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CMS to begin provider reimbursement for end-of-life care

December 13, 2022


A new California law that takes effect January 1, 2023, requires California physicians to provide patients with a written or electronic notice about the availability of the federal Open Payments database. It also requires physicians to post in their offices and on their websites a notice informing visitors about the Open Payments database, which can be used to search payments made by drug and medical device companies to physicians, physician assistants, advanced practice nurses and teaching hospitals.

To assist physicians with this new requirement, the California Medical Association (CMA) has published sample forms and notices available at cmadocs.org/open-payments.

What is the Open Payments Database?

Under federal law, drug and medical device manufacturers are required to report their financial interactions with physicians – including consulting fees, travel reimbursements, research grants and other gifts. Any payments, ownership interests and other “transfers of value” are reported to the Centers for Medicare and Medicaid Services (CMS) for publication in the public Open Payments database.

Open Payments data is published annually by June 30, and physicians are able to preview the data attributed to them during a 45-day, pre-publication review and dispute period that runs from April 1 to May 15. Physicians are encouraged to review the data attributed to them during the review period.

Physicians who believe their data contain discrepancies can initiate a dispute with the reporting entity. This gives the reporting entity an opportunity to correct the information before the data is made public. 

Disputes can be initiated until the end of the calendar year in which the record was submitted, but disputes initiated after the end of the review and dispute period will not be reflected in the initial publication.

For more information, visit cms.gov/openpayments.

 

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