Get a refresher on your public Open Payments data
Hey, doctors of optometry: Do you know whether your Open Payments data was reported accurately last year? The AOA offers a new resource to help you find out.
The AOA's Committee on Ethics & Values (EVC) has released a handy, one-page summary paper on the Affordable Care Act's "Sunshine Act," or Open Payments program.
The summary, available to AOA members, along with related materials, provides a refresher of what's included and how doctors of optometry can register to review their data.
Open Payments requires that certain manufacturers and others report any payments or gifts provided to doctors of optometrys and other physicians on an annual basis. Items may include travel and housing, grants, consulting fees, honorarium, gifts, food and beverage, lodging and travel, and education. The summary paper clarifies that the act just requires public reporting—it does not bar or restrict these types of payments or transfers in value.
Know what's in those reports
Last year, the Centers for Medicare & Medicaid Services (CMS) made data on these types of financial transactions publicly available for the first time. An initial AOA analysis of the data determined that in the latter part of 2013, drug and device manufacturers paid doctors of optometrys approximately $965,000 in the "general payments" category.
Taking into account additional data from 2013 released by CMS in December, doctors of optometrys received less than $3 million of the more than $3.7 billion that was reported under all payment categories. The sum for doctors of optometrys represented just a small percentage of the total payments made to physicians. The deadline has since closed to dispute and correct any reports for 2013.
However, it's still worthwhile for a doctor of optometry to know what's been reported and published, and to find out if this data is accurate, says Douglas L. Totten, O.D., MBA, a member of the EVC.
Patients and others viewing the data may have questions for their doctors. Dr. Totten advises that ODs "need to be prepared for any questions that may come from patients, the media or interested parties."
Get ready for 2014
The summary paper includes more information. Review any 2013 data reported by manufacturers in your name, and be ready to review any 2014 reports this fall, Dr. Totten says. CMS plans to publish the full calendar year of 2014 financial data by June 30.
Just as last year, CMS will make a 45-day review-and-dispute period available to physicians before the 2014 data is publicly released.
New noteworthy optometry codes
Changes in coding and reimbursements worth knowing. Meanwhile, with the clock winding down on 2023, the AOA continues to press for Congress to act on reforms that would give doctors of optometry an annual, permanent inflationary Medicare payment tied to the Medicare Economic Index.
Modifier -25: How to use it appropriately and avoid costly penalties
The federal government and private payers are heavily scrutinizing the use of modifier -25. When used appropriately, it can help to ensure that patients receive appropriate treatment and that doctors of optometry are reimbursed appropriately for their service. If you believe a claim that includes modifier -25 was inappropriately denied, follow appropriate criteria when appealing.
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