Medicare Compliance & Reimbursement

If you fall into the Covered Recipients’ category of the Centers for Medicare & Medicaid Services (CMS) Open Payments program, you can look at and dispute recently-updated data through May 15.

Reminder: CMS began Open Payments to ensure accountability and transparency in healthcare. “Drug and medical device companies must report to CMS payments or transfers of value they make to certain healthcare providers and teaching hospitals for research, meals, travel, gifts, speaking fees, and more,” the Open Payments website reminds.

Each year the agency publishes this data and makes it available for public perusal. Covered Recipients have the opportunity to dispute any information they deem incorrect by the deadline. In the past, only physicians were considered Covered Recipients, but that changed in January 2021 when CMS added five non-physician practitioners (NPPs) to the list. The following are now included in CMS’ Covered Recipients’ group: physician assistants; nurse practitioners; clinical nurse specialists; certified registered nurse anesthetists and anesthesiologist assistants; and certified nurse-midwives.

You aren’t required to review your Open Payments data, but CMS highly recommends that you do. If you find any issues, you must begin the dispute by May 15 “in order [for the update] to be reflected in the June 2022 data publications,” the agency says in alert. “CMS does not meditate or facilitate disputes. Covered Recipients should work directly with reporting entities to resolve disputes,” CMS warns.

Don’t forget: Covered Recipients must register in the Open Payments system before they can review and dispute information.

Find out more about the program, including how to register, at www.cms.gov/OpenPayments.