Medicare & Medicaid

Sunshine Act proposal threatens doctors' due process for disputes

. 3 MIN READ

A newly proposed dispute resolution process for inaccurate Physician Payments Sunshine Act data would deny physicians their due process rights, the AMA told the Centers for Medicare & Medicaid Services (CMS) in a comment letter last week that calls for fairness and urges the agency to modify the deadline for publication of physicians’ payment data.

In a recent proposal, CMS contradicted its own final rule and congressional intent for the Sunshine Act by allowing disputed data to be released to the public without flagging it as such and permitting drug manufacturers to unilaterally dismiss disputes without physicians’ agreement or consent.

The proposed process and guidelines “contravene the express due process provisions of the Sunshine Act, are contrary to congressional intent and violate well-settled rights and principles governing due process,” the AMA said in its letter.

The AMA is worried this dispute resolution process could cause physicians economic and reputational harm, especially since the point of the Sunshine Act program is to give the public an accurate picture of the financial interactions between physicians and the drug industry.

“Physicians are uniquely positioned to be highly motivated to ensure that their report is accurate since inaccurate reporting may result in loss of employment, disciplinary action, reputational harm, loss of associations and affiliations, other financial sanction, and even civil and criminal liability,” the letter said. 

CMS plans to release the data reported by manufacturers of drugs and medical devices to the public by Sept. 30. Physicians now are able to register for step one of the two-step process to review their data, and will be able to complete the registration process and begin reviewing disclosure data sometime in July. The agency has said physicians would then have 45 days to review and dispute their data.

The AMA is urging CMS to delay publishing Sunshine Act data by six months, until March 31, 2015. The agency has denied physicians the ability to register for the program for the past six months, despite previously inferring that physicians would be able to do so at the start of the year.

Implementation of the Sunshine Act has been “marked by missed deadlines mandated by statute and regulation, as well as by moving target dates, inadequate and unreasonable registration and data submission timeframes, and poor methods and platforms for providing basic and essential information,” the letter said.

The AMA will continue to work with CMS to revise the Sunshine Act program to provide accurate and fair reports on interactions and ownership interests. In the meantime, physicians should register for step one of the data review process on the CMS website.

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