Deadline approaching for Open Payments review, dispute period

Certain physicians and teaching hospitals have until May 15 to review, and if appropriate, dispute, information submitted about them through the Open Payment Program before it goes public, according to CMS.

The program — also known as the Physician Payment Sunshine Act and created under the Affordable Care Act — gathers data on payments that drug and medical device companies make to physicians and teaching hospitals for items such as travel, research, gifts, speaking fees, and food and drinks.

“CMS makes this information available to the public to allow interested stakeholders to analyze, monitor and use the data,” CMS states on its website. “It's important that you, as a physician, know about this program, what's reported about you, and how you can answer questions from your patients.”

The CMS also stated that data applicable to the Open Payments Program from July 2013 forward can be entered into the CMS portal.

According to the agency’s website, doctors of medicine and osteopathy, as well as podiatrists, optometrists, licensed chiropractors, dentists and dental surgeons are affected by the program. In addition, teaching hospitals that receive funds for indirect medical education, direct graduate medical education and psychiatric hospital indirect medical education are all affected by the Open Records Program.

CMS recommends that these health care providers and entities:

•become familiar with Open Payments requirements and the information that can be reported;

•ensure their information on the National Plan and Provider Enumeration website is current;

•keep track of their financial interactions with the health care industry;

•work with device and drug manufacturers to ensure information entered is correct;

•check that the information manufacturers submit on their behalf before it is publicly posted on June 30;

•understand what to do if there is disagreement with submitted information; and

•sign up at CMS’ open payments website to get email updates about the program.

A CMS spokesperson told Healio Family Medicine that between May 15 and June 30, CMS will share disputed information with the manufacturers and/or group purchasing organization that first reported the data. If the dispute cannot be resolved before June 30, the information is posted, but marked as disputed.

According to CMS, after June 30, physicians and teaching hospitals have until the end of the calendar year in which the data is first published to review and dispute data. The changes that a drug and/or device company make as a result of disputes can usually be seen on the Open Payments website starting in January of the next year.

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CMS stated on its website the purpose of the program.

“Open Payments doesn’t identify which financial relationships are beneficial or which may cause conflicts of interest. Instead, the program is designed to increase public awareness about these relationships and promotes transparency in the health care industry.”

Further details about registering, viewing and disputing records, as well as what CMS and the public do with the data, can be found on CMS’ website.

Further reading :

CMS Open Payments Website (Accessed 05-02-17)

CMS Open Payments Fact Sheet for Physicians (Accessed 05-02-17)

CMS Open Payments Quick Reference Guide Review and Dispute for Physicians (Accessed 05-02-17)

National Plan and Provider Enumeration System Website (Accessed 05-02-2017)

Disclosure: Healio Family Medicine was unable to determine relevant financial disclosures prior to publication.