Healthcare Market Research
Open Payments and market research honoraria: what actually triggers reporting
Are market research honoraria reportable under the Sunshine Act? It generally turns on whether the sponsor knows who respondents are, not who pays them.
In this guide 6 sections
Most sponsors ask whether their market research honoraria are reportable under Open Payments. That is the right question. It is usually asked ten days before fieldwork starts, which is the wrong time — the structural decisions that determine the answer were made months earlier, at contract stage, when nobody was thinking about physician payment reporting.
The question is not complicated once you have the structure right. Getting the structure right requires understanding what the reporting framework is actually measuring, and that is where most project teams have a gap when they reach out to compliance at the last minute.
What the reporting framework covers
Open Payments — the CMS program implementing section 6002 of the Affordable Care Act — requires applicable manufacturers to report transfers of value made to covered recipients. Applicable manufacturers are companies operating in the United States that make covered drugs, biological products, devices, or medical supplies, along with certain affiliates that support them.
Covered recipients are physicians and teaching hospitals and, for payments made from 2021 onward, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse-midwives.
The reporting threshold is low and adjusted annually for inflation. For 2026, CMS excludes an individual payment under $13.82 unless the total paid to that recipient during the year exceeds $138.13; the 2027 figures are $14.31 and $143.01. The categories are broad: consulting fees, honoraria, speaker fees, food and beverages, travel, research payments, royalties, and several others.
The obligation to report belongs to the manufacturer — not to the research firm, and not to the physician. But it is not limited to checks the manufacturer writes itself. It extends to payments the manufacturer makes through someone else, and that is the structural point most project teams miss.
Who is paying the physician is the wrong question
It is common to hear that honoraria paid by an independent research firm fall outside Open Payments because the firm is not a manufacturer. That is not how the regulation is built.
The rules define indirect payments (42 CFR 403.902) as payments a manufacturer makes to a covered recipient through a third party, where the manufacturer “requires, instructs, directs, or otherwise causes” the third party to make the payment, in whole or in part. A manufacturer that commissions a physician study and funds the honoraria the agency pays to respondents is causing those payments, so they generally fit that description. The firm’s independence, and the fact that its name is on the check, does not by itself take the payment out of the framework.
What generally does take it out is a specific exclusion. Under 42 CFR 403.904(h)(1), indirect payments are excluded from reporting where the manufacturer is unaware of the covered recipient’s identity — meaning it does not know who they are during the reporting year or by the end of the second quarter of the following year. “Know” is defined broadly in the same rules: it covers deliberate ignorance and reckless disregard, not only actual knowledge.
The test is generally not who issues the check. It is whether the manufacturer knows who was paid. A properly maintained blind, in which the sponsor never learns respondent identities, is what generally keeps market research honoraria out of Open Payments.
This is why the research firm’s role matters, though not for the reason usually given. The firm is not a shield because it is independent. It is useful because it can hold respondent identities so that the sponsor never receives them. A manufacturer that recruits and pays physicians directly knows exactly who they are, and those payments are generally reportable whatever the project is called internally. A manufacturer that funds a study through a firm handling physician recruitment, and that keeps identities on the firm’s side of the wall, can generally rely on the exclusion.
The protection is real, but it is not self-executing. It lasts exactly as long as the sponsor stays unaware, and the ways that ends are mostly ordinary project habits.
Identities flowing to the sponsor. A respondent roster attached to an invoice or honoraria reconciliation, recordings or transcripts that carry names or faces, a deliverable that quotes a physician by name and institution, or a named target list the sponsor supplied and can match back to who took part. Any of these can give the manufacturer knowledge of who was paid.
Sponsor contact with respondents. A manufacturer employee who observes an interview with names on screen, sees a respondent on camera and recognizes them, or is introduced to them, may now know who was paid. At that point the exclusion may no longer apply to that respondent’s honorarium.
What the double blind actually does
“Double blind” in market research describes two separate things, and only one of them decides the reporting question.
The respondent-side blind means the physician does not know who the sponsor is. That protects data quality and keeps the study from reading as promotion. It is not what the Open Payments exclusion turns on.
The sponsor-side blind means the manufacturer does not know who the respondents are. This is the side the exclusion in 403.904(h)(1) is about. A study can have a perfect respondent-side blind and still be reportable, if the sponsor receives a named list during the reporting year or by the end of the second quarter of the next.
So “we are double-blinded, so this is not reportable” is roughly right only when the blind that matters — the sponsor-side one — holds through the end of the second quarter of the following year, and nobody on the sponsor side goes looking. “We use an independent firm, so this is not reportable” is not right on its own at all.
