Audits and Penalties for Open Payments Reporting Entities

Audits and Penalties

Reporting entities may be audited to ensure that the data they report is accurate, complete, and submitted on time.

CMS requires reporting entities to keep all records related to financial transactions with covered recipients for at least five years after the records are published. This includes records of payments, transfers of value, and ownership and investment interests.1

Civil monetary penalties (CMPs) of up to $1,000,000 as adjusted annually2 may be imposed on reporting entities if they fail to report information in a timely, accurate, or complete manner.3 Any CMPs collected will be used to operate the Open Payments program.4

Physician-owned distributors are not exempt from reporting requirements.

Additional information on penalties for failure to comply with Open Payments reporting requirements can be found in section 42 CFR §403.912 of the final rule.

Program Expansion

Open Payments expanded in 2021. Visit the Changes for Reporting Entities page to learn how the expansion could affect you.

 

Reference List

  1. Ownership and investment interests extends to physicians as well as physicians’ immediate family members (42 CFR §403.912(e)(1)(i)). For more information about maintaining payment records, refer to §403.912(e)(1)(i).
  2. See 45 CFR part 102.
  3. See 42 CFR §403.912(a) and 42 CFR §403.912(b).
  4. See 42 CFR §403.912(f).
Page Last Modified:
09/10/2024 06:01 PM