April 7, 2014 – Although the Physician Payment Sunshine Act preempts state laws that require reporting of similar information required under the Act, several states continue to call for the reporting of additional information that relates to gifts, payments or other transfers of value, according to an article posted last week by Policy and Medicine.
The April 1 posting states that the Act “does not preempt all aspects of state disclosure requirements covering payments to physicians and other health practitioners” and that “most aggregate spend states have a much broader list of covered recipients and a larger set of reportable activities.”
Policy and Medicine compiled a chart with the states that have different requirements from the Federal Sunshine Act, which we include below to inform companies of their reporting obligations in these states. To view the full Policy and Medicine article go to: http://www.policymed.com/2014/04/physician-payments-sunshine-act-review-of-individual-state-reporting-requirements.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+policymed+%28Policy+and+Medicine%29
| State | Covered Recipients | Reportable Activities | Other Considerations |
| Vermont | • Everyone from Federal Sunshine Act• Residents • Physician Assistants • Nurse Practitioners • Pharmacists • Employees of Prescribers • Non-teaching hospitals/clinics • Health plans • Pharmacies • Universities • Non-Profit Foundations • Patient Advocacy Associations • Professional Associations. Note that a number of these come in to play for sponsorships, charitable donations, displays and exhibits, so there is a lot left after Federal to still report in Vermont. |
• Everything from Federal Sunshine Act • Samples, includes OTC drugs and devices • Demo units • Coupons, vouchers, co-pay cards • Patient starter kits • Accredited CME • Patient education and disease management materials• Clinical spend prior to 8/1/2013: VT has given companies the option to check a box if they are not going to report Federally preempted spend in their state report. For other states, if you choose to take advantage of the preemption, you still have to report the state spend for the first half of the year (before 8/1). In VT, this is not the case. • Patient education and disease management materials • Anatomical models and charts- Textbooks and reprints are considered by Federal rules to benefit doctors and are reportable, but models and charts are not. In the states, these are considered “gifts.” |
VT still has the only total ban on food for their prescribers if they “regularly practice in Vermont,” which is left a bit up to company interpretation. It becomes difficult to know whether a doctor who is licensed in Vermont, but actually practices in a surrounding state.Also, companies will have to pay extra attention to their Federal Reports with respect to Vermont doctors. Doctors are only allowed to partake in a meal if they are paid as a speaker or consultant. Vermont will likely focus in on the doctors in the Federal report from VT if they see meals to doctors without fees or other expenses attached. |
| Massachusetts | • Everyone from Federal Sunshine Act• Residents • Physician Assistants • Nurse Practitioners • Pharmacists • Employees of Prescribers • Non-teaching hospitals/clinics • Nursing Homes |
• Everything from Federal Sunshine Act • Accredited CME • Anatomical models and charts |
Reporting not required under “de minimus” threshold of $50 per covered recipient eventNote that MA allows “modest” out of office meals for healthcare providers
MA requires a separate report mainly for the additional covered recipients. |
| Minnesota | • Everyone from Federal Sunshine Act• Residents • Physician Assistants • Nurse Practitioners • NOT Pharmacists |
• Everything from Federal Sunshine Act | There is a $50 limit on meals and physician education per prescriber, per yearRisks: Payments apparently in excess of annual limit would be listed on Federal reports. For example, pure device companies do not fall within MN law, so in the Federal reports, you will see physicians who have over $50 meals with no fees or expenses attached. While MN has not been litigious, the worry is that reporters could state that companies have disregarded the state limit. |
| Washington, DC | • All Licensed Healthcare Providers:(Nurses, CDEs, Reg. Dieticians, Licensed Nutritionists, Radiology techs, etc.)
• Non-Teaching hospitals/Clinics • Universities • Patient Advocacy Associations • Professional Associations •All Licensed Healthcare Facilities (Hospice, LTC, Dialysis, etc.) Pretty much anyone remotely involved with healthcare |
• All activities for additional CRs• Employee costs (salaries/overhead)
• All print and media advertising, but only within DC- if you advertise in MD and VA, you are safe |
Reporting not required under “de minimus” threshold of $25 per covered recipient per day.For in-office meals, this $25 limit is very helpful- most meals for lab techs and other licensed healthcare providers are under $25 and will help lower reporting responsibilities. |
| West Virginia | • Everyone from Federal Sunshine Act• Residents • Physician Assistants • Nurse Practitioners • NOT Pharmacists |
• All activities for additional CRs• All national and print media advertising divided by the population of WV | • Reporting is aggregated by buckets of spend• De minimus threshold of $100 per covered recipient |
| California | CA requires companies to adopt a compliance program in accordance with HHS’ Compliance Program Guidance for Pharmaceutical Manufacturers. A company’s program must have policies for compliance w/ the PhRMA Code on Interactions with Health Care Professionals• Each company sets annual (fiscal year) limit on meals and educational items to any CA physician per year
• Risks: Payments apparently in excess of annual limit would be listed on Federal report |
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| Connecticut | Connecticut requires companies to adopt policies consistent with the PhRMA Code or AdvaMed’s “Code of Ethics on Interactions with Health Care Professionals” | ||
| Louisiana | • $50 limit on meals and educational items to any state employee, per year (most hospitals are state-owned)• Risks: Payments apparently in excess of annual limit would be listed on Federal report | ||
| Nevada | Drug companies must adopt general compliance programs in accordance with the Code on Interactions with Healthcare Professionals, and follow through with training and auditing procedure. Companies must submit an annual report, including a certification that annual audit has been conducted and that the certifying entity is in compliance with its code of conduct.Risks: inconsistencies between state and federal reports |
Source: Policy and Medicine, April 1, 2014. Published with permission.