The Approaching CMS Open Payments Expansion in 2021/2022

Signed into law on October 24, 2018, the ‘Fighting the Opioid Epidemic with Sunshine Act’ expands the scope of reporting requirements under the Open Payments (Sunshine Act) program to include Advanced Practice Registered Nurses (APRN) and Physician Assistants (PA) in the definition of a Covered Recipient.

Starting on January 1, 2022, Life Sciences organizations will be required to report Aggregate Spend data with APRNs and PAs to the Centers for Medicare and Medicaid Services (CMS) for their Open Payments reporting. This means transparency data capture for the 2021 calendar year must include this data for submission to CMS in 2022.

Including APRNs and PAs as Covered Recipients introduces roughly 450K additional healthcare practitioners (HCPs) with potentially reportable transactions, significantly increasing the scale of Open Payments data capture.

Furthermore, there are over 400 variations of state license credentials for APRNs, and not all APRNs and PAs have NPI numbers, adding complexity to existing license validation processes your organization may have.

How Can MedPro Systems help?

MedPro’s suite of healthcare license validation solutions are powered by our 25 million HCP database, including all APRN and PA license data required for capture, and backed by our premier customer service.

Our team has been closely following CMS’ implementation of these new requirements and have developed best practices for Life Sciences organizations to review and update their internal data processes to meet them.

Contact us today, and our team would be happy to share in greater detail the impact of this upcoming expansion to Open Payments, the steps your organization should be taking now to prepare for reporting in 2022, and how MedPro Systems can help.

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