Yesterday’s CMS Open Payments Review & Dispute Resolution Process Call

By Andy Bender

Updates from Yesterday’s National Provider Call on the CMS Open Payments Review & Dispute Resolution Process

CMS Open Payments ReviewOn July 22nd, CMS held a National Provider Call on the Registration, Review and Dispute process, which began on July 14th. The call discussed the CMS Open Payments act on a high level and reviewed the process by which physicians and Teaching Hospitals should register with CMS and view all payments and transfers of value attributed to them. Like applicable manufacturers and GPOs, these Covered Recipients would have to first complete the EIDM registration and then the more specific, Open Payments registration.

Aside from this high-level discussion, the call brought out several key points:

  • Physicians and Teaching Hospitals may only select 1 and 10 authorized representatives, respectively
  • Only applicable manufacturers and GPOs can make any changes to the published data, but may only do so when the change reflects a “meeting of the minds” between the manufacturer/GPO and the physician/Teaching Hospital
  • While physicians/Teaching Hospitals can proactively affirm data that has been submitted, applicable manufacturers and GPOs do not have any view into the system to see which data has been affirmed; CMS is considering this option for future upgrades.
  • One caller representing a Teaching Hospital noted to CMS that the 45-day review period is insufficient for institutions with large amounts of spend

The review and dispute process will end on August 27th, 2014 and all corrections for this publication cycle must be submitted by September 11th, 2014. Data will be published on September 30th, 2014.

During this process, applicable manufacturers/GPOs should consider the process by which they will document the “meeting of the minds” between themselves and physicians/Teaching Hospitals when they resolve a dispute. The documentation should clearly state the final data to be published and both parties’ agreement.

Polaris has already seen across our clients how delicately this exchange must be handled, since CMS is not helping to facilitate in any manner.

The presentation deck for the call can be found here.