Open Payments

Key facts

Run by

Centers for Medicare and Medicaid Services (CMS)

Legal basis

Social Security Act Section 1128G; 42 CFR Part 403, Subpart I

Data types

General payments, research payments, ownership and investment interests

Publication

Annually by June 30, covering the prior calendar year

First data collected

Starting August 1, 2013; first public release in 2014

What is Open Payments?

Open Payments is the national database created by the Physician Payments Sunshine Act. Applicable manufacturers, meaning companies that make drugs, devices, biologics or medical supplies covered by Medicare, Medicaid or the Children's Health Insurance Program (CHIP), must report payments and transfers of value to covered recipients.

Manufacturers and applicable group purchasing organizations (GPOs) must also report ownership and investment interests that physicians or their immediate family members hold in those companies.

The program is a disclosure system. Publication does not mean a payment was improper, and the data does not show whether a payment influenced any clinical decision.

Who and what is reported

Reports cover these recipients and payment types:

• Physicians: doctors of medicine or osteopathy, dentists, podiatrists, optometrists and chiropractors.
• Teaching hospitals, based on a list CMS publishes for each program year.
• Starting with 2021 data: physician assistants, nurse practitioners and other non-physician practitioners, including clinical nurse specialists, certified registered nurse anesthetists and certified nurse-midwives.
• General payments, such as consulting fees, speaker compensation, food and beverage, travel, education and royalties.
• Research payments made under a research agreement or protocol.

Why Open Payments matters

Open Payments is the main public record of industry financial relationships with U.S. clinicians. Commercial and medical affairs teams use it to see which experts competitors engage as consultants, speakers or investigators, and compliance teams use it to reconcile their own reported spend.

Records identify recipients by name, address and specialty, and recent data files include the National Provider Identifier (NPI) for individual recipients. That allows joins to NPPES, Medicare Part D prescribing data and clinical trial records, which journalists and researchers use to study links between payments and prescribing.

Limitations of Open Payments data

Before each annual publication, recipients can review and dispute records during a 45-day period, followed by a 15-day correction period for reporting companies. Unresolved disputes are published and marked as disputed.

Some value never appears. Payments below a minimum threshold, which CMS adjusts annually for inflation, are excluded unless the yearly total to a recipient exceeds an aggregate threshold. Product samples for patients, patient education materials, and discounts and rebates are excluded. Some research payments tied to products not yet approved can be withheld until approval or for up to four years, whichever comes first.