The act does not create new penalties for financial interactions with drug or device companies, or any other organization. The Stark Law and anti-kickback laws still apply in those areas, but the Sunshine Act now compels disclosure and enacts penalties for failing to comply.
"It does create more pressure for the physician," Garner says. "They are the ones who could be embarrassed if they don't want anyone to know about these transactions—if, for instance, they've been prescribing this medicine pretty heavily and it turns out they've been paid by the manufacturer. If that's the case, you have to clean up your act and comply with this act."
Companies will disclose doctors' names
The disclosure is made by the companies or GPOs, not the physicians, and Garner says most companies will not hesitate to list all the physicians they work with. They don't have anything to gain by keeping your name off the list and much to lose if they are found out of compliance, he explains. That means physicians must determine whether they are comfortable having their names listed as receiving money from the company, or whether they can give up that revenue for the sake of appearances, he says.
"The difficult cases will be those in which you are doing nothing improper and the relationship is entirely legitimate, yet it can give the appearance of some type of undue influence on your practice of medicine," Garner says. "Those cases will require you to assess how much that income means to you. There's not always something wrong with doing work for these companies, but there is such a stigma these days that any nexus can be negative."
The transparency program will have a profound effect on the relationship between physicians and the rest of the healthcare industry, says Robert Hitchcock, MD, FACEP, a practicing physician and vice president and chief medical informatics officer with T-System, a nationwide company based in Dallas that helps physicians improve efficiency and maximize revenue. He notes that the individual physician is largely powerless to control how the information is disclosed. Even if the physician disagrees with the company's intention to disclose a relationship, the company must go ahead with disclosure if no agreement has been reached in 60 days.