To quote CMS, “The Open Payments program is a national disclosure program that promotes a more transparent and accountable health care system. Open Payments houses a publicly accessible database of payments that reporting entities, including drug and medical device companies, make to covered recipients like physicians.”
For this transparency to work, though, it’s important for the data to actually be used. Kelly Cooper (LinkedIn), Compliance Specialist at UF Health Shands Compliance Services, reports that too often it isn’t. There is a downward trend of providers reviewing the data collected, she reports, due to lack of awareness of the program and why it matters.
That needs to change. Physicians and the hospitals that employ them are now required to post a notice for patients about the Open Payment system and how to access it. This will likely lead to more questions from patients and the need for providers to monitor the data more closely.
So what should compliance teams do? She recommends looking at training, awareness and policies. In addition, be sure that the profiles of covered individuals are correct and up to date.
And, be prepared to navigate the dispute process. It can be a long one, but there are shortcuts.
Finally, she urges compliance teams to use the data to get a better handle on staffing, credentialing, what the payment trends are and any red flags.
Listen in to learn more about what the Open Payments program is and how your compliance team should be working with it.