Activities that are generally reportable
The exclusion helps market research honoraria where the sponsor genuinely does not know who took part. It does nothing for engagements where the manufacturer knows the physician and is engaging them directly, and those often sit in the same project scope as market research.
Blinded market research interview, paid by a research firm: A manufacturer funds a study. The firm recruits, screens, interviews, and pays respondents, and keeps their identities on its own side. The manufacturer receives anonymized findings and never learns who took part. Generally excluded, as an indirect payment to recipients the manufacturer does not know.
Advisory board stipend, paid by a firm on the manufacturer’s behalf: A physician advises the manufacturer’s commercial team on product strategy, pipeline priorities, or market positioning. The team knows who is in the room; that is the point of the engagement. The research firm processes the payment. Generally reportable, with the manufacturer as the reporting entity.
Advisory board fees — even when processed through a research firm — are generally reportable. An advisory board member provides consulting services to the manufacturer: reviewing data, reacting to strategy, advising on commercial positioning. The manufacturer knows who they are, and the firm in this context is an administrative layer.
Speaker bureau fees and consulting fees are generally reportable for the same reason. Travel and meals provided in connection with any of these generally are too.
Again, the test is not who issues the payment. A firm in the middle changes the mechanics of a payment, not whether the manufacturer knows who received it.
How a blind breaks in practice
For any study relying on the exclusion, the operational requirements for keeping the sponsor genuinely unaware are more demanding than they look on paper.
The most common break is paperwork. Honoraria reconciliations that list respondents by name, recording files named after the physician, transcripts that keep names and practice details, video that shows faces. None of it is malicious; all of it is the default output of a busy project team, and any of it reaching the sponsor can end the sponsor’s unawareness.
Observer access creates a second category of breaks. A manufacturer employee who joins a call as a silent observer is fine for the sponsor-side blind only if they cannot see names or faces and are not in a position to recognize the respondent. In a small specialty, a well-known physician can sometimes be recognized from their voice and their answers alone.
Post-study outreach is a third and underappreciated failure mode. A manufacturer that wants to share results with participants, invite them to an advisory board, or ask a follow-up question needs their identities to do it. If the manufacturer learns who they are before the end of the second quarter of the following year, the exclusion may no longer cover their honoraria — and the new engagement is its own physician-to-manufacturer relationship.
The discussion guide is where the respondent-side blind usually breaks. A study focused on a drug with no approved competitors, or a device with a mechanism unique to one manufacturer, effectively identifies the sponsor through its subject matter. That does not by itself change the reporting analysis, which turns on what the sponsor knows, but it affects data quality and how the study reads.
If the exclusion is what the study relies on, respondent identities need to stay with the firm and out of deliverables, invoices, and recordings. Observer access needs masked names and no cameras on respondents. Post-study contact plans need to be reviewed as a separate compliance question before anyone promises them.
Structure before fieldwork, not after
The right time to address the reporting question is when the engagement scope is defined and the contract is structured — when data flows, observer access, and who holds respondent identities are still decisions being made.
Once fieldwork has begun, these things are facts about the past. A sponsor that has already received a named list cannot become unaware of it.
Before any physician market research engagement
- Is the manufacturer funding the honoraria, even though the firm pays them? If so, treat them as indirect payments that rely on the exclusion, not as payments outside the framework.
- Will any respondent’s name, NPI, practice, or face reach the sponsor — in a list, invoice, recording, transcript, or deliverable?
- Will any manufacturer employee observe fieldwork, and if so, are names and faces masked?
- Does anyone on the sponsor side plan to contact respondents after the study, for results, follow-up, or an advisory board?
- Is any part of the scope — advisory board, consulting, speaking — an engagement where the manufacturer knows the physician? Those payments are generally reportable and need to be captured.
- Has the discussion guide been reviewed for sponsor-identifying language before any recruiting begins?
If each of these has a clean answer at contract stage, the reporting question becomes operational rather than analytical. It is a matter of execution, not retroactive legal assessment of a structure that cannot be changed.
An earlier post on this site about the Sunshine Act and double-blinding introduced the topic at a high level. The question most project teams actually face is narrower: whether the sponsor-side blind holds for the whole reporting window, and whether any part of the scope was never eligible for the exclusion to begin with. Those are different analyses, and conflating them is where most compliance exposure originates.
This article is general information, not legal advice. How Open Payments applies depends on the facts of each engagement, so confirm the treatment of any specific study with your compliance team or counsel.
If you are planning physician interviews or surveys and the reporting question is still open, talk to us. We can walk through how respondent identities, observer access, and follow-up will be handled before any contracts are signed.