Sunshine Act: Understanding Appropriate Industry-Physician Interactions
By Christopher L. White, Senior Executive VP and General Counsel, AdvaMed
As the Centers for Medicare and Medicaid Services (CMS) works to develop a searchable public website for reported “transfers of value” from health industry manufacturers to physicians and teaching hospitals, as required under the Physician Payment Sunshine Act, the requirement for “background information on industry-physician relationships” deserves significant attention.
Appropriate background information will be critical to help patients, caregivers, and others understand the practical nature of industry payments to physicians and teaching hospitals, and how industry-physician relationships benefit patients, the health care system, and medical progress.
Viewed simply as columns of numbers and transfer-of-value categories, the transparency reports would otherwise tell very little in terms of real-world impact, and could be subject to a wide variety of positive and negative interpretations.
In fact, there are numerous ways in which medical innovation companies interact with physicians, academics, and other health care professionals in connection with the development of new medical technologies, the improvement of existing technologies, and training and education of other health care professionals, among other beneficial services. These relationships produce breakthrough technologies, advance existing devices and enhance patient care. Examples of industry-physician collaborations can be found on the National Dialogue for Healthcare Innovation (NDHI) website.
Reportable transfers under the Sunshine Act include payments to physicians and teaching hospitals for consulting, training, education, serving as faculty or as a speaker for continuing education, honoraria, research, and grants.
AdvaMed has offered background and context explaining transfers of value to ensure reported data is meaningful to patients. In our February 2012 comments to CMS, we recommended that our proposed text content be included on the CMS website.
Appropriate interactions between health care providers and industry include established safeguards to ensure that health care decisions are made in the best interests of patients. Such safeguards include manufacturers’ voluntary compliance with industry codes of conduct, such as AdvaMed’s Code of Ethics, as well as best practices guidance documents. Therefore, we recommend that CMS also incorporate these into its website to promote a complete understanding of industry-physician relationships.
Understanding disclosures made under the Sunshine Act will help preserve appropriate industry-physician relationships that are critical to the innovation process while ensuring enhanced transparency, as intended under the law. Patients will be able to see these reported payments and transfers of value — hopefully with the necessary context — when the website goes live in September 2014.
AdvaMed (the Advanced Medical Technology Association) is the largest trade association representing U.S. medical device manufacturers.