CMS Calls for Sunshine

On Wednesday, CMS announced their proposed Sunshine Rule, an addendum to the Affordable Care Act (ACA) that would require a very specific kind of transparency. The overarching goal of the rule, much like the remainder of the ACA, is “better care at reduced costs.” Under this new regulation, certain drug or device producers would need to report on any financial relationships they share with healthcare providers.

“When people are faced with the difficult task of choosing the right doctor, they need all the information they can gather. If your doctor is taking money from manufacturers of prescription drugs, suppliers of wheelchairs or other devices, you deserve to know about it,” said Peter Budetti, M.D. CMS deputy administrator for Program Integrity.  “Disclosure of these relationships will discourage the inappropriate influence on clinical decision-making that sometimes occurs while still allowing legitimate partnerships.”

If accepted, the rule will take effect on January 1, 2012.

CMS stressed that the purpose of the rule was not to end the endorsement of medical devices or prescriptions, but simply to make consumers more aware that these financial relationships exist. Effected manufacturers would include, “manufacturers of drugs, devices, biologicals, and medical supplies covered by Medicare, Medicaid, or the Children’s Health Insurance Program.” These manufacturers would be required to report any financial compensation or “transfers of value” made to teaching hospitals or physicians. Both parties would have the opportunity to review the report before it is made public.

Healthcare transparency is rarely a negative thing, and the consumer benefits of Sunshine seem obvious. However, there will always be opponents to new compliance legislation, and we’d love to hear those opinions. If you have strong feelings or evidence against (or in support of) the Sunshine Rule, leave them in the comments below.

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Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.