The Open Payments Program Revisited


More than seven years ago Palmetto GBA announced the Open Payments initiative. The goal of this program — then and now — is to increase public awareness and knowledge of the financial relationships between drug and medical device companies and physicians and teaching hospitals. 

Open Payments is described by the Centers for Medicare & Medicaid Services (CMS) as “a national disclosure program that promotes a more transparent and accountable health care system. Open Payments houses a publicly accessible database of payments that reporting entities, including drug and medical device companies, make to covered recipients like physicians.” It further says, “Please note that CMS does not comment on what relationships may be beneficial or potential conflicts of interest. CMS publishes the data attested to by reporting entities. The data is open to individual interpretation.”

In summary, this is a program that provides data on how much your doctor or teaching hospital receives from drug companies or medical device companies. The data do not state what kind of relationship exists between these entities. It is not a finding of fraud or abuse. It is only an accounting of dollars that were spent.

To test the program, I went to the site and entered my general practitioner’s name. I found that she received $1,762.10 with 116 payments in 2019. The payments were primarily for food and beverages (96.3%). AstraZeneca Pharmaceuticals LP was the highest contributor, followed by Novo Nordisk, Inc. There were a total of 10 companies that bought her food or beverages that year. The data show that she is well below the norm for the doctors in the United States (the mean general payment for 2019 was $3,736.21. Knowing this, I am not concerned about my doctor).

The open payments data are available for the years of 2013–2019. CMS will publish the data for the year 2020 on or by June 30, 2021. 

If you’d like to look up your doctor or teaching hospital, you can visit the open payments website at https://openpaymentsdata.cms.gov

A short video about how open payments work is available on YouTube. This video was created by CMS and is part of their national educational program. 

If you have any questions about your Railroad Medicare coverage, you can call our Beneficiary Contact Center at 800–833–4455, Monday through Friday, from 8:30 a.m. to 7 p.m. ET. You can also visit our newly redesigned website at www.PalmettoGBA.com/RR/Me. There you can sign up for email updates on the top right-hand of the page. This will let you receive emails from us about topics you are interested in getting updates about. We won’t share your email address with anyone. 

We also encourage you to use our free, beneficiary website portal called MyRRMed. MyRRMed provides you with access to your claims information, along with historical Medicare summary notices, and a listing of individuals you have authorized to have access to your protected health information (PHI). You can also submit requests to add or change your authorized representatives through the portal. To access MyRRMed, please visit us at www.PalmettoGBA.com/MyRRMed



Last Updated: 06/23/2021