CMS Publishes Program Year 2021 Open Payments Data on Health Care Providers

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WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services (CMS) recently published Program Year (PY) 2021 Open Payments (PY) data to publicly disclose the financial relationships between applicable manufacturers and group purchasing organizations (GPOs) (known as “reporting entities”) and certain health care providers (known as “covered recipients”). This data publication reflects a total of 12.10 million records and $10.90 billion in publishable payments or transfers of value made to covered health care providers during PY 2021. It also includes newly submitted or updated records from previous program years.

Open Payments is a national disclosure program that promotes a transparent and accountable health care system. The Open Payments data make it possible for anyone to search through and access information about payments and other transfers of value such as gifts, honoraria, consulting fees, research grants, travel reimbursements, and other payments and transfers of value that reporting entities such as drug or device manufacturers provide to covered health care providers. The data also includes ownership and investment interests held by physicians or their immediate family members in reporting entities.

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The data released marks the first year of the Open Payments program expansion mandated by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018 (SUPPORT Act). Prior to the expansion, physicians and teaching hospitals were the two provider types included as covered recipients under the Open Payments program. The SUPPORT Act added five additional provider types as covered recipients and requires reporting entities to submit data about certain relationships that they hold with these covered recipients. The five additional provider types are: 1) physician assistants, 2) nurse practitioners, 3) clinical nurse specialists, 4) certified registered nurse anesthetists and anesthesiologist assistants, and 5) certified nurse-midwives.

In addition to being the inaugural year of the program expansion, this year’s data publication updates the categories of payments reported by reporting entities and adds reporting requirements to identify certain medical devices. Beginning with the data released on June 30, 2022, CMS now includes covered recipients’ National Provider Identifier (NPI) in the published dataset.

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The data published was reportedly submitted and attested to by reporting entities. Reporting entities are held accountable for submitting timely, accurate and complete data to CMS, including payment amounts and other pertinent details. Reporting entities reported publishable payments to covered recipients during PY 2021 in the following three major categories:

  • General Payments: $2.55 billion
  • Research Payments: $7.09 billion
  • Ownership and Investment Interest: $1.26 million.

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