On Friday, the Centers for Medicare and Medicaid Services (CMS) added approximately 68,000 payment records—valued at more than $200 million—to the Open Payments dataset.
“With this new data, Open Payments now reports information on $3.7 billion in payments and transfers of value made to up to 546,000 individual physicians and up to 1,360 teaching hospitals in the last five months of the 2013 calendar year,” states CMS.
CMS notes that an updated data set will be routine going forward.
“Every year, CMS will update the Open Payments data at least once after its initial publication,” according to the announcement. “The refreshed data will include updates to data disputes and other data corrections made since the initial publication of this data documenting payments or transfers of value to physicians and teaching hospitals, and physician ownership and investment interests.”
In our previous coverage of the Open Payments release, we wrote that Open Payments was missing a lot of data. Upon release of the database on September 30, Open Payments showed $3.5 billion in payments in various categories. This included 1.7 million records, totaling $2.2 billion, which were de-identified. A few weeks later CMS announced that they actually withheld an additional $1.1 billion from the database. This makes the total $4.6 billion in industry payments from August – December 2013. While the missing $1.1 billion includes $551 million in research payments for new drugs (which were allowed a four year reporting delay), $514 million in payments were not published due to “unresolved disputes at the end of the review period.”
The $200 million new totals reflect close to half of these previously withheld payments. In CMS’s announcement they clarified why certain payments were not published:
The approximately 68,000 records added today to the Open Payments dataset were not published in the initial release on September 30 for one of the following reasons:
The record was still under dispute at the end of the physician and teaching hospital review period (September 11, 2014); or,
Records attested to on the last day of the data submission period for the 2013 program year (July 7, 2014) were inadvertently excluded from publication (however, they were still included in the full 45-day review and dispute process).
CMS states that they will publish the full calendar year of 2014 financial data by June 30, 2015. In addition, CMS plans to include and publish the missing identification of the de-identified data from 2013 by June 30, 2015 as well.
Open Payments System Unavailable in January
“To improve functionality and build on lessons learned, registration, data submission, and review and dispute functions in the Open Payments system will be unavailable beginning on January 1 through late January 2015, due to system enhancements and preparations for the 2014 program year,” states CMS.
“However, stakeholders will continue to be able to view Open Payments data and use the data search tool on the CMS website at www.cms.gov/openpayments. CMS’ Enterprise Portal (EIDM) registration will continue to be available throughout this period, for reporting entities, physicians, and teaching hospitals to continue to register in the EIDM. For assistance in completing EIDM registration, visit the Resources page on the Open Payments website.”
When the system becomes available, a number of enhancements will be operational:
For applicable manufacturers and applicable GPOs: Records that are not successfully matched to a physician or teaching hospital will be identified as records in error that need to be corrected and re-submitted prior to final submission and attestation. This change removes the record status of “Unmatched,” along with the option for attesters to override records that are unmatched. In addition, new matching logic will be implemented that will prompt records previously in an “on hold” status to be moved through the final submission process.
For physicians: The status of “conditionally approved” will no longer exist. Physician profiles that do not successfully pass vetting will now return errors that the physician must correct before proceeding in the Open Payments system.
CMS will provide detailed guidance on these and other enhancements to the Open Payments system in upcoming documentation and Q&A sessions beginning in January 2015. CMS anticipates that the Open Payments system will re-open for 2014 registration and data submission shortly after these system preparations are completed.
Attend Open Payments Question & Answer Session on January 15
CMS will hold an “informal Question & Answer session” on Thursday, January 15, 2015 from 11:30 a.m. to 12:30 p.m. For call-in information, view the EVENTS page.
The session will cover the data refresh, and the upcoming 2014 Open Payments program year. “CMS plans on conducting these sessions regularly each month, and will announce upcoming calls at least a week in advance,” they note in their announcement.