CMS Publishes Program Year 2021 Open Payments Data
Applicable manufacturers and Group Purchasing Organizations (GPOs) collectively reported $10.90 billion publishable payments and ownership and investment interests to covered recipients in Program Year 2021. Program Year 2021 includes payments or transfers of value made between January 1, 2021 and December 31, 2021, and is the inaugural year for the Open Payments program expansion mandated by the SUPPORT Act.
Today, the Centers for Medicare & Medicaid Services (CMS) published Open Payments Program Year 2021 data, along with newly submitted and updated payment records for previous program years. The data is accessible at https://openpaymentsdata.cms.gov/.
Open Payments is a national disclosure program that promotes transparency and accountability by making information about the financial relationships between applicable manufacturers and group purchasing organizations (GPOs) and physicians, physician assistants, advanced practice nurses, and teaching hospitals available to the public. Through this program, the public has access to a transparent and accountable healthcare system.
Program Year 2021 Highlights
Program Year 2021 is the inaugural year for the Open Payments program expansion, put into place under the SUPPORT Act of 2018. Beginning with Program Year 2021 the Open Payments definition of a “covered recipient” is expanded to include: physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, anesthesiologist assistants and certified nurse midwives.
For Program Year 2021, CMS published $10.90 billion in payments and ownership and investment interests made by applicable manufacturers and GPOs to physicians, physician assistants, advanced practice nurses and teaching hospitals. This amount is comprised of 12.10 million total records attributable to 533,056 physicians, 233,471 non-physician practitioners and 1,237 teaching hospitals.
Payments are reported across three categories: general payments, research payments, and ownership or investment interests. The dollar value in each of the three major reporting categories for Program Year 2021 are:
- $2.55 billion in general (i.e., non-research related) payments
- $7.09 billion in research payments
- $1.26 billion of ownership or investment interests held by physicians or their immediate family members
The Program Year 2021 data publication is the first Open Payments data publication that includes data about physician assistants and advanced practice nurses. Due to the program expansion and inclusion of these provider types as covered recipients the amount of data increased noticeably when compared to prior program years. However, the ratio of payment trends remains the same with the highest dollar value of the data being in research payments, and the largest number of records being in the general payment category.
Also, if the newly added covered recipients are removed from the Program Year 2021 data, the dollar value of the data as well as the number of records remains on par with previous program years, therefore we can attribute the noticeable increases in the data to the addition of the physician assistants and advanced practice nurses. Open Payments also considers the impact of the COVID-19 pandemic as reasoning to the decrease in amount of data for Program Year 2020. While there are lingering results from the global pandemic, the Program Year 2021 data may indicate a return to normal data trends for purposes of the Open Payments program.
The Open Payments data will be refreshed in early 2023 to reflect any updates made to the data since this publication.
For more information and resources, please visit: https://www.cms.gov/openPayments
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Additional Information
Archived Data
Data publication occurs for five year from the time the program year data is first published. After a program year reaches its fifth full year of data publication it is closed and archived. Program Years 2013 – 2014 are archived and are not displayed on the Search Tool. More information about the archiving process as well as the archived data is available on the Open Payments Archived Datasets page.
Covered Recipient Post Publication Review and Dispute Availability
Covered recipients have until December 31, 2022 to review, affirm and, if necessary, dispute records attributed to them that were submitted in Calendar Year 2022. Action taken on the data between now and December 31, 2022 will be reflected in the annual data refresh or in a later publication. In order to participate in review and dispute activities, covered recipients must be registered in the Open Payments system. For more information about the registration process and the review and dispute process visit the Open Payments Covered Recipients page.
Upcoming Program Changes
In November 2021, CMS finalized the Calendar Year 2022 Medicare Physician Fee Schedule (PFS) Final Rule. In the Calendar Year 2022 PFS, CMS finalized changes to the Open Payments program to support the usability and integrity of the data for the public, researchers and reporting entities. The following is a summary of the changes finalized for Open Payments:
- Addition of a mandatory payment context field for records attributed to teaching hospitals
- Addition of the option for reporting entities to recertify annually even when no records are being reported by the reporting entity.
- Disallowing record deletions without a substantiated reason
- Added definition for physician- owned distributorship(s) (PODs) as a subset of group purchasing organizations as well as an updated definition of ownership interest
- Requirement for reporting entities to update their contact information
- Disallowing publication delays for general payment records
- Clarifying the exception for short-term loans; adding clarification that the exception for short term loan applies for 90 total days in in a calendar year, regardless of whether the 90 days were consecutive
- Removal of the option to submit and attest to general payment records with an “Ownership” Nature of Payment category.
These updates will be applicable to data collection beginning in Calendar Year 2023 and will be reflected in the data reported and published in Calendar Year 2024. More details will be in the forthcoming months. Please continue to subscribe to the Open Payments email list and check the Open Payments website to stay up to date with the program.
Contact Us
For program related questions including registration, review and dispute and data submission questions contact our Help Desk at openpayments@cms.hhs.gov or by phone at 1-855-326-8366 (TTY Line: 1-844-649-2766). The Help Desk is open Monday through Friday, from 9:00am – 5:00pm (ET), excluding federal holidays.
Please note that all press inquiries should be submitted to the CMS’ Press Office.
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