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Preparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsLive Webinar EventPresented...
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www.certify.com | @certifyTravel & Expense Management Trends for 2013:How CFO’s are Employing New Technologies to Increase...
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Certify webinar 6_21_13_final

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Transcript of "Certify webinar 6_21_13_final"

  1. 1. Preparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsLive Webinar EventPresented by: CertifyJune 25th, 2013www.certify.com | 1.888.925.0510
  2. 2. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsRobert Neveu, PresidentCertify, LLCSpeaker:
  3. 3. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsTodays Topic:The Physician Payments Sunshine Act (Sunshine Act),which is part of the Patient Protection and AffordableCare Act (ACA).Understanding the Sunshine Act & ItsAffects on Organizations
  4. 4. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsPOLL QUESTION
  5. 5. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsPOLL QUESTION
  6. 6. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsWhat is the Sunshine Act?
  7. 7. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizations47% of physicians and compliance officersdon’t know about the Sunshine Act*2012 CBI Audience Poll
  8. 8. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsIntroduced by Senators Charles Grassley ofIowa and Herb Kohl of Wisconsin to enhancetransparency between drug makers,physicians and the public in hopes toprovide objective information on the typesof financial relationships that exist betweenmanufacturers or GPOS and physicians orhospitals.The Act requires accurate reporting of all financial transactions betweenpharmaceutical manufacturers and healthcare providers to be reportedannually to the Centers for Medicare & Medicaid Services (“CMS”).
  9. 9. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsThe Final Ruling on the Sunshine Actwas issued on February 1, 2013 where the CMS within the Department ofHealth and Human Services (HHS) announced the release of the final ruleimplementing the Transparency Reports and Reporting of PhysicianOwnership or Investment Interests section of the Patient Protection andAffordable Care Act (“ACA”), commonly referred to as the “Sunshine Act.”
  10. 10. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsWho does it impact?
  11. 11. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsManufacturers and GroupPurchasing Organizations (GPOs)• Operating in US or conduct activates in US• Manufacturers producing even one:• Drug• Device• Biologic agent• Medical supplyWhere payment is available under Medicare, Medicaid, or theChildrens Health Insurance Program
  12. 12. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsPhysicians and Teaching HospitalsIncluding:• Physicians that are legally authorized topractice:• Medicine• Osteopathy• Dentistry• Dental Surgery• Podiatry• Optometry• Chiropractic MedicineNot only those enrolled in or billing Medicareor Medicaid*A “teaching hospital” is any institution receiving direct orindirect payments from Medicare for graduate medicaleducation
  13. 13. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsWhat needs to be tracked?
  14. 14. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsPharmaceutical anddevice manufacturersmust report all giftsand paymentsgreater than $10made to physiciansand hospitals.
  15. 15. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsWhen does it begin?
  16. 16. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsAugust 1st,2013BEGIN TRACKINGManufacturers must begin tracking all spend madeto physicians and teaching hospitals greater than$10.Data collection and reporting requirements fallon manufacturers and GPOs, not on physiciansand teaching hospitals
  17. 17. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsMarch 31, 2014FIRST REPORT DEADLINEManufacturers must submit their first report tothe CMS no later than March 31st, 2014.The report must contain all spend made tophysicians and teaching hospitals from August 1,2013 through December 31st, 2013.
  18. 18. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsMarch 31, 2014 - May 15th, 2014REVIEW PROCESSPhysicians can voluntarily review and dispute databefore information is made public.Physicians will have 45 days to review and disputeany data that appear inaccurate, and manufacturersand GPOs will then be able to make necessarycorrections.
  19. 19. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsSeptember 30th, 2014DATA POSTED TO PUBLIC SITEAll spend over $100 will be made public onSeptember 30, 2014, published on a public website,identifying physicians who have received payments.The data will be released online in an easilysearchable form and will contain contextualinformation on the many appropriate reasons forwhich physicians and teaching hospitals maintainrelationships with drug and device manufacturers.
