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ADVANCE Discourse: Lab

Sunshine Act on Cloudy Finances

Published January 29, 2014 3:37 PM by Michael Jones

The implementation of the Affordable Care Act, or ObamaCare, has already seen several new laws and regulatory measures introduced since its implementation, with many more soon to be on the horizon. One of these is the Sunshine Act, a law requiring public disclosure of any financial agreements between healthcare vendors and providers. Recent articles from both the New England Journal of Medicine (NEJM) and Dark Daily discussed the specifics of the new law and the potential impact to those affected in the healthcare industry.

In terms of the specifics, the Sunshine Act became effective on August 21, 2013 and the NEJM story identified all drug or device manufacturers in the US, as well as doctors of medicine, osteopathy, dentistry, podiatry, optometry, chiropractic medicine, physicians and teaching hospitals. In order for an amount to require disclosure, it must be a transaction of at least $10 or more than $100 annually. The law also requires that certain items also be reported, including “cash or a cash equivalent, in-kind items or services, stock, consulting fees, compensation for services other than consulting, honoraria, gifts, entertainment, food, travel (including the destination), education, research, charitable contributions, royalties or licenses, current or perspective ownership or investment interest, speaker compensation for CME events and grants.”

Additionally, the Dark Daily piece discussed some concerns about the financial disclosure, specifically regarding the strain placed on the relationship between patients and providers. While the impact of financial records being made available online could be substantial for “computer-savvy patients,” there is also concern that availability of this information could jeopardize the trust between patients and physicians, leading patient to ultimately question a doctor’s decisions. The information is set to be published as of September 2014.

“Whether transparency will lead to fewer relationships is really the million dollar question,” commented Daniel Carla, MD, director of the Pew Charitable Trusts Prescription Project, in the Dark Daily piece. “The kinds of relationships that may drop off may well be the most inappropriate relationships.”

The story went on to note that Carla also mentioned the possibly of pharmaceutical companies or medical equipment manufacturers finding new ways to maintain relationships with physicians and clinicians. The NEJM article, on the other hand, examined the purpose of the program: “to provide objective information on the type of financial relationships that exist between manufacturers or GPOs and physicians or hospitals.” Regardless of the predicted changes, the Sunshine Acts stands leave its mark across the healthcare industry.

Apart from its impact on industry vendors, providers and patients, the Dark Daily briefing also noted another area that stands to be affected: the laboratory. According to the Dark Daily article, the impact could be seen by pathologists and laboratory professionals, especially in the case of in vitro diagnostics, manufacturers of which fall under the vendor category of the new law. In the coming future, new policies -- not only federal, but within the companies themselves -- should be taken into account for laboratory professionals. 

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