In an article published yesterday on Dr. Sanjay Gupta’s blog, The Gupta Guide, MedPage Today’s Joyce Frieden highlights a number of concerns surrounding the administration’s implementation of the Sunshine Act. Among the issues outlined in the article, specific attention is directed to CMS’ proposal “to remove an exemption in the database for fees the physician receives for giving lectures certified as continuing medical education (CME).” The article raises concerns expressed by organizations including the American Medical Association, who have said that the proposal “would have a significant, chilling impact on CE, which runs contrary to the public interest.”
Physicians are also upset about the way the database is being set up. For example, at this point the Centers for Medicare and Medicaid Services (CMS), which is running the database, is proposing to remove an exemption in the database for fees the physician receives for giving lectures certified as continuing medical education (CME).
CMS is proposing to allow continuing education to be exempted only if the manufacturer paying for the CME is paying through a third party and is completely unaware of who the speaker is both before and after the speaker has been paid.
"Our organizations believe that this raises concerns as industry could learn the identities of speakers/faculty and potentially participants after the funds have been transferred through brochures, programs, and other publications, or through their physician-employees' participation in CE [continuing education] activities (either as speakers/faculty or attendees)," wrote the American Medical Association and more than 100 other provider groups in an Aug. 5 letter to CMS administrator Marilyn Tavenner. "Our organizations are concerned that this would have a significant, chilling impact on CE, which runs contrary to the public interest."
Instead, the groups suggested, CMS could modify the exemption slightly so that the exemption applies to cases where the manufacturer doesn't select the speaker and doesn't know who the speaker is beforehand -- without addressing what happens afterward.
A CMS spokesman said in an email to MedPage Today that "the CME subject matter is under active rulemaking, and comments should be submitted through the normal process."