The Physician Payments Sunshine Act (“Sunshine Act”), enacted to address financial conflicts in health care, is the first comprehensive federal legislation mandating public reporting of payments between drug companies, device manufacturers, and medicine. This article analyzes the Sunshine Act’s uneven record, exploring how the law serves as an intriguing example of the uncertain case for transparency regulation in health care. The Sunshine Act’s bumpy rollout demonstrates that commanding transparency through legislation can be arduous because of considerable implementation challenges. Capturing all the relevant information about financial relationships and reporting it with sufficient contextual and comparative data has proven disappointingly difficult. In addition, the law suffers from uncertainty and poor design as to the intended audience.
Yet the Sunshine Act nonetheless retains important and perhaps underappreciated value. From the information generated, we have learned that industry-medicine financial ties vary significantly by physician specialty, and somewhat by physician gender. In many medical fields the distribution of top dollar payments tends to be heavily skewed to a few recipients, all of which have important implications for optimal management of financial conflicts and for health policy more generally. Accordingly, the Sunshine Act’s greatest potential is not guiding decisions of individual patients or physicians, but its downstream effects. This Article traces how secondary audiences, such as regulators, watchdogs, and counsel are already starting to make productive use of Sunshine Act information. Moreover, savvy counsel are recognizing that Sunshine Act information provides explosive evidence in private civil litigation and this Article explores the first wave of cases.
Keywords: Physician Payments Sunshine Act, transparency, financial conflicts, physicians, drug and device manufacturers
Suggested Citation: Suggested Citation
Saver, Richard S., Deciphering the Sunshine Act: Transparency Regulation and Financial Conflicts in Health Care (December 1, 2018). 43 American Journal of Law and Medicine 303 (2018), UNC Legal Studies Research Paper, Available at SSRN: https://ssrn.com/abstract=3455572
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