CMS Publishes 2019 Open Payments Data

The Centers for Medicare & Medicaid Services recently published their 2019 Open Payments data. In the 2019 report, which includes transactions that took place between Jan. 1 and Dec. 31, 2019, applicable manufacturers reported $10.03 billion in publishable payments, ownership, and investment interests to healthcare professionals (HCPs) and healthcare organizations (HCOs), which is approximately 680 million more than the previous reporting year. Over 1,600 companies reported a total of 10.98 million records attributable to 614,910 physicians and 1,196 teaching hospitals.

For reporting purposes, payments are broken down into three categories; general, research and ownership and investment interest. According to CMS, general payments accounted for $3.56 billion. Research payments totaled $5.23 billion while ownership or investment interest accounted for $1.24 billion. Ownership and investment interest include those held by both healthcare professions and their immediate family members.

Physicians and teaching hospitals registered in the Open Payments Portal are provided the opportunity to review and dispute data attributed to them directly with the company reporting the data prior to publication. During this year’s review and dispute period, 5,544 records were disputed, and 3,487 records were published with unresolved disputes. Open Payments Program Year 2019 data is still eligible for review through December 31.2020. CMS will refresh its 2019 data at least once after this initial publication to reflect any additions or updated disputes.

CMS requires pharmaceutical and medical device manufacturers—as well as group purchasing organizations—to gather and report for CMS to enhance the transparency between the healthcare industry and the public. Patients can use the information to learn about the relationships their doctors have with the companies that are manufacturing the devices and medications for which they have been prescribed.

Knowingly failing to submit required information in a timely manner to CMS can result in civil monetary penalties of at least $10,000, but no more than $100,000, for each transfer of value not reported as required. The publishing of the 2019 Open Payments data is another reminder for companies to make compliance and policies around interaction with healthcare professionals a priority. Investing in technology that can make transparency reporting more efficient can be extremely beneficial.

Since the start of the Open Payments program in 2013, CMS has published 76.25 million records, accounting for $53.06 billion in payments and ownership and investment interests.

Lauren Howe

Compliance Attorney, MediSpend

Posted on Jul 8, 2020 12:30:00 PM

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