CMS Open Payments Rules and Database

The Centers for Medicare & Medicaid Services (CMS) rule, Transparency Reports and Reporting of Physician Ownership or Investment Interests, also known as the Physician Payments Sunshine Act, requires applicable manufacturers of drugs, devices, biologicals, or medical supplies to annually report to the CMS certain payments or transfers of value made to physicians or teaching hospitals. It also requires manufacturers and group purchasing organizations to disclose physician ownership or investment interests.

• The CMS is required to publish this information on or by June 30 each year and submit an annual report to Congress. Physicians and teaching hospitals are responsible for reviewing payments and submitting disputes annually.
• Physicians and teaching hospitals can review and dispute the payments reported about them before the data are made publicly available on the CMS Open Payments website. Registration in the CMS Identity Management System (PDF) is required to participate in review and dispute. If you have already registered, you can go directly to the CMS Portal to participate in the review and dispute process.
• The CMS is not responsible for the facilitation of disputes. Physicians and teaching hospitals should communicate directly with reporting entities for resolution.
• In 2021, the CMS expanded and now covers the following recipient types: physicians, teaching hospitals, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and anesthesiologist assistants, and certified nurse-midwives.

Related AAMC and CMS Initiatives

In 2023, the CMS Open Payments team, in consultation with the AAMC FOCI Steering Committee and AAMC staff, developed educational resources for use at institutions. These resources are designed to help educate physicians about the Open Payments program and for authorized representatives of teaching hospitals:

• Educational Resources for Physicians (PDF)
• Educational Resources for Teaching Hospitals (PDF)

AAMC Resources

• AAMC letter in response to the Medicare Program: CY 2020 Revisions to Payment Policies Under the Physician Fee Schedule (September 2019, PDF) (See page 15 for comments on the Open Payments program).
• AAMC Letter to CMS regarding delays in Open Payments review and dispute Process (August 2014, PDF).
• AAMC letter in response to comment request for Activities Relating to the Revision of Registration, Attestation, Dispute and Resolution Assumptions Document and Data Retention Requirements (June 2014, PDF).
• AAMC letter to CMS in response to the Notice of Proposed Rulemaking (February 2012, PDF).

CMS Resources

• Covered recipient registration for physician and nonphysician practitioners video.
• Covered recipient registration for teaching hospitals video.
• Open Payments program data.
• Open Payments Registration for Teaching Hospitals and Physicians (Registration is a two-step process: Step 1: Register in the Enterprise Identity Management System. Step 2: Register in the CMS Portal. This is required to see the publicly reported data. For Questions, contact the Open Payments Help Desk (1-855-326-8366).
• Resources for Covered Recipient. This includes information on registration, user roles, nominations, and the review and dispute process.
• Open Payments User Guide for Covered Recipients (February 2021, PDF).
• CY 2015 Physician Fee Schedule Proposed Rule. The CMS proposed making four changes to the Sunshine Rule for calendar year 2015. See pages 40383-40385 for the Open Payments Program.
• Comment request for activities relating to the revision of registration, attestation, dispute & resolution assumptions document and data retention requirements for Open Payments (May 2014, PDF).
• Federal Register notice of the final rule Transparency Reports and Reporting of Physician Ownership or Investment Interests (February 2013, PDF).
• Federal Register notice of the proposed rule Transparency Reports and Reporting of Physician Ownership or Investment Interests (December 2012, PDF).