The Iowa State Senate approved a healthcare reform bill on March 19 that includes a ban on gifts to physicians and other healthcare practitioners. The bill, which must be approved by the Iowa House of Representatives before it’s adopted, comes on the heels of similar restrictions adopted into law in Massachusetts.

The law would prohibit drug and device companies that participate in a state healthcare program from providing gifts to healthcare practitioners. In the law, the definition of gifts includes payments, meals, entertainment, travel, honoraria, or anything of value provided to a physician “unless consideration of equal or greater value is received.”

The ban does not include “reasonable honoraria and payment of reasonable expenses” for faculty presenting at a “significant” educational conference. The bill defines a significant educational conference as one that is offered by a provider accredited by the Accreditation Council of Continuing Medical Education or comparable organization, offers CME credits, features multiple presenters on scientific research, or is authorized by the sponsoring association to recommend or make policy. Companies are allowed to provide funding for certified CME, provided the money is used solely for educational purposes, is free from industry influence, and is not paid directly to a healthcare practitioner.

The law would require companies to disclose all permitted payments to healthcare practitioners on an annual basis on a public Web site or gift registry.

The Iowa bill, Senate File 389, carries a proposed penalty of up to $10,000 per violation.

“The bill has a very expansive definition of gifts,” says Marissa Seligman, chief, clinical and regulatory affairs and compliance officer at Pri-Med Institute, Boston. Among other things, the definition of gift includes speaker honoraria for anything other than certified CME. A gift is something that’s given without service in-kind, she says. Speaking at a promotional meeting is a service, not a gift. “I think they have mixed apples with oranges in that regard,” she says.