The 45-Day Review Period: Your Window to Dispute Open Payments Data (42 CFR § 403.910(a))

Open Payments gives clinicians a 45-day review and dispute period to check industry-reported records before the data are posted publicly. Under 42 CFR 403.910(a), this is the main chance for small clinics to correct mistakes in names, dates, amounts, natures of payment, and product associations that would otherwise be visible to patients, payers, and journalists for the entire program year. If you miss this window, the data can still be corrected later, but reputational harm from an initial posting is harder to undo.

For lean practices, the 45-day period must be run like a time-boxed project with a single owner per clinician, evidence pre-staged, and a standard way to cite fields when disputing. Aligning your internal records to the public data elements listed in 42 CFR 403.904(c) results in faster, cleaner resolutions. Treat the window as non-optional and build it into your annual compliance calendar.

Open Payments makes industry relationships visible, but the system only works if the posted information is accurate. Manufacturers submit the data. Your clinicians’ names, practice locations, and product associations appear on the public site. The 45-day review period in 42 CFR 403.910(a) creates a structured chance to catch mis attributions and fix them before publication. Small practices tend to get surprised when the window opens because time is short and the staff is busy. A simple, repeatable routine can turn the annual cycle into a predictable compliance task that protects reputation and reduces downstream administrative friction.

This article explains the legal framework for the 45-day period, maps common operational pitfalls to corrective controls, and provides an actionable playbook that a single coordinator can run for a multi-clinician office.

Legal Framework & Scope Under 42 CFR 403.910(a)

What the rule provides.
 42 CFR 403.910(a) establishes an annual review and dispute period of 45 days before public posting of Open Payments data. During this time, covered recipients can review records reported about them, initiate disputes when they believe a record is incorrect, and attempt to resolve those disputes with the reporting manufacturer. The rule anticipates dialogue between the clinician and the manufacturer that may result in correction before the data goes live.

Key intersections.

• Data elements that are visible to the public are set out in 42 CFR 403.904(c). Knowing these fields helps you create element-specific disputes.

• Statutory authority for the overall program is 42 U.S.C. 1320a-7h, which directs HHS to collect and publish certain payments and ownership interests.

• The 45-day period does not rewrite reporting definitions. It simply provides the time-limited right to review and challenge accuracy before publication.

Scope boundaries.
 The rule covers all reported payments or transfers of value and physician ownership or investment interests that are heading toward public display in the current cycle. It does not change whether a payment is reportable or which categories apply. It governs timing and process for review and dispute.

Operational takeaway.
 Because the clock is fixed, clinics should prepare for the 45-day window in advance with role assignments, pre-collected artifacts, and a calendar that reserves time for clinicians to sign off.

Administrator: CMS operates the Open Payments system, receives manufacturer submissions, opens the 45-day window, and posts the data to the public site after the review period. CMS also facilitates dispute workflows between clinicians and manufacturers and records the final status of each record.

Practical triggers for your clinic under this rule:

• The portal notification that the review period has opened for your clinicians.

• Manufacturer outreach seeking confirmation or providing proposed corrections during the 45 days.

• Public posting date approaching while some items remain “in dispute,” which may require a prepared external statement to explain status if asked by payers or media.

The clinic’s leverage lies in submitting disputes that are precise and backed by documentation. Vague objections consume time and rarely lead to correction within the window.

Below is a lean set of controls you can run with one coordinator and minimal tools. Each control ties to 42 CFR 403.910(a) and, where relevant, to the published data elements in 42 CFR 403.904(c). The goal is to resolve issues inside the 45 days and prevent problem records from reaching public view.

Control 1. Assign a single verifier per clinician and grant portal access early

• How to implement: Before the window opens, confirm each clinician’s role-based access in the portal and assign one verifier who will own that clinician’s queue end to end.

• Evidence to retain: Screenshot of active access, assignment memo, and contact list for the manufacturers that most often report about your clinicians.

