Update on the Open Payments Program Policy

The Centers for Medicare & Medicaid Services (CMS) recently released an overview of key points discussed in the Medicare Learning Network (MLN) Connects National Provider Call on the OPEN PAYMENTS program.  The National Provider Call focused on third party payments and indirect payments, and the Physician Resource Toolkit.  Under Section 6002 of the Affordable Care Act, the government established an OPEN PAYMENTS program, which requires manufacturers of pharmaceuticals or medical devices to publicly report payments made to physicians and teaching hospitals.  The program aims to (1) make financial relationships transparent on a national scale; and (2) provide consumers with information that will enable them to ask questions and make more informed decisions about their healthcare professionals.

The OPEN PAYMENTS program collects information on payments or other transfers of value that are: (1) paid directly to physicians and teaching hospitals; (2) paid indirectly to physicians and teaching hospitals; and (3) designated by physicians or teaching hospitals to be paid to another party.  CMS recommends that physicians track and review all interactions they have with the industry that involve payments or transfers of value.  Although physicians and teaching hospitals are not required to register with the program, voluntary registration will enable physicians and teaching hospitals to review their data before releasing to the public. 

CMS is taking the following actions to promote awareness about the OPEN PAYMENTS program:

• Hosting National Provider Calls; and
• Creating two free mobile applications (OPEN PAYMENTS Mobile for Physicians and OPEN PAYMENTS Mobile for Industry).

The schedule for the national provider calls is available at:

http://www.cms.gov/Outreach-and-Education/Outreach/NPC/National-Provider-Calls-and-Events.html

The Medicare Learning Network (MLN) Matters is available at:

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1330.pdf.

Centers for Medicare & Medicaid Services.  “Open Payments: An Overview for Physicians and Teaching Hospitals.”  MLN Matters Number SE1330.  22 Aug. 2013. 

About the Author

Ms. Shuman assists health care organizations to develop, implement and evaluate their compliance programs and HIPAA privacy programs. Ms. Shuman specializes in our firm’s HIPAA Privacy services, including leading privacy investigations, breach risk assessments, breach notification letters, breach reporting to the Office for Civil Rights and corrective actions plans. She specializes in serving as Interim Privacy Officer for large health care systems, managed care organizations, comprehensive cancer center and health care business associate.