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Dialogues: Continuing Medical Education

8/14/2014

 
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As part of their ongoing efforts to inform the public and keep industry abreast of developments within the Physician Payment Sunshine Act, Partners for Healthy Dialogues published a blog post on CMS recent proposal which could effectively eliminate the CME exemption.  “CMS does not reconcile its proposed change with the current requirement that manufacturers report indirect payments if the manufacturer is “aware” of the identity of the physician recipient,” they write.  The post goes on to highlight the overall importance of CME, and suggests that the current proposal could cause some commercial supporters to no longer fund educational programming.  “Based on the existing regulations, some manufacturers presently fund only accredited CME,” the article states. “It is possible that eliminating the exclusion for payments to speakers at accredited CME could cause some manufacturers to no longer fund CME at all."

Over the last month, there has been considerable news coverage of how payments for continuing medical education (CME) are reported under the Sunshine Act. What exactly is CME and how is it important to physicians and patients?

Physicians must attend CME to stay up-to-date on the latest research and breakthroughs in the world of medicine. Physicians can receive CME credits by attending online courses, attending in-person training, or even by participating in specific sessions at annual meetings of medical societies or other organizations to which they belong. Many states require physicians and other medical professionals to receive a certain amount of CME credits (usually 25-50 credits) to maintain their medical license.

Funding for CME programs may be provided by outside sources, such as pharmaceutical and medical device manufacturers. To prevent conflicts of interest, CME sponsors and providers typically maintain strict guidelines regarding these grants, such as ensuring that manufacturers do not influence the content of the CME or the selection of speakers.

Currently, manufacturer sponsorship of accredited CME is excluded from Sunshine Act reporting if certain guidelines are followed. On July 3rd, however, CMS released a proposal to eliminate that exclusion. CMS proposes that, beginning in 2015, payments to CME speakers be excluded under another exemption for “indirect payments.” CMS’s rationale for the change is to remove a redundancy between the specific exemption for accredited CME and the more general exemption for “indirect payments.”

CMS’s proposal raises potential issues for CME funding because of differences between the current standard for manufacturer reporting of “indirect payments” and CMS’s proposed criteria for reporting “indirect payments” related to CME. Specifically, CMS does not reconcile its proposed change with the current requirement that manufacturers report indirect payments if the manufacturer is “aware” of the identity of the physician recipient. The proposal also does not address the effect of the change on reporting registration fees for physician attendees at CME events.

It is unclear what affect the proposed change would have on manufacturer funding of CME. Based on the existing regulations, some manufacturers presently fund only accredited CME. Thus, it is possible that eliminating the exclusion for payments to speakers at accredited CME could cause some manufacturers to no longer fund CME at all. Physicians of all disciplines participate in CME courses in order to learn about new innovations, collaborate with colleagues, and discuss their experiences treating patients. Any changes to Sunshine Act reporting that might impact the ability of physicians to attend CME should be carefully evaluated.

How many CME courses is your doctor required to complete each year? Find out here.

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