• Low-cost method: One shared spreadsheet listing each clinician, their verifier, and the manufacturer contacts.

• Authority: 42 CFR 403.910(a) establishes the review period that the assigned verifier will manage.

Control 2. Pre-stage, an evidence bundle mapped to publication fields

• How to implement: Build a folder per clinician with subfolders named after the 403.904(c) fields you might challenge, such as recipient name/NPI, date, amount, nature of payment, associated product, and contextual notes for ownership or investment interests.

• Evidence to retain: Invoices, remittances, agendas, contracts, speaker agreements, and W-9 or NPI validation screenshots.

• Low-cost method: A standardized folder template replicated per clinician.

• Authority: Using 403.904(c) field names makes disputes specific and actionable during the 403.910(a) window.

Control 3. Run a week-by-week cadence for the 45 days

• How to implement:

  • Days 1–7: Bulk review and tag obvious errors.

  • Days 8–14: File disputes with element citations and attach exhibits.

  • Days 15–28: Respond to manufacturer questions and propose corrected values or text.

  • Days 29–38: Verify updated records in the portal.

  • Days 39–45: Close out, escalate unresolved items to senior contact at the manufacturer, and stage a neutral statement if any records remain “in dispute.”

• Evidence to retain: Dated dispute submissions, manufacturer replies, and final portal screenshots before posting.

• Low-cost method: Calendar blocks with a checklist per week.

• Authority: Implements the fixed timing under 42 CFR 403.910(a)

Control 4. Use element-based dispute templates

• How to implement: Create short templates that reference the specific data field. Example: “Dispute of Amount (403.904(c)): Evidence attached shows total of $125 was split across four attendees and our clinician received $31.25 on [date]. Request correction to amount and nature = food and beverage.”

• Evidence to retain: Redacted receipt, attendee list, and sponsor email.

• Low-cost method: Text snippets you verifier can paste and adapt.

• Authority: Directly aligns to the fields that become public under 403.904(c), used within the 403.910(a) process.

Control 5. Maintain a manufacturer contact roster and escalation path

• How to implement: For the top ten manufacturers that report about your clinicians, keep current emails for the Open Payments contact and one manager. Use this when a dispute stalls in week four.

• Evidence to retain: Contact list, copies of escalation emails, and outcomes.

• Low-cost method: A single tab in your spreadsheet labeled “Escalations.”

• Authority: Supports timely resolution inside the 403.910(a) window.

Control 6. Prepare a neutral external statement for “in dispute” items

• How to implement: Draft a short statement that explains a record is under formal review per 42 CFR 403.910(a) and will be updated when the manufacturer completes its verification. Keep it on file for payers or media.

• Evidence to retain: Versioned statements associated with specific record IDs.

• Low-cost method: A text file in the clinician’s folder.

• Authority: Communicates process status tied to 403.910(a) without revealing sensitive details.

Control 7. Post-window reconciliation and lessons learned

• How to implement: After public posting, compare your portal view to the live data. Note patterns in errors and add preventive steps for next year.

• Evidence to retain: A one-page summary of corrections achieved and unresolved disputes.

• Low-cost method: A simple after-action review template.

• Authority: Ensures continuous improvement for future 403.910(a) cycles.

Playbook wrap-up: Concentrating ownership, structuring evidence by published fields, and pacing work within the fixed 45-day window yields faster corrections and fewer surprises on posting day.

Case Study

Setting: A four-physician specialty clinic learns that the 45-day window has opened. One physician’s record shows a $2,000 “consulting fee” from a device manufacturer. The physician recalls a one-hour advisory call that should have been reported as $500 and associated with a different product.

Action using the playbook:

• The assigned verifier finds the contract and remittance showing $500 for the advisory call and an email confirming the product line.

• In week one, the verifier files an element-based dispute: “Amount” and “Associated Product” under 403.904(c), citing the contract and manufacturer email.

