Assure Compliant CMS Reporting, Detect Risks Early On & Simplify Spend Reporting
CMS Open Payments Reporting Solution
qordata’s CMS Open Payments Reporting solution enables life sciences companies and compliance officers to submit Federal and State spend reports completely, accurately, and timely to the Centers for Medicare & Medicaid Services (CMS).
This data-driven CMS Open Payments Reporting solution is designed to bring visibility to your data and detect risks associated with your CMS reports.
The solution augments your transparency reporting process within the commercial compliance space through AI-powered automation, white glove service, efficient data validation, integration with Concur, Veeva, NPPES, VPL, NPI & other data sources, and more
Data-Driven Open Payments Reporting Solution Offers
Empower Your Open Payments Reporting Process
The following capabilities of our CMS Open Payments Reporting solution allow compliance officers to gain confidence regarding their spend reports and reduce the risk of regulatory fines and penalties.
- Automated checks for outliers and anomalies before CMS submission
- Interactive dashboards for data-driven decision-making
- Organize and validate data with a four-tiered physician matching system
- Integration with SAP Concur, MS SharePoint, FTP locations, etc
- Built-in data validation rules for risk remediation and data accuracy
- Streamline HCP/O validations with a vast database of NPPES, VPL & NPPL
Failure to timely report complete and accurate data to the CMS can result in Penalties and Fines of up to $1,150,000​
In the highly regulated life sciences landscape, timely submission of complete and accurate spend data to the CMS has become a critical aspect of compliance. Failure to meet these obligations can lead to severe penalties and fines, with potential repercussions of up to $1,150,000. Several real-world cases highlight the consequences of inaccurate reporting.
For instance, a medical device company paid $1.11 million to resolve allegations of underreported payments, a clear violation of Open Payments regulations. Such cases underscore the importance of thorough and precise reporting practices.
Compliance officers also face challenges in navigating the dynamic regulatory environment. Regulatory changes, updates, or ambiguities can create complexities that compromise CMS reporting, leading to non-compliance. Therefore, staying abreast of these changes is essential to assure ongoing adherence to reporting requirements and mitigate associated risks effectively.
Additionally, life sciences companies are increasingly turning to data-driven CMS Open Payments Reporting solutions to mitigate risks associated with CMS reporting and augment the transparency reporting process.
Powered by advanced analytics, A.I and automation, qordata’s CMS Open Payments Reporting solution streamlines data collection, validation, and submission processes. It allows proactive identification of anomalies such as duplicate or erroneous transactions, helps adhere to evolving rules and regulations, and minimizes the risks of regulatory fines and penalties.
Conventional Vs. Data-Driven CMS Open Payments Reporting
Conventional CMS Open Payments Reporting | Data-Driven CMS Open Payments Reporting |
---|---|
Compliance officers manage Open Payments Reporting with a limited team and budget constraints. | Utilizing AI-driven data analysis, compliance officers efficiently prepare accurate Open Payment Reports. |
Accessing and analyzing data is challenging due to siloed systems. This affects data quality. | Integration with data sources such as SAP Concur, Veeva, NPPES, VPL and NPPL enhances quality data. |
Limited visibility into Open Payments Data compromises spend data accuracy submitted to the CMS. | Data-driven approach provides comprehensive visibility ensuring early detection of data anomalies. |
Reporting inaccurate data leads to an increased risk of board scrutiny and penalties. | A.I-driven verification to assure accuracy in HCP/HCO data, leading to error-free CMS reporting. |
Uncertainty in data completeness significantly affects CMS Audit Readiness. | Compliance officers assess and monitor CMS Data with limited resources while ensuring Audit Readiness. |
6 Steps to Increase the Effectiveness of Your CMS Open Payments Reporting Program
Step 1: Establish a clear understanding of the CMS reporting requirements​
Step 2: Plan and strategize your CMS Open Payments Reporting Process​
Step 3: Implement a robust data collection process and quality controls​
Step 4: Utilize data analytics to gain insights and identify and remediate inaccuracies/ incompleteness
Step 5: Conduct internal audits and assure compliance with CMS reporting requirements​
Step 6: Maintain continuous improvement of the reporting program​ ​
Step 1
Needs Assessment Plan
Step 2
Streamline the HCP Engagement Process
Step 3
HCP Selection and Background Checks
Step 4
Fair Market Value Assessments
Step 5
Effectively Manage HCP Contracts
Step 6
Ensure Accurate & Timely PaymentsÂ
Step 7
Document Proof of Performance 
Increase the effectiveness of your CMS Open Payments Reporting Program. See how our CMS Open Payments Reporting solution can help you assure the timely submission of accurate and complete spend reports to the CMS.