CMS Reopens Open Payments System After Rejecting One-Third of Reported Payments

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Explore:  CMS Open Payments

The Centers for Medicare & Medicaid Services (CMS) announced last week that the Open Payments system was available again after it was taken off-line on August 3, 2014 to “resolve a data integrity issue.”  Because the Open Payments system was taken off-line during a critical period in which physicians and teaching hospitals were able to review data reported by manufacturers and group purchasing organizations (GPOs) and, if necessary, dispute incorrect information, CMS extended the review and dispute process by the number of days that the system was off-line until September 9, 2014.  Manufacturers and GPOs will have until September 23, 2014 to resolve disputed payments before the data is posted publicly by CMS on September 30, 2014.

CMS described the data integrity issues as instances where manufacturers and GPOs submitted incorrect information, such as state license numbers or national provider identifiers (NPI) for physicians with the same first and last names.  CMS also announced that incorrect payments transactions were removed from the current review process and will not be published until 2015.  According to news sources, as many as one-third of all payments received by CMS from manufacturers and GPOs were rejected, suggesting that a significant data quality issue was uncovered.  The full scope of this issue is unclear.

CMS indicated that the removed payments will be resubmitted at a later date, but no specific information has been provided.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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