A blog by attorneys for anyone interested in or affected by The Sunshine Act.

Dispute Resolution, Continued

June 28, 2014
Ruselle W. Robinson

CMS continues to work towards its September 30, 2014 publication date for 2013 payment and physician ownership data.  Phase 2 registration for Industry (applicable manufacturers and applicable group purchasing organizations (GPOs)) will close on June 30th.  Physicians and teaching hospitals are still registering with CMS so that they can participate in the upcoming dispute resolution process.

Last week, CMS updated its web page on dispute resolution.  CMS expanded the name from dispute resolution to review, dispute and correction.  CMS also clarified the review, dispute and correction process by including new detail on how the timing of a dispute and correction will affect CMS’ posting of the data.

The review, dispute and correction process for 2013 payment and physician ownership data will begin in mid-July (exact date not yet announced) and will last 60 days.  The 60 days still break down two periods, the first lasting 45 days, the second lasting 15 days.

60 Day Review, Dispute and Correction:

Days 1-45        Registered physicians and teaching hospitals review data applicable to them before the data is made public.  The physicians and teaching hospitals may dispute the accuracy and/or completeness of the reported data.  While CMS will not mediate any disputes, it encourages Industry to work with physicians and teaching hospitals to correct disputed data.

If the dispute is resolved and the data corrected within the 45 days, the applicable manufacturer or applicable GPO must send a revised report to CMS and re-attest to the submitted data.  CMS then will publish the corrected data.  If the dispute is not resolved within the 45 days, CMS will publish the data as originally submitted, but will show it as disputed.

Days 46-60      Applicable manufacturer and applicable GPOs continue to work with physicians and teaching hospitals to resolve ongoing disputes over reported data.   Also, physicians and teaching hospitals may initiate dispute and correction during these 15 days.

If the applicable manufacturer or applicable GPO agrees to correct disputed data within the 15 days, the applicable manufacturer or applicable GPO must send a revised report to CMS and re-attest to the submitted data.  CMS may publish the corrected data on September 30th, but is not required to do so.  If the dispute is not resolved within the 15 days, CMS will publish the data as originally submitted and show it as not disputed.  CMS may publish the original data as disputed, but is not required to do so.

 

Dispute, resolution and correction continues year-round.  CMS will update previously filed data at least once annually.  If disputes are resolved at any time during the year, the corrected data will be published during the next data update.

For example, if a 2013 data dispute is initiated after the 60 days described above and is resolved before the next data update, CMS will (i) publish the original 2013 data as not disputed in September 2014, and (ii) publish the corrected 2013 data as not disputed with the next data update.

If a 2013 data dispute is initiated after the 60 days described above, and is not resolved before the next data update, CMS will (i) publish the original 2013 data as not disputed in September 2014, and (ii) publish the original 2013 data as disputed with the next data update.

I will continue to report on new developments as they become available.

 

 

Comments

Leave a Comment

Your email address will not be published. Required fields are marked *