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Dispute and Resolution

Physicians, Teaching Hospitals and Industry Review, Dispute and Resolution Now Available

Through September 8, 2014, physicians and teaching hospital representatives can review and dispute data submitted about them before public release on September 30, 2014.

Important Updated Resource for ALL Open Payments System Users:
The Open Payments User Guide has been extensively updated and is now available to provide industry, physicians, and teaching hospitals with a comprehensive understanding of Open Payments system and requirements.  New chapters have been added to include review and dispute system functionality. It can be downloaded on the Open Payments Fact Sheets and User Guides web page.

CMS developed a Quick Reference Guide on how to initiate and dispute a record in the Open Payments system.

The Review and Dispute period ends September 8, 2014. Registered physicians and teaching hospitals have the ability to review and dispute data submitted about them before public release on September 30, 2014. Applicable manufacturers and applicable GPOs can see disputes and correct data before CMS makes it public. 

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
Time Frame: What Happens During Review? What Happens During Dispute? What Happens During Correction?
45 Day Review and Dispute Period
Ends 9/8/2014
• 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.
15 Day Correction Period
Starts 9/9/2014 and ends 9/23/2014
• 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.

 

Additionally, here is how the dispute initiation and resolution timing affects the public display status of the data:

 

Dispute Initiation and Resolution Timing - Impact on Public Display of Data

 

Timing of Dispute Initiation Dispute Resolution Status
Within 45-Day Initial Period or 15-Day Correction Period
Public Display Status
Within 45-day initial review, dispute, and correction period:
7/14/2014 - 8/2/2014 (20 days)
and 8/15/2014 - 9/8/2014 (25 days)
Resolved Published as non-disputed in September, 2014
Not resolved Published as disputed in September, 2014
After current 45-day initial review, dispute, and correction period, but before 45-day period preceding subsequent data refresh Resolved Published as non-disputed in both September, 2014 and the subsequent data refresh; but note the values of non-disputed data are theoretically different
Not resolved Published as non-disputed in September, 2014, and
disputed in the subsequent data refresh

Additional Information

  • The review and resolution process is open year-round, but note the dates above related to when disputes must be initiated and resolved, to see when they will be publicly reflected in the data.
  • Data corrections made by applicable manufacturers or applicable GPOs may be made at any time and the corrections will be updated with the next data refresh.
  • 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.
  • 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.