CMS-10495 Crosswalk of Revisions

CMS-10495 Crosswalk of Revisions.pdf

Registration, Attestation, Assumptions Document and Data Retention Requirements for Open Payments

CMS-10495 Crosswalk of Revisions

OMB: 0938-1237

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Revisions Crosswalk (CMS Form Number: CMS-10495)
DE#

Data element Action to be Changes to the registration data elements
name
performed
Data elements collected to register physicians covered recipients
9
Ownership/
Delete
Data element is deleted.
Investor
Indicator

Reason for the change

Applicable manufacturers and applicable group
purchasing organizations are required to report
physicians’ ownership or investment interests, as
opposed to physicians reporting if they are an owner
or investor.

Data elements collected to register teaching hospitals
8
Verify
Addition
Verify Authorized Official's relationship
Provide information to verify the Authorized
Authorized
with teaching hospital data element is
Official's relationship with the teaching hospital.
Official's
added.
This is an optional field, which will assist in
relationship
verifying the Authorized Official has the authority to
with teaching
register the teaching hospital.
hospital
Data elements collected to register applicable manufacturers and applicable group purchasing organizations
20

Points of
contact

Addition

Applicable manufacturers and applicable
group purchasing organizations are required
to provide identifiers for two points of
contact, including the name, job title, email
address, and phone number for each point
of contact.

15

Verify
Authorized
Official's
relationship
with
applicable

Addition

Verify Authorized Official's relationship
with applicable manufacturer or applicable
group purchasing organization data element
is added.

Identifying two points of contact for an applicable
manufacturer and applicable group purchasing
organization will assist in effective communication
between the Open Payments system and applicable
manufacturers and applicable group purchasing
organizations. The two points of contacts identified
may be the same individuals fulfilling an officer,
attestor or submitter role for the applicable
manufacturer or applicable group purchasing
organization.
Provide information to verify the Authorized
Official's relationship with the applicable
manufacturer or applicable group purchasing
organization. This is an optional field, which will
assist in verifying the Authorized Official has
authority to register the entity, nominate and

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DE#

Data element Action to be Changes to the registration data elements Reason for the change
name
performed
manufacturer
approve additional individuals to work on behalf of
or applicable
the applicable manufacturer or applicable group
group
purchasing organization.
purchasing
organization
Data elements collected to register authorized representatives and authorized officials
1
Registration
Addition
Applicable manufacturers, applicable group A registration ID will be assigned to an applicable
ID
purchasing organizations, and teaching
manufacturer, applicable group purchasing
hospitals’ authorized representatives may
organization, and teaching hospital after the entity is
use an entity’s registration ID when
successfully registered. The registration ID may be
entering the Open Payments System.
used by authorized officials and authorized
representative when entering the Open Payments
system.
2
Nomination
Addition
Applicable manufacturers, applicable group A nomination ID will be assigned to authorized
ID
purchasing organizations, teaching
representatives nominated to work on behalf of
hospitals, and physicians authorized
applicable manufacturers, applicable group
representatives may use an entity’s
purchasing organizations, teaching hospitals, and
registration ID when entering the Open
physicians. The nomination ID may be used by
Payments System.
authorized representatives when entering the Open
Payments system.

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File Typeapplication/pdf
File TitleIssue #
AuthorCMS
File Modified2013-11-13
File Created2013-10-29

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