The Accreditation Council for Continuing Medical Education (ACCME) believes that CMS should not rescind the Sunshine Act's continuing medical education exclusion, according to a letter sent to the Centers for Medicare and Medicaid Services (CMS). According to a press release (below), the ACCME recommends that accredited continuing education should be exempt from reporting within the CMS Open Payments program if the accreditation system utilizes the ACCME standards, and successfully completes a verification process to ensure that it evaluates its continuing education providers for compliance with these accreditation standards.
The Accreditation Council for Continuing Medical Education (ACCME®) has sent a letter to the Centers for Medicare & Medicaid Services (CMS) in response to its proposal to rescind the Continuing Education Exclusion (§ 403.904(g)(1)) of the Open Payments program.
The ACCME believes that CMS should not rescind the continuing education (CE) exclusion. The ACCME recommends that accredited CE should be exempt from reporting within the CMS Open Payments program if the accreditation system utilizes the ACCME Standards for Commercial Support℠: Standards to Ensure Independence in CME Activities and successfully completes a verification process to ensure that it evaluates its CE providers for compliance with the Standards using the same rules, data sources, and interpretations as the ACCME.
Safeguarding Independence
This verification process would fulfill the independence aspirations of the Open Payments program. The Standards for Commercial Support include the essential elements for independence that are described in the Open Payments program. Under the Standards, commercial interests are not allowed to pay speakers directly nor are they allowed to suggest or select speakers. In addition, the Standards safeguard independence by requiring the identification and resolution of conflict of interest; the appropriate management of funds derived from industry; the absolute separation of promotion from education; the freedom from commercial bias; and the full disclosure of relevant financial relationships, as well as of any commercial support.
The Standards for Commercial Support were first implemented in 1991 and were updated in 2004. They were the first accreditation standards written to implement the separation of promotion from education and they have become a national model. The 2004 Standards for Commercial Support were approved by each of the ACCME’s seven member organizations, which represent the profession of medicine and include physician licensing and credentialing bodies. The accreditation bodies of dentistry, family medicine, nursing, optometry, osteopathy, pharmacy, and physician assistants base their accreditation requirements on the Standards. The Standards are recognized nationally, by the profession, by the regulators, and by the government as protecting the public from commercial bias in accredited CME.
Professional Self-Regulation
By using the Standards for Commercial Support verification process as the mechanism for ensuring independence, CMS would leverage the long-established system of professional self-regulation in continuing education. Since 1987, the ACCME has administered an oversight system for other CE accreditors. This ACCME verification system includes 42 US state and territorial medical societies, the Accreditation Council for Pharmacy Education (ACPE), and the Joint Accreditation for Interprofessional EducationTM program created in partnership by the ACCME, the ACPE, and the American Nurses Credentialing Center (ANCC).
In its letter, the ACCME offers the Standards for Commercial Support verification process as a service to CMS, explaining that it could be administered by the ACCME or by the Joint Accreditation for Interprofessional Education program, if that were acceptable to the partners (ACCME, ACPE, and ANCC).
“We offer this service [to CMS] to facilitate the appropriate exclusion of accredited continuing education from reporting under the Open Payments program,” Murray Kopelow, MD, President and CEO, ACCME, states in the letter. “We propose to offer a service to the healthcare professions of the US–and the people that we all serve – that we believe will facilitate health professionals’ engagement in valid, practice-based, independent continuing education that has been shown, unequivocally, to improve their abilities and performance-in-practice in the healthcare system.”
Download the letter here.
