Modernizing the CMS Open Payments System

The CMS Open Payments Program (OPP) is a federal transparency initiative that requires applicable manufacturers and group purchasing organizations to report certain payments, transfers of value, and ownership interests involving physicians, other healthcare practitioners, and teaching hospitals. To execute the program, CMS implemented the CMS Open Payments System (OPS), a national health IT platform designed to meet legislative mandates for public transparency. Reporting entities use OPS to submit and certify payment data, while covered recipients, including physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and anesthesiologist assistants, certified nurse-midwives, and teaching hospitals, can use it to review and, when necessary, dispute information reported about them.

Modernizing and maintaining this complex system requires an understanding of Open Payment policies, reporting requirements, participant workflows, data-quality standards, and annual submission, along with review, dispute, and publication processes. To support CMS requirements, TurningPoint offered a resilient technology architecture capable of managing high-volume data submissions, complex user registrations, and detailed dispute resolution workflows, all while ensuring continuous availability and strict regulatory compliance.

TurningPoint delivers a comprehensive solution architecture, software development, and ongoing operational support to support this mission-critical platform.

The primary challenge demanded modernizing legacy frameworks into a scalable, cloud-native infrastructure, streamlining multi-team software delivery, and automating security and testing to ensure reliable program operations. TurningPoint’s expertise has helped CMS achieve key program milestones, reinforcing our commitment to healthcare IT excellence.

Our Impact in OPS

• Supporting Transparency & Accountability: TurningPoint has helped CMS process and publish millions of records, empowering policymakers, healthcare professionals, and the public with crucial financial data that helps to identify and address instances of fraud, waste, and abuse.
• Enhancing System Performance & Compliance: We have helped drive system modernization efforts, including transitioning OPS to a cloud-based infrastructure for improved efficiency, scalability, and security.
• Enabling Stakeholder Engagement & Access: Through enhanced user interfaces and educational outreach, we have made it easier for industry stakeholders to report, navigate, validate, and analyze OPS data, ensuring accessibility for healthcare organizations, researchers, and policymakers.
• Innovating for the Future: Our contributions to a modernized OPS reflect our commitment to innovation and government digital transformation, ensuring the program remains a gold standard in healthcare financial transparency.
• Audit Readiness & Compliance: TurningPoint has supported CMS’s audit readiness, leading to improved reporting accuracy and compliance.

Quality Assurance, DevSecOps & Strategic Deliverables

Appraised at CMMI Maturity Level 5 for Development, TurningPoint helped execute disciplined quality controls supported by an automated DevSecOps pipeline, Selenium-based regression testing, and Splunk IT Service Intelligence (ITSI) predictive operations monitoring. These capabilities help improve release quality, identify issues earlier, strengthen security, and support reliable OPS operations through:

TurningPoint’s combination of cloud-native architecture, SAFe Agile delivery, and CMMI-DEV Maturity Level 5 quality practices has strengthened the CMS Open Payments System and advanced the mission of the Open Payments Program. By supporting secure, reliable, and efficient reporting, validation, review, dispute, and publication workflows, the modernized OPS platform helps CMS deliver timely and accessible healthcare transparency data to the public. Together, these capabilities provide CMS with a dependable platform for sustaining current OPS operations and implementing future program enhancements. This program reflects our commitment to delivering results through disciplined, proven processes and deep domain expertise in CMS OPP.