The Accreditation Council for Continuing Medical Education sent a letter on August 21 to the Centers for Medicare and Medicaid Services saying it believes CMS should not take back the exclusion from Open Payments tracking and reporting that CMS had previously granted to CME. With this letter, the officially joins a growing protest over the proposal. When CMS floated the idea earlier in August, The American Medical Association and 112 other medical organizations sent a letter outlining why they thought the CME exclusion should remain, as did the Pharmaceutical Research and Manufacturers of America and another group of medical societies.
The ACCME letter says that CMS should not rescind the continuing education exclusion, and that
“…accredited CE should be exempt from reporting within the CMS Open Payments program if the accreditation system utilizes the ACCME Standards for Commercial Support and successfully completes a verification process to ensure that it evaluates its CME providers for compliance with the Standards using the same rules, data sources, and interpretations as the ACCME.”
This is because the existing system already ensures that manufacturers don’t pay CME speakers directly, and that manufacturers can’t cherry-pick speakers for accredited CME activities, two of the Open Payments goals in making public all transfers of value between physicians and pharmaceutical companies. The Standards also require CME providers to identify and resolve conflicts of interest; ensure commercial support dollars are managed correctly; have firewalls between promotion and education; keep their activities fair and unbiased; and ensure that all relevant financial relationships with pharmaceutical companies are disclosed.
Since 1987, ACCME has administered an oversight system of CE accreditors that include 42 U.S. state and territorial medical education accreditors, the Accreditation Council for Pharmacy Education, and the Joint Accreditation for Interprofessional Education program created in partnership with ACPE and ANCC.
Now ACCME is proposing a further broadening of scope for its SCS verification system.
ACCME explains in the letter that it would consider making “public, open, and transparent” its long-established Standards for Commercial Support verification process as a way CMS could ensure the independence of CME. The verification process is currently available only to accreditors that have adopted its SCS in full. The ACCME offered to administer the system, under the auspices of the Joint Accreditation for Interprofessional Education, if its partners, the ACPE and ANCC, agreed. Basically, the accreditor is offering to let CMS use its SCS system as a mechanism to exclude CME from Open Payments reporting requirements.
However, ACCME also acknowledged that this could be stepping on the toes of the American Academy of Family Physicians, The American Academy of Physician Assistants, the American Dental Association, the AMA, the ANCC, the American Osteopathic Association, and the Association of Regulatory Boards of Optometry—all of which also offer accreditation, activity approval, and credit systems of their own. “This service is not intended to impinge on the rights, responsibilities, or autonomy of the continuing education accreditation and credit bodies or to imply any judgment on the integrity of their systems,” the letter states.
“We offer this service [to CMS] to facilitate the appropriate exclusion of accredited continuing education from reporting under the Open Payments program,” ACCME President and CEO Murray Kopelow, MD, says in the letter. “We propose to offer a service to the healthcare professions of the U.S.—and the people that we all serve—that we believe will facilitate health professionals’ engagement in valid, practice-based, independent continuing education that has been shown, unequivocally, to improve their abilities and performance-in-practice in the healthcare system.”