made available to the public. A physician is defined as a M.D., D.O., D.D./D.D.M., D.D.S., D.P.M., O.D. and D.C.P. who is licensed in any state in the U.S., whether or not they are practicing. Starting with the 2021 data, payments will also be reported for physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists (including anesthesiologist assistants) and certified nurse midwives (collectively referred to as advanced practice providers).
The Act has implications for Johns Hopkins physicians and advanced practice providers who consult, serve on scientific advisory boards, receive royalties or engage in other compensated activity in a personal capacity for manufacturers of drugs, devices or biologics. Details of the compensation for these activities, including the purpose of the payment, are posted on a publicly accessible web site that is maintained by the federal Centers for Medicare and Medicaid Services (CMS).
Physicians and advanced practice providers may review and, if necessary, dispute reported payments. Individuals, not the provider’s employer, are responsible for reviewing the accuracy of reported data and submitting disputes if the data are inaccurate. The first cycle of payment data (covering payments made during the five-month period of August 1 through December 31, 2013) became publicly accessible in September 2014. Beginning in 2015, data for the previous calendar year has been published annually in June on the CMS web site. Physicians can view their previously published data by searching for their name using the Open Payments web site search tool.
Key Dates and Important Information
- By March 31, manufacturers must report to CMS any payments made to physicians and advanced practice providers during the prior calendar year as well as, in certain circumstances, any corrections to previously reported payment data.
- The review and dispute period for recipients generally begins around April 1 and ends on or about May 15.
- Manufacturers must submit corrected payment data to CMS by May 30.
- Payment data for the prior calendar year is then made available to the public on the CMS Open Payments web site around June 30.
- Physician payment data includes individual general payments as well as institutional research payments for which the physician is identified as a Principal Investigator.
Registration:
In order to review and dispute reported payments, physicians and advanced practice providers must be registered in the Open Payments system. Registration is a two-step process. Individuals must first register in the CMS Enterprise Identity Management (EIDM) System and then register in the Open Payments system.
Registration information is available here.
For step-by-step instructions on the registration process click here.
If you registered previously, you may be required to reset your password. Accounts are locked if there has been no activity within the past 60 days and deactivated after no activity for 180 days. CMS has specific requirements for passwords which can be found here.
You should allow sufficient time to complete the registration process and be aware that the CMS Help Line may have limited hours.
Review and Dispute:
Beginning on or about April 1, JHM physicians and advanced practice providers are advised to review their reported payments for accuracy and submit any disputes to Open Payments by May 15. CMS will then notify the manufacturer of the dispute. Individuals should work with the manufacturer to resolve the dispute and correct any inaccuracies by May 30. Manufacturers have generally provided contact information in Open Payments to assist in resolving disputes.
After the pre-publication review and dispute period has closed, recipients can still dispute inaccurate payments until December 31. The dispute will not be reflected in the published data, but it will advise the manufacturer that there’s been a dispute.
Information about the review and dispute process is available here.
If physicians or other providers initiate disputes regarding either (i) payments of a significant dollar amount, or (ii) a significant number of individual payments, they are asked to advise the Office of Interaction with Industry at [email protected].
To determine whether the reported payment data are accurate, physicians and advanced practice providers are advised to maintain records of the payments they receive from manufacturers.
Research Payments:
At Johns Hopkins, research payments are made to the institution and not to individual physician investigators. Research payments are displayed in a dedicated section of the Open Payments database. The Sunshine Act requires that manufacturers identify up to five Principal Investigators in connection with research payments made to the institution.
Physicians are able to review and dispute their designation as a Principal Investigator in connection with institutional research payments.
- Please be aware that the CMS definition of Principal Investigator may differ from that used within Johns Hopkins Medicine. As a result, manufacturers may designate co-investigators as Principal Investigators in the Open Payments database.
- Physicians designated as a Principal Investigator can only dispute their association with the payment. Other payment details must be disputed by the covered recipient of the payment.
- Payments to physicians that are related to research but not covered by an institutional research agreement may still be attributed to physicians as personal payments (e.g., travel or medical writing and editing services).
Other Key Elements of Open Payments
- Manufacturers must collect and provide information about indirect payments as well as payments made directly to physicians and advanced practice providers. For example, if a physician is paid indirectly through a third party (e.g., a contract research organization or travel agency), the payment will be listed as a transfer from the manufacturer to the physician.
- Payments to physicians for serving as speakers at accredited Continuing Medical Education activities are generally not included. This can vary depending on the specific details of the payment.
- Manufacturers are responsible for reporting payments to CMS; physicians, advanced practice providers and research institutions are not responsible for reporting to CMS.
- Manufacturers must identify physicians by their National Provider Identifier (NPI), so physicians may be asked to provide their NPI to a company that has made payments to them, whether directly or indirectly.
- Categories of payments and transfers of value include, among others, consulting fees, compensation for speaking, travel, food, entertainment, gifts, honoraria, royalties, education, research, current or prospective ownership or investment interest. Starting with the 2021 payment data, additional categories of debt forgiveness, long term medical supply or device loan, and acquisitions will be included.
- Information about payments to teaching hospitals will be listed by hospital name. The teaching hospitals that are part of Johns Hopkins Medicine are the Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Sibley Memorial Hospital, Suburban Hospital and Johns Hopkins All Children’s Hospital.
Resources
More information about the Sunshine Act is available on this CMS web site. To receive updates from CMS, physicians and advanced practice providers may register for the listserv by emailing [email protected].
Questions?
- For questions about registration and other technical assistance, contact the CMS Open Payments Help Desk at 1-855-326-8366 or [email protected]. The Help Desk is generally available Monday through Friday from 8:30 a.m. to 7:30 p.m. (ET), excluding Federal holidays. There may be unannounced changes to that schedule. For step-by-step instructions on the registration process, click here.
- For information about the review and dispute process, click here. After noting a payment as disputed on the CMS Open Payments web site, physicians and other providers must contact the manufacturer directly to resolve the dispute and correct any inaccuracy.
- Faculty and investigators who have questions about Sunshine payment data and the School of Medicine disclosure requirements should contact [email protected].
- All other questions should be directed to the Office of Interaction with Industry preferably by e-mail to [email protected]. Voice mails can also be left at 667-208-8950 and will be answered as soon as possible. Please note that our staff are all working remotely.
CMS procedures are subject to change and this site will be periodically updated.
Last update: November 2022.