  20. 20. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsRisks of Non-Compliance
  21. 21. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsIncomplete Submission of SpendFailure to submit the required information result infines of $1,000-$10,000 for each payment not fullyreported for a maximum of $150,000 annuallyKnowingly Failure to SubmitKnowingly failure to submit spend and exchanges riskfines of $10,000-$100,000 for each payment notreported for a annual maximum of $1,000,000
  22. 22. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsImpacts on Organizations• Financial risks for non-compliance (up to$1,000,000 annually)• New process for managing and trackingspend• Increased cost for resources to maintaincompliance• Risk of large legitimate payments,necessary for the development of all drugsto be misconstrued as improper gifts64% ofcompaniesanticipate amoderate tosignificantchange in theircurrent reportingprocess2012 CBI Audience Poll
  23. 23. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsCMS estimated that the total cost ofthese provisions will be approximately$269 million in the first year and $180million annually thereafter.http://www.policymed.com/2013/02/physician-payment-sunshine-final-rule-cost-and-impact-of-regulation.html
  24. 24. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizationshttp://www.policymed.com/2013/02/physician-payment-sunshine-final-rule-cost-and-impact-of-regulation.htmlBreak Down of Estimated Cost of Complying with the Sunshine Act• Large manufacturers are estimated to hire on average 2.5 full timeemployees to comply with reporting requirements• 2 full time bookkeepers/accounting/auditing staff support• 0.5 full time equivalent compliance officer• For an average of 5,200 additional hours for the first year• With an average hourly rate of $35.75, the first year investment tocomply with the new act is roughly estimated at $185,900 perorganization
  25. 25. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsHow to be Compliant
  26. 26. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsAs of 2012, 53% of organizations were not engaged inany type of transparency reporting2012 CBI Audience Poll0%10%20%30%40%50%60%Not engaged in reporting Required Reporting Voluntarily report
  27. 27. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsHow to be Compliant1. Track and record all spend made to physicians and teaching hospitals over $10Each itemized expense must include:• Physician’s name• Physicians NPI (National Provider Identifier)• Physicians Primary Specialty Code• Practice name• Practice address• Amount of expense• Product detail/name• Nature of benefit1. Provide detailed spend report to CMS by March 31st, 20141. Keep a detailed record (receipt images, expense details) for each itemized expenseThe CMS may request verification or further information regarding expenses due toerror, incomplete information or disputes related to physicians. Each expensereported incomplete may result in fines up to $10,000.
  28. 28. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsPOLL QUESTION
  29. 29. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsPOLL QUESTION
  30. 30. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizations59% of companies are somewhat ornot confident in being complaint withSunshine Act in 20132012 CBI Audience Poll
  31. 31. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsSummary
  32. 32. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsWho’s Affected: Medical Device Manufacturers/ PharmaceuticalCompanies and Physicians/Teaching HospitalsWhat: Manufacturers to track and report all spendmade to physicians over $10Compliance Cost: $185,900 for the first year with 25% decreasein year twoRisks: Fines between $1,000 to 10,000 upward of$1,000,000 annuallySummary
  33. 33. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsAugust 1st,2013TRACKManufacturers mustbegin tracking spendmade to physiciansand teachinghospitalsMarch 31st,2014May 15th,2014September 30th,2014REPORTThe first report to besubmitted to the CMS ofdata from August 1, 2013through December31st, 2013REVIEWPhysicians will have 45 days toreview and dispute any datathat appear inaccurate, andmanufacturers and GPOs willthen be able to make necessarycorrections. PUBLIC KNOWLEDGEFirst public record Sept30, 2014 published on publicwebsite (identify physicianswho have received paymentsor hold ownership.)Know the Dates
  34. 34. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizations
  35. 35. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsWeb-based Travel & ExpenseManagement software• 100% fully automated expensereporting system• Mobile applications for on-the-goreporting and management• Enforce company travel policies• Integrate with your current accountingand HR systems• Integrate with corporate credit cards
  36. 36. www.certify.com | @certifyTravel & Expense Management Trends for 2013:How CFO’s are Employing New Technologies to Increase Insight and Drive GrowthTruly Automated Expense Reporting With CertifyReportExecutiveTM from Certify1. Schedule company wide or individualAutomatic Expense Report Dates2. Schedule Reminders3. ReportExecutiveTM will automatically buildexpense reports for end users4. The user will then be notified by e-mailand directed to review the expense reportand submit it for approval.
  37. 37. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsNPI Database IntegrationCertify customers utilizing Certifys NPI Integration are able to track T&E expenses and link expenseswith specific Physician and Organization NPI records. Complete integration with the United States NPIdatabase allows you to generate the required Federal reports instantly.Certify’s NPI Integration• Link multiple physicians to a singleexpense• Search for physicians and link them to anexpense• Instantly create the federal requiredreport• Ensure all required fields are attached toeach itemized expense• Certify’s NPI Database updated monthly
  38. 38. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsMobile Access to NPI Database for On-The-Go FunctionalityAlong with the web-based NPI functionality, Certify has integrated its mobile application to the USFederal NPI database, allowing users to track and manage receipts and expenses for Sunshine Actcompliance while on-the-go.
  39. 39. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On OrganizationsInstant Access to Federally Required Reports forSunshine Act ComplianceCertify has developed reporting specific to the Sunshine Act, allowing companies to report allphysician spend by employee, date, category, expense total, NPI, physical name andaddress, ensuring compliance with all federal reporting. The NPI Expense Data is dynamic, allowingthe manager to get up-to-the-minute reporting on all Physician Payments.
  40. 40. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizations
  41. 41. www.certify.com | @certifyPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizations
  42. 42. www.certify.com | @certifyIf you would like to schedule a livedemonstration of Certify, leave amessage in the question box to theright or visit:www.Certify.comPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizations
  43. 43. www.certify.com | @certifyQ&A SessionPreparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizations
  44. 44. www.certify.com | @certifyThank youfor attending todays session.Sign up for a free 30-day trail of Certify athttps://www.certify.com/FreeTrial.aspxFor more information on Certify:www.certify.com1-888-925-0510Preparing for the 2013 Sunshine ActUnderstanding the Sunshine Act & Its Affect On Organizations
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