• In week two, the manufacturer requests a meeting. The verifier provides the documents, and the clinician confirms the date and purpose.

• By week four, the manufacturer edits the entry to $500 and corrects the product association.

• The clinic retains a portal screenshot of the corrected record and closes the dispute before day 45.

Outcome: The record posts accurately. The clinic avoids reputational questions about a higher-than-actual fee and an unrelated product appearing next to the physician’s name.

Checklist wrap-up: These tasks anchor the 45-day timeline in routine actions and preserve the evidence trail that supports accurate public posting.

Risk Traps & Fixes Under 42 CFR 403.910(a)

The 45-day window is short, and common mistakes can cost you accurate public data. Each trap below includes the error, the legal reference, and a practical consequence so you can prioritize fixes.

• Waiting for clinicians to self-initiate review.
   Reference: 42 CFR 403.910(a).
   Consequence: Records post with preventable errors because the clinic never opened the queue or delegated a verifier.

• Submitting a dispute without citing the affected field.
   Reference: 42 CFR 403.904(c) for field names used in public display.
   Consequence: The manufacturer cannot target the correction, leading to back-and-forth that exceeds the 45 days.

• Relying on memory rather than artifacts.
   Reference: 42 CFR 403.910(a) requires timely dispute resolution.
   Consequence: You lose days recreating evidence and risk missing the window.

• Letting unresolved items go quiet in the final week.
   Reference: 42 CFR 403.910(a).
   Consequence: Records post while still wrong, forcing reputational clean-up and later corrections.

• Disputing policy questions instead of data accuracy.
   Reference: 42 CFR 403.910(a) governs review and dispute of records, not broader coverage or compliance debates.
   Consequence: Time wasted on arguments outside the scope of the 45-day process.

• Ignoring product associations.
   Reference: 42 CFR 403.904(c) requires product linkage for many entries.
   Consequence: Incorrect associations can attract scrutiny, even when the amount and date are right.

Wrap-up: Precision, speed, and documentation are your best tools. These fixes optimize your limited time under 403.910(a) and reduce the chances of incorrect public listings.

Embed the 45-day process into your annual compliance calendar with named roles and measurable outcomes. Provide a 20-minute training to verifiers on the specific objectives of 403.910(a), how to cite 403.904(c) fields, and how to attach evidence. Track two metrics:

1. Percent of records reviewed within 10 days of window opening.

2. Percent of disputes resolved before day 35.
    Assign one senior reviewer to handle escalations and approve any public statements for items that remain “in dispute.” This keeps the operation lightweight and durable even when staff changes.

The 45-day review period under 42 CFR 403.910(a) is your most effective safeguard against inaccurate Open Payments data. The rule does not add staff or systems. It gives you time. Use it deliberately with a single-verifier model, element-based disputes keyed to 403.904(c), and a paced week-by-week plan that reserves time for corrections and escalation. When you treat the window as a scheduled project, small clinics can achieve the same quality outcomes as large systems.

Immediate next steps for a small clinic

1. Confirm portal access for every clinician and assign one verifier to each queue, documented on a single roster (403.910(a)).

2. Build evidence folders that mirror the public fields listed in 403.904(c) so disputes can cite the exact element needing correction.

3. Populate a 45-day calendar with weekly targets and a day-35 escalation checkpoint to manufacturer management (403.910(a)).

4. Prepare short, element-based dispute templates with slots for exhibits and record IDs, so verifiers can file in under 10 minutes per error (403.910(a); 403.904(c)).

5. After posting, complete a one-page after-action review capturing corrections achieved, unresolved items, and preventive tweaks for next year (403.910(a)).

• 42 CFR 403.910 — Review, dispute, and correction process
  

• 42 CFR 403.904(c) — Publication data elements for payments and other transfers of value
  

• 42 U.S.C. 1320a-7h — Transparency reports and reporting of physician ownership or investment interests