A Closer Look at Changes to the Open Payments Program

Last Updated: Dec 10, 2019

doc-computer2-articleThe Open Payments Program requires the Centers for Medicare and Medicaid Services (CMS) to collect – and share with the public – information on payments and other transfers of value made to physicians and teaching hospitals by medical device manufacturers and pharmaceutical companies. Examples of payments include stocks, research money, gifts, speaking fees, and meals.

Here’s a look at Open Payments news, including an upcoming deadline as well as recent and upcoming changes to the program.

Adjustment to Minimum Threshold for Reporting

Key thresholds for minimum reporting under Open Payments have been adjusted for the 2020 Program Year. Small payments or other transfers of value of less than $10.97 do not need to be reported, except when the total annual value of payments or other transfers of value to a covered recipient exceeds $109.69.

Open Payments System Enhancements

In September 2019, CMS made several enhancements to its online Open Payments System, including:

  • System Generated Emails – Users such as physicians will be able to view messages associated with their organization with the Open Payments application.
  • Compliance Portal: This allows the CMS Open Payments Compliance team to upload copies of any compliance related communications that may be sent to reporting entities.
  • Physician Matching – This feature validates physician information and downloads results at any time during or outside the submission period.

Get more details about the enhancements in this CMS resource on Open Payments System Enhancements.

Open Payments Will Expand to Other Clinicians

A new federal law – the SUPPORT Act – includes a provision expanding the types of clinicians who are considered covered recipients whose data (if any has been attributed to them by a reporting entity) must be included in Open Payments reporting. The expanded definition includes the following provider types:

  • Physician assistants
  • Nurse practitioners
  • Clinical nurse specialists
  • Certified registered nurse anesthetists
  • Certified nurse midwives

CMS has proposed that the expansion of Open Payments be effective for data collected beginning in calendar year 2021.

Additional Resources

CMS offers more information about Open Payments at www.cms.gov/openpayments.

Pennsylvania Medical Society members with questions can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.

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