PPACA “sunshine provisions” and Continuing Medical Education

PPACA includes some “carve out” exemptions from reporting by Applicable Manufacturers, for CME certified activities/programs. This does not represent a blanket exemption for CME related events, as PPACA still requires reporting of some payments/transfers of value to physician participants at CME activities and to faculty/speakers at non-CME certified events.

EXEMPT CONTINUING EDUCATION ACTIVITIES

A.  Payments and other transfers of value as compensation for speaking at certified continuing education activities, if all three of the following apply:

1. The continuing education activity meets the accreditation or certification requirements and standards for continuing education by one of the following organizations:  Accreditation Council for Continuing Medical Education (ACCME); American Academy of Family Physicians; American Dental Association’s Continuing Education Recognition Program; American Medical Association; or the American Osteopathic Association.
2. The applicable manufacturer does not pay the covered recipient directly;
3. The applicable manufacturer does not select the covered recipient speaker or provide the third party (such as a continuing education vendor/provider) with a distinct, identifiable set of individuals to be considered as speakers for the continuing education program.

Note that Provisions 2 and 3 are and have historically been forbidden by the ACCME Standards of Commercial Support and the OIG Guidance to Industry on Interactions with Physicians. See ACCME Standards of Commercial Support and OIG Guidance to Industry on Interactions with Physicians.

B.  Food and beverage, when the cost of the recipient’s meal in a group setting (among covered recipients, such as a buffet) is not separately identifiable.

C.  For large, unaccredited educational programs where it may be difficult for the applicable manufacturer to establish the identity of specific physicians who have partaken of food and beverage (and to determine the amount of food partaken).

D.  Educational materials directly benefiting patients or intended for patient use, per PPACA.

REPORTABLE CONTINUING EDUCATION RELATED ACTIVITIES

A.  Compensation for serving as faculty or as a speaker for an unaccredited and non-certified continuing education program or at a certified CE program for an organization that is not listed as exempt (see above).

B.  Travel, lodging and meals, entertainment, and all other payments to physician attendees that are provided in conjunction with accredited or certified CME events (with exception of educational materials included in the tuition fees for certified CME activities that meet all three criteria above).

C.  Sponsored meals, receptions or breaks where the applicable manufacturer can identify specific attendees.

D.  Materials such as medical textbooks, journal reprints for the further education of covered recipients but not intended for patient use or directly beneficial to patients .

E.  Awards from specialty societies provided to covered recipients (including fellows).

 

NOTES

• Some Applicable Manufacturers are electing to report more broadly than others, so there will be variations by company with respect to the reporting requirements of PPACA.
• In an effort to track and report these data, the Office of Continuing Medical Education will soon request NPI numbers from all physician and fellow presenters and participants.
• If you need clarification on these reporting requirements or exemptions, please contact the Office of Continuing Medical Education (924-5310).