The Physician Open Payments Act (formerly known as the Sunshine Act) requires pharmaceutical and device companies to report certain transfers of value they make to physicians. Currently, the act has a continuing medical education “exemption,” meaning that payments to CME providers that ultimately fund speaker fees and attendee tuition do not have to be reported. To qualify, the Accreditation Council for Continuing Medical Education, the American Medical Association, the American Osteopathic Association, the American Academy of Family Physicians, or the American Dental Association must accredit the CME activity, and commercial supporters may not suggest faculty or pay faculty directly. In providing this exemption, the Centers for Medicare and Medicaid Services recognized that accredited CME has strict rules to separate education from supporter influence.

On July 3, CMS proposed eliminating the exemption for accredited CME programs and expanding the list of Open Payments­­–exempt events. However, they did this in an ambiguous way. CME payments would now only be exempt if the supporter remained “unaware” of the identity of the physician speaker or attendee for 18 months after providing a grant to the CME provider. CMS is correct that companies have no influence on CME faculty, but the ongoing “awareness” standard doesn’t work because speakers’ names are published in CME event programs, and attendees who stop by company booths at annual meetings interact with representatives. Under the new rule, companies would have to track these brief interactions because they know the identity of a doctor who attended a sponsored event.

CME faculty work entirely independent of commercial support. Thus, speakers shouldn’t have their names publicly listed as receiving industry money. Likewise, it would be improper to attach “transfers of value” to attendees, especially since attendees are often unaware of which supporters are sponsoring their event. Over-reporting could chill participation in important CME programs.

CMS shouldn’t change the Sunshine Act just as companies are adjusting to the requirements. I encourage you to access the CME Coalition’s action page and portal and petition CMS to clarify that speakers and attendees at accredited CME events will not be reported for the value of their participation.

This proposal is bad for both patients and healthcare providers and needs some TLC to get it back to where it protects against tracking free speech. Medical meeting managers need to let their voices be heard.

Editor's note: What do you think about the CME exemption going away? What effect might that have on accredited CME?