CMS Shines the Light on the Transparency Final Rule: Insight & Implications
February 12, 2013


CMS Shines the Light on the Transparency Final Rule: Insight & Implications
Tuesday, February 12, 2013 at 12:00 PM Eastern Standard Time

On Friday February 1, 2013, the Center for Medicare & Medicaid Services (CMS) released the highly anticipated Final Rule implementing the physician payment sunshine provisions on Section 6002 of the Affordable Care Act, the program now being called the National Physician Payment Transparency Program: Open Payments. Designed to create and promote greater transparency across health care markets, the Transparency Program requires applicable manufacturers to collect, aggregate and report payments or transfers of value to physicians and teaching hospitals as well as for physician ownership or investment interests in manufacturers and group purchasing organizations. Of particular interest to the sector is the amended date for collection and reporting to reflect a 180 day grace period – collection is to begin on August 1, 2013 with the first report due on March 31, 2014. (CMS will publically post the reported information in its web site by September 30, 2014).

The Final Rule provides numerous definitions, updates and clarifications, including those regarding:
  • Indirect payment or other transfers of value made to a covered recipient through a third party
  • Key exclusions from disclosure requirements
  • Clarity on continuing medical education
  • Attribution of meals and beverages provided to covered recipients
  • Special rules for research payments
  • Contents of separate disclosure reports for three key categories – direct or indirect payments or transfer of value; research payments; and physician ownership or investment interests
  • The rules for the amended review and correction period for all stakeholders
  • State preemption
  • CMS/Office of Inspector General audit rights and provisions
These and the many other components of the Transparency Program have broad implications for companies who have and are making significant investments of budget, resources and time to develop, implement and maintain the processes and systems necessary to comply with the law, including the impact to systems and data; business processes and controls; and program governance and compliance.

Please join PwC as we host a webcast on Tuesday, February 12, 12-1 PM EST to overview and discuss the impact of the Transparency Program to the industry’s efforts to comply with the provisions. PwC will provide a summary of the key provisions of the Final Rule as well as engage in a facilitated discussion about the impact of the provisions on the industry’s efforts to develop, implement and maintain the processes and systems necessary to comply with the law. PwC's white paper overview and analysis of the impact of the Final Rule is now available. To download a copy, please click here.
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