Physician rights in the open payments program

The Open Payments program requires the federal government to collect and publish information reported by certain pharmaceutical manufacturers and group purchasing organizations (GPOs) about the payments these companies make to physicians. Physicians should take seven steps to ensure their data is correct.

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Register your account: Register at U.S. Centers for Medicare and Medicaid Services’ (CMS) enterprise portal and on the Open Payments system. Accounts are locked if there is a period of inactivity, so if you have not used your account recently, it may need to be reactivated. Register at bit.ly/CMS-enterprise-portal.

Know the timing: CMS requires manufacturers and GPOs to submit data by March 31 of each year. Physicians are notified by CMS when the data is ready to review for accuracy. Physicians have a 45-day window to review and dispute information prior to publication, so be ready to examine the data when it is made available.

Check your data ASAP: Check your profile as soon as possible to ensure that any errors in the data do not prevent you from initiating a dispute within the 45-day window.

Certify correct data: If the reported information is correct, you can electronically certify it. Physicians can leave comments regarding a payment to provide context.

Dispute incorrect data: If you disagree with your data, initiate a dispute. When a physician disputes a payment, the system will alert the applicable manufacturer or GPO. That organization will then work with the physician directly to resolve the dispute.

Understand correction timelines: In order for data to be corrected by CMS before publication, manufacturers and GPOs must notify CMS of a resolution within 15 days after the 45-day review period. An unresolved dispute will be published, but will be marked as disputed. Physicians can initiate a dispute after the review period, but any changes will not be made until the next time CMS refreshes the data.

Check data often: Physicians should become accustomed to periodically checking their profile and keeping accurate records of all dealings with pharmaceutical companies in the event they need to dispute reported payments.

The types of payments reported:

• Speaking engagements

• Travel expenses

• Meals

• Entertainment

• Gifts

• Educational materials (text books, journal reprints)

• Paid advisory board membership

Zachary B. Cohen, JD is an associate at Garfunkel Wild, P.C., in Great Neck, New York. Send your legal questions to medec@advanstar.com.