Does your organization have an annual process to review the Open PaymentTM Database?
The Open PaymentTM Database was created to promote transparency and accountability in the healthcare system and is managed by the Centers for Medicare & Medicaid Services (CMS). The database houses physician payments reported by Reported Entities such as drug and medical companies.
These payments are reported annually and are broken down by “Nature of Payments” including food and drink, education, and consulting fees. Additionally, payments relating to research are included in the database.
For 2023, there was a total of $12.75 billion reported and 15.64 million reported.
Organizations should have a process to review any payments associated with their physicians to ensure there are no Conflicts of Interest (COI) or payments that may implicate Start or Anti Kickback Statutes. It is also important for physicians to complete a review to make sure that all payments are reported correctly (type of payment, amount, etc.). If any errors are found, they can be disputed with the Reporting Entity.
LW Consulting, Inc. (LWCI) recently completed this review for a large private practice group with 143 physicians. Download the case study to learn more about the process, what we found, and some of our recommendations.
Do you have questions about the Open PaymentTM Database or the review process? Contact Harriett Wall at [email protected] or call (207) 613-2992.
| Sources: |
| CMS open Payments. (n.d.). openpaymentsdata.cms.gov. https://openpaymentsdata.cms.gov/ |
| What is Open Payments? | CMS. (n.d.). https://www.cms.gov/priorities/key-initiatives/open-payments |
