Transparency Reporting Solution

The Transparency Reporting Solution by qordata is designed for compliance officers and teams at pharmaceutical and medical device manufacturers, as well as group purchasing organizations (GPOs), who are required to report healthcare professional (HCP) and healthcare organization (HCO) spend to federal and state authorities. The solution automates data cleansing, validation, standardization, and organization to reduce manual effort and produce submission-ready spend reports for CMS and state-level transparency programs.

Using AI-trained models, the platform supports the full reporting cycle — from data source identification through post-submission dispute resolution — and is built to handle the complexity of both US federal Open Payments reporting and multiple state-level requirements including Nevada, Minnesota, District of Columbia, Oregon, Massachusetts, Connecticut, and Vermont.

AI-Enhanced Capabilities

• Comprehensive visibility: Aggregates and monitors HCP/HCO spend across federal and state mandates to provide full transparency over transfer-of-value activity.
• Regulatory confidence: Automates data validation and applies CMS and state-specific rule checks to minimize errors and confirm report readiness.
• Accurate, standardized reporting: Cleans, matches, and profiles data across sources using AI to meet complex and varied reporting requirements consistently.
• Time-saving automation: Streamlines workflows for monthly and quarterly data uploads, report preparation, and recipient validation to reduce manual effort.
• End-to-end support: Covers the entire reporting cycle from data preparation through the dispute period, with real-time insights throughout.
• Deadline-driven compliance: Includes built-in scheduling and deadline tracking to help teams meet CMS and state submission timelines.

Transparency Reporting Workflow

1. Identify data sources: Pulls spend data from sources including Concur, ERP systems, CRO/R&D, Medical Affairs, and third-party HCP spend platforms.
2. Data mapping and business rules: Maps data fields and defines business rules and assumptions relevant to reporting obligations.
3. Data retrieval and validation: Performs scheduled data pulls on a monthly or quarterly basis and validates completeness, accuracy, and entity information (HCP, NPP, HCO).
4. Data processing: Determines reportable versus non-reportable spend, classifies spend categories, and analyzes data for outliers, misclassification, and duplicates.
5. Report generation and submission: Generates CMS and state-level reports and supports submission of final reports.
6. Post-submission activities: Assists with CMS error resolution, dispute resolution, and generation of analytical reports following submission.

US Federal Reporting (Open Payments / CMS)

• Submission deadline: March 31; publication deadline: June 30.
• Authority: Department of Health and Human Services, Centers for Medicare and Medicaid Services.
• Who must report: Applicable pharmaceutical and medical device manufacturers and GPOs that operate in the US and manufacture or purchase at least one covered product reimbursed by Medicare, Medicaid, or CHIP, or that requires FDA premarket approval or notification.
• Covered recipients: Physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives.
• What is reported: All payments, gifts, and other transfers of value to US physicians and teaching hospitals, including consulting fees, honoraria, gifts, entertainment, food and beverage, travel and lodging, research, charitable contributions, royalty or license fees, ownership interests, faculty or speaker compensation, grants, space rental, debt forgiveness, long-term medical supply or device loans, and acquisitions.
• Exemptions include: Companies with less than 10% revenue from covered products (partial reporting only); entities with no US business presence; raw material or component manufacturers; hospitals manufacturing solely for internal use; and wholesalers or distributors not holding title to a covered product.
• How to report: Annual reports submitted through the CMS online portal.

Nevada State Reporting

• Submission deadline: March 1.
• Authority: Nevada Board of Pharmacy.
• Who must report: Pharmaceutical manufacturers and pharmaceutical manufacturer sales representatives.
• Covered recipients: HCPs licensed, certified, or registered in Nevada; pharmacies and their employees; operators and employees of medical facilities; and persons licensed under title 57 of NRS.
• What is reported: Compensation exceeding $10 per transaction or $100 in aggregate provided by a sales representative to an HCP; names of drugs for which free samples were provided; and names of recipients of free samples.
• Required data points: Manufacturer name, representative state ID, transaction date, recipient name, professional designation, NPI, zip code of practice, compensation amount and type; drug name and NDC if samples were provided.
• Exemptions: Medical device representative information is not required; only manufacturers of drugs on the "List of Essential Drugs for Treating Diabetes" must report under SB539.
• How to report: Submit template file via email to [email protected].

Minnesota State Reporting

• Submission deadline: May 1.
• Authority: Minnesota Board of Pharmacy.
• Who must report: Any entity engaged in manufacturing, wholesale distribution, or selling of drugs and/or medical devices, medicines, chemicals, or poisons for medicinal purposes, licensed by the state.
• Covered recipients: Advanced practice registered nurses (APRNs), physician assistants, veterinarians, and dental therapists.
• What is reported: Payments, reimbursements, or other compensation of $100 or more to a covered recipient practicing in Minnesota during the calendar year.
• Required data points: Practitioner name, professional designation, address, value of payment, and specific reason for payment.
• Exemptions include: Medical device manufacturers distributing drugs incidentally; professional drug samples for free patient distribution; transfers of value with a combined retail value of $50 or less annually; payments to conference sponsors not made directly to a practitioner; honoraria and expenses under $100 annually for faculty at professional conferences; consulting or research compensation under $100 annually; publications and educational materials; and employee salaries or benefits.
• How to report: Electronic spreadsheet submitted via email to [email protected] or on CD-ROM.

District of Columbia Reporting

• Submission deadline: July 1.
• Authority: D.C. Department of Health.
• Who must report: Pharmaceutical manufacturers and labelers, including subsidiaries and affiliates; labelers are defined as entities that repackage prescription drugs for retail sale and hold an FDA labeler code.
• Covered recipients: All licensed HCPs including nurses, certified diabetes educators, registered dieticians, licensed nutritionists, and radiology technicians; non-teaching hospitals, clinics, universities, patient advocacy associations, professional associations; and all licensed healthcare facilities.
• What is reported: All expenses for advertising and direct promotion of prescription drugs to DC residents via radio, television, magazines, newspapers, direct mail, and telephone; expenditures for consulting fees, honoraria, charitable grants, educational programs, gifts, meals or entertainment over $25, and travel reimbursement for DC healthcare professionals; and aggregate costs of employees or contractors engaged in reportable activity.
• Exemptions include: Expenses of $25 or less; compensation related to bona fide clinical trials of modest value; and scholarships for recipients attending qualifying educational or scientific conferences where