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Dispute and Resolution

Registered physicians and teaching hospitals have the ability to review and dispute data submitted about them before public release. Applicable manufacturers and applicable GPOs can see disputes and correct data before CMS makes it public. CMS anticipates opening this process soon after the data submission period has ended for each Open Payments program cycle.

 

See the below table for a summary of the dispute and resolution process and timing, and review the additional information below the table.
 

Review, Dispute and Correction Processes
During:What Happens During Review?What Happens During Dispute?What Happens During Correction?
Day 1-45

• Applicable manufacturers, applicable GPOs, physicians and teaching hospitals review their data before it is made public

• Physicians and teaching hospitals can dispute information reported about them or their institutions.
• Disputes initiated during this 45 day period that do not get resolved will be in the public data, but shown as under dispute.
• CMS will not mediate any dispute.
• Applicable manufacturers and applicable GPOs should work with the disputing physician or teaching hospital to correct disputed data.
• Applicable manufacturers or applicable GPO must send CMS a revised report to make the corrections and re-attest to the updated data.
Day 46-60• Applicable manufacturers and applicable GPOs seek to resolve disputes received from physicians or teaching hospitals.
• Physicians and teaching hospitals may continue to review the data.
• Physicians and teaching hospitals may continue to initiate disputes during this period but resolutions may not be reflected in publicly displayed data.• Applicable manufacturers and applicable GPOs should work with physicians and teaching hospitals to make corrections.
• Corrections made to disputes issued during this 15 day window (and resubmitted) may not be in the public data.
• Applicable manufacturers and applicable GPOs must send CMS a revised report to make the appropriate corrections and re-attest to the updated data.

 

Additional Information

  • The review and resolution period starts at least 60 days before the information is made public to allow for the 45-day and 15-day periods described in the table above.
  • If the applicable manufacturer or applicable GPO can’t resolve the dispute with the physician or teaching hospital and correct the data in the initial 45-day or subsequent 15-day period, the applicable manufacturer or applicable GPO and covered recipient or physician owner or investor should continue to seek a resolution.
  • Physicians and teaching hospitals should be aware that corrections from disputes initiated after the 45-day period may not be:
    • Reflected initial public data, or
    • Pursued or corrected by applicable manufacturers or applicable GPOs
  • The review and resolution system is open year-round, but only disputes initiated during the 45-day period and resolved during the subsequent 15-day dispute resolution period will be guaranteed to be in the initial public posting of data.
  • During the 15-day period, new disputes issued or corrections may not be in the initial public posting of data.
  • CMS will update data from the current and previous year at least once annually, in addition to the initial data publication that followed the data submission. Data updates will be included when possible during data refresh.
  • In the cases where a dispute cannot be resolved, the latest, attested-to data submitted by the applicable manufacturer or applicable GPO will be published and marked under dispute.
  • CMS will monitor the disputes and resolutions to inform the auditing process:
    • How often disputes are reported by physicians and teaching hospitals.
    • The volume of disputes unresolved between physicians, teaching hospitals, and applicable manufacturers and applicable GPOs.

Data corrections made by applicable manufacturer or applicable GPOs may be made at any time and the corrections will be updated with the next data refresh.