A number of health care attorneys have told me that providers and drug and device manufacturers can expect significantly expanded administrative burdens courtesy of the recently released "Sunshine Act" final rule. In some cases,  patient care and medical research might even suffer. For example, Laurence Freedman, an attorney with Patton Boggs, Washington, told me that the final rule lacks clarity on how to handle teaching hospitals. While drug and device manufacturers are required to report payments made to physicians and teaching hospitals, Freedman said the final rule contains no list of teaching hospitals, and no way for a manufacturer to determine if a client is part of a complex teaching hospital. "If this is not clarified, this could have a detriment to research and patient care," Freedman said.

Kirk Nahra, an attorney with Wiley Rein, Washington, also told me that he's concerned that the benefits of payment transparency will be worth the costs of the associated burdens, including risks to ongoing patient research. He also said there is a real chance the payment transparency information will never be used by patients, but will instead be used by lawyers looking to challenge relationships between manufacturers and providers.