July 23, 2014
Area(s) of Interest: Payor Issues and Reimbursement Practice Management
Physicians have until Aug. 27 to review and dispute reports about their financial interactions with manufacturers of drugs and medical devices under the Physician Payments Sunshine Act (also known as the Open Payments program). Here’s how to make sure the information reported about you is accurate before the data is released to the public Sept. 30.
Step 1: Register for the Centers for Medicare & Medicaid Services (CMS) Enterprise Portal, a step many physicians may have already completed as the gateway enables access to a number of other CMS programs.
Step 2: Register with CMS’ Open Payments system.
Step 3: Review your data, and file disputes (if necessary).Log into the Open Payments System.Select the “Review and dispute” tab.Select the physician name and program year you wish to review data for, then click the “Show records” button. If data has been reported, then you will be taken to the “Review and dispute” page. If no data has been reported, you will receive an error message stating there are no records to review. On the “Review and dispute” page, you will see a list of all submitted records. You can filter using the tools in the search box. Review your records by scrolling to the right and selecting the “View” link under the “View record” column. View all information available for each record, including links to view the payment record, using the scroll bar at the bottom of the table.Choose whether you want to affirm or dispute the record. Select the desired record and click on the corresponding button. Follow the on-screen text to complete the action. You may also withdraw a dispute you previously initiated.
If you experience any difficulties while attempting to use the Open Payments system, you can contact the CMS help desk at firstname.lastname@example.org or (855) 326-8366.
Disputing a record
If you choose to dispute a record, you must enter a reason for the dispute within the text box before continuing. The text box allows you to input up to 4,000 characters (including spaces). Any text you enter into this box will be made available to the organization that reported the payment, and the organization will receive an email notifying them that you have initiated a dispute.
Records that have been disputed will be listed with one of the following statuses:“Initiated” indicates that you have initiated a dispute against a record.“Acknowledged” indicates that the industry organization has received and acknowledged the dispute initiated against them. Acknowledging a dispute will trigger a notification to you, letting you know your dispute has been received.“Resolved, no change” indicates that either the manufacturer does not agree with the dispute or the manufacturer has discussed the dispute with you and it was determined that no change in the data was necessary. You can initiate a new dispute if you disagree with the “resolved, no change” status.“Withdrawn” indicates that you have withdrawn a dispute you initiated against a record.“Resolved” indicates that disputed data was updated and then resubmitted and re-attested to by the manufacturer.
Industry organizations either will correct disputed data, or, if not corrected right away, that data will be marked as disputed when it is released to the public. The industry will have a 15-day period, from Aug. 28 to Sept. 11, to submit dispute corrections. CMS plans to release physicians’ financial data to the public by Sept. 30.
The agency has updated its Open Payments user guide (relevant sections for physicians begins on document page 310 under the Chapter 9 heading Review and Dispute for Physicians and Teaching Hospitals) and Quick Reference Guide with new information about how to dispute information.
For more information on registering for the Open Payments system and how to dispute data, visit the AMA’s Sunshine Act Web page.
CMS also hosted a webinar on July 22, 2014, to help physicians register, review and, if necessary, dispute disclosures under the Sunshine Act. A link to the audio recording and written transcript of this call will be posted under the "Call Materials" section approximately 2 weeks following the call.