Buried at the bottom of a fact sheet on proposed policy and payment changes to the Medicare Physician Fee Schedule for Calendar Year 2015 that was released on July 3 is a proposed reversal of the Centers for Medicare & Medicaid Services’ Open Payments policy that has stunned the continuing medical education community.

One of the four changes it seeks to make to the Open Payments program—which was established to increase public awareness of financial relationships between drug and device companies and certain healthcare professionals—is to delete the continuing education exclusion in its entirety. The fact sheet states:

Eliminating the exemption for payments to speakers at certain accredited or certifying continuing medical education events will create a more consistent reporting requirement, and will also be more consistent for consumers who will ultimately have access to the reported data.

As Thomas Sullivan, president of medical education company Rockpointe and a proponent of the exemption, said in a LinkedIn post, “No one I know saw this coming.” Adds Andrew Rosenberg, senior advisor, CME Coalition, “We are stunned that CMS would reverse course on the common-sense reporting exemption for accredited CME that they, themselves, created and finalized last year. … We are at a loss to explain why CMS would abruptly reverse its own Final Rule, which came as a result of significant stakeholder input and participation from all sides.”