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Sunshine Act and FMV Compliance Check

Audit site-payment data for Sunshine Act reporting and FMV adherence.

View Source YAML

---
name: Sunshine Act and FMV Compliance Check
version: 0.1.0
description: Audit site-payment data for Sunshine Act reporting and FMV adherence.
metadata:
  domain: business
  complexity: medium
  tags:
  - payment
  - sunshine
  - act
  - fmv
  - compliance
  requires_context: true
variables:
- name: fmv_table
  description: fair market value reference table
  required: true
- name: fx_rates
  description: foreign-exchange rate table
  required: true
- name: payment_ledger_csv
  description: raw payment ledger CSV
  required: true
model: gpt-4o-mini
modelParameters:
  temperature: 0.2
messages:
- role: system
  content: 'You are a compliance auditor reviewing a CSV ledger of payments for calendar year 2025.


    Audit site-payment data for Sunshine Act reporting and FMV adherence.'
- role: user
  content: "1. Load the CSV and normalize currency to USD using the provided FX rates.\n1. For each line item:\n   - Determine\
    \ if a single payment ≥ $13.46 or annual aggregate > $134.54.\n   - Verify required Sunshine fields: NPI, address, payment\
    \ nature, and related product.\n   - Compare investigator fees to FMV benchmarks (±10 %).\n1. Output two tables:\n   -\
    \ **Reportable Payments** – rows that must be reported to CMS.\n   - **Compliance Exceptions** – missing data or FMV variance\
    \ > 10 % with remediation notes.\n1. Summarize lines reviewed, percent reportable, and percent exceptions.\n1. Ask questions\
    \ if thresholds or tables seem outdated.\n\n  Inputs:\n  - `{{payment_ledger_csv}}` – raw payment ledger CSV\n  - `{{fx_rates}}`\
    \ – foreign-exchange rate table\n  - `{{fmv_table}}` – fair market value reference table\n\nOutput format:\nTwo CSV-formatted\
    \ tables followed by a short executive summary.\n\nAdditional notes:\nUse clear column headers so the tables can be imported\
    \ without modification."
testData:
- payment_ledger_csv: 'NPI,Amount

    1234567890,150'
  fx_rates: 'Currency,USD

    USD,1'
  fmv_table: 'Procedure,FMV

    Consult,100'
  expected: Reportable Payments
evaluators:
- name: Generates reportable payments table
  string:
    contains: Reportable Payments