CMS Reopens Open Payments System, Extends Review/Dispute Period and 15-Day Correction Period

by King & Spalding
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On Friday, August 15, 2014, CMS officially announced the reopening of its Open Payments system and an extension of the covered recipient review/dispute period and subsequent data correction period. Our understanding is that the system was reopened at some point on Thursday, August 14. As we previously reported in Health Headlines, the Open Payments system was taken offline on August 3 to resolve a “technical issue” that resulted in data regarding physicians with the same name being linked together in the system.

To resolve the issue, CMS implemented “enhanced algorithms and validation checks . . . and verified that . . . all payment records are attributed to a single physician.” Notably, CMS indicated that “[i]ncorrect payment transactions have been removed from the current review and dispute process and . . . will not be published this year.” The agency did not provide further explanation regarding what it deems to be an “incorrect payment transaction” or how it made those determinations.

As a result of the temporary suspension of the system, CMS has extended the covered recipient review/dispute period and subsequent data correction period. Under the new timeframe, covered recipients will be able to initiate disputes until September 8, 2014. The subsequent 15-day correction period will extend until September 23, 2014. We note that any changes to data that result from disputes initiated after September 8 will not be considered for CMS’s initial publication of the data (in that case, the data that the manufacturer reported initially will be published and not marked “disputed”). Similarly, if a dispute that was initiated by September 8 is not resolved by September 23, then any updates to the disputed data made after that time will not be considered for CMS’s initial publication of the data (in that case, the data that the manufacturer reported initially will be published and marked “disputed”).

Finally, despite these time extensions and calls by the American Medical Association and others, CMS appears to be holding strong to its intention to publish data by September 30, 2014. Indeed, CMS noted somewhat cryptically that the public website will “launch” on September 30, 2014.

The email that CMS sent on August 15 regarding these issues is available here. CMS’s Press Release on this issue is available here.

Reporter, Brian Bohnenkamp, + 1 202 626 5413, bbohnenkamp@kslaw.com

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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