Open Payments Law and Policy

Law and Policy

Open Payments is a federally mandated program that collects and publishes information about payments reporting entities make to covered recipients. The Open Payments database is publicly accessible.

Reporting entities submit information annually to the Centers for Medicare & Medicaid Services (CMS). CMS is required to publish this information on or by June 30 each year and submit an annual report to Congress.

Please note that if you have policy questions, CMS cannot comment on individual circumstances. You may wish to consult legal counsel specializing in federal compliance.

Originally enacted in 2013, the policies governing Open Payments continue to evolve. The final rule that determines Open Payments requirements is updated occasionally through official rule making.

Find more information on the following policies that impact Open Payments:

Read the Open Payments 2020 Annual Report to Congress (PDF).

Program Expansion

Open Payments has expanded to include five new covered recipient types. Learn more on the Newly Added Covered Recipients page.

For information about changes that will affect Applicable Manufacturers and Group Purchasing Organizations, visit the Changes for Reporting Entities page.

Open Payments Proposed Final Rule Changes

Open Payments has included several proposed updates to the program’s regulations in the CMS 2022 Physician Fee Schedule, such as disallowing publication delays of general payments, creating a formal definition of a physician-owned distributorship, and requiring reporting entities to provide additional payment identifier details when reporting payments made to teaching hospitals. You may review the proposed rule in the Federal Register. Open Payments proposals begin on page 39333.

CMS is formally soliciting feedback via comments on the 2022 Physician Fee Schedule, which is available now through September 13, 2021. Further instructions for submitting public comments are included in the Federal Register. Please note that CMS will not respond to comments individually, but will give feedback in aggregate once the comment period is complete.

Open Payments Through the Years

Image Depicting 2013 Calendar

Original Final Rule

Read the Original 2013 Final Rule with Preamble (PDF).

Image Depicting 2015 Calendar

First rule change

Read the first rule change in the 2015 Physician Fee Schedule (PDF).

Image Depicting 2020 Calendar

Second rule change

Read the second rule change in the 2020 Physician Fee Schedule (PDF).

SUPPORT Act and Open Payments

The Support Act:

  • Enabled Open Payments to expand the definition of a covered recipient to include five additional provider types:
    • Physician Assistants
    • Nurse practitioners
    • Clinical nurse specialists
    • Certified registered nurse anesthetists and anesthesiologist assistants
    • Certified nurse midwives
  • Allows CMS to publish National Provider Identifiers (NPIs) within the Open Payments Data

2020 Physician Fee Schedule and Open Payments

In addition to the changes outlined in the SUPPORT Act above, the 2020 Physician Fee Schedule Final Rule includes:

  • Updates to the Natures of Payment categories to add debt forgiveness, long term medical supply or device loan, and acquisitions
  • Consolidation of the Continuing Medical Education and Natures of Payment into one category
  • Additional reporting requirements for the ‘device identifier’ component of the unique device identifier for devices and medical supplies, which will help standardize data

Changes enacted by the SUPPORT Act and the 2020 Physician Fee Schedule applies to Open Payments data collected in calendar year 2021. This is the data that reporting entities will submit to CMS in 2022.

Page Last Modified:
07/28/2021 01:17 PM