Program Year 2018 Data Submission and System Availability

Program Year 2018 Data Submission and System Availability

The Centers for Medicare & Medicaid Services (CMS) would like to remind reporting entities of resources available for reference when preparing for Program Year 2018 Data Submission. Please note: the Open Payments system will be unavailable from Thursday January 3, 2019 – Sunday January 6, 2019 and Monday January 14, 2019 – Saturday January 26, 2019 due to system updates being made for the upcoming data submission.

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Validated Physician List

Additional Resources

December 31, 2018 Deadline Reminder

The following additional resources are available on the Open Payments Resources Page

Submission Mapping Document. This document serves as a data dictionary for the three types of reports (General, Research, and Ownership/ Investment Interests) submitted to Open Payments. It also shows the connection between data elements in the data submission specifications to specific data fields in character-separated value (CSV) sample files. Please note that there are two versions of the Submission Mapping document: (1) the reporting requirements for Program Year 2013 through Program Year 2015; and (2) the reporting requirements for Program Year 2016 and upcoming Program Years. There have been no changes to the submission mapping documents since the 2016 submission cycle so you can use the same version as last year.
Sample Submission CSV Files. These files can be used to check formatting of data submitted through bulk file uploads. For research and general payments, there are two sets of sample CSV files: (1) set that is applicable to submissions for Program Year 2013 through Program Year 2015; and (2) set that is applicable to Program Year 2016 and upcoming Program Years. There have been no changes to sample submission CSV files since the 2016 submission cycle so you can use the same versions as last year.
Open Payments Physician Taxonomy Code List. This list has all of the accepted physician taxonomy codes and can be used to report physician specialty. If a covered recipient physician’s National Plan and Provider Enumeration System (NPPES) profile does not contain any of the specialties on the Open Payments Physician Taxonomy Code List, the reporting entity may provide an alternative code from that list.

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Preliminary Validated Physician List (VPL). CMS encourages applicable manufacturers and GPOs to utilize the provided physician list to validate profile information. The VPL is designed to minimize matching errors during data submissions and eliminate any inconsistencies in the data they report. Use this preliminary version for pre-validation of physician identifying information. The list contains physicians who have previously been reported in the Open Payments system and whom CMS was able to verify using its data sources.

There are two versions of the VPL, one containing physicians who have a National Provider Identifier (NPI) and one containing physicians who do not have an NPI.

The VPL containing Physicians with NPIs includes:

- Variations of physician first/ last name - National Provider Identifiers (NPIs)

- State License Numbers

The VPL containing physicians without NPIs includes:

- Variations of physician first/ last name

- State License Numbers and associated primary types

CMS encourages reporting entities who have implemented automated processing of the VPL to review the new layout for the VPL containing physicians without NPIs as soon as possible and determine if any changes in processing logic are needed to avoid delays during data preparation process at the close of the year. The final version of this list will be released in early 2019 before data submission begins.

Please note: You must be registered in the Open Payments system and affiliated with a reporting entity in order to access and download the VPL and the accompanying instructions document. Access to the VPL will be unavailable during the scheduled system outages.

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Corrections to records in response to active disputes can be made through December 31, 2018 in order to be included in the January Data Refresh.

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Questions - Contact the Live Help Desk

For more information about Open Payments, please visit the Open Payments website.

If you have any questions, you can submit an email to the Help Desk at openpayments@cms.hhs.gov. Live Help Desk support is available by calling 1-855-326-8366, (TTY Line: 1-844-649-2766) Monday through Friday, from 9:00 a.m. to 5:00 p.m. (ET), excluding Federal holidays.

To sign up for the Open Payments listserv, visit the Open Payments Contact Us page at: https://www.cms.gov/OpenPayments/Contact-Us/Contact-Us.html and enter your email address.