President Donald Trump on Oct. 24, 2018, signed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act), which included updates to payment policies, payment rates and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after Jan. 1, 2020. On Nov. 1, 2019, The Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing the SUPPORT Act that included changes to transparency reporting requirements set forth in Section 6002 of the Patient Protection and Affordable Care Act (Public Law No. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Public Law No. 111-152) (Open Payments).
The SUPPORT Act and the final rule make changes to Open Payments transparency reporting in the following ways:
- Expands the Open Payment’s definition of a “covered recipient” to include five additional provider types:
- Physician assistants
- Nurse practitioners
- Clinical nurse specialists
- Certified registered nurse anesthetists
- Certified nurse midwives
- Updates the Nature of Payment categories to include the following new categories:
- Debt forgiveness
- Long-term medical supply or device loan
- Phases out the exclusion from making National Provider Identifiers (NPIs) publicly available
- Provides that the two categories related to education programs be combined into one
- Standardizes data on reported products
- Adds reporting requirements for the “device identifier” component of the unique device identifier for devices and medical supplies.
The changes listed above apply to information from calendar year 2021 that is required to be submitted on or after Jan. 1, 2022. Companies should now be preparing to implement these changes to their transparency reporting processes and procedures for 2021 activities.