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Continuing Medical Education Payments To Physicians Will Be Exposed To Sunshine

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After a long and complicated struggle it now appears highly likely that industry will be required to disclose payments to physicians for continuing medical education (CME). This decision from CMS, which I am told by reliable sources is final, follows a long period in which CMS appeared to waver in its approach to incorporating CME into the Sunshine Act.

Since CMS first posted its proposed rules for implementation of the Sunshine Act over three years ago there has been uncertainty over the responsibility of industry to report payments to physicians from third party companies and organizations that produce CME programs with industry funding. The initial CMS proposal for implementation of the Sunshine Act required industry to report these payments. But after considerable debate and lobbying from industry, the final rule included an exemption. As a result, companies were not required to report payments to speakers at accredited CME events as long as the companies didn't select the speakers or directly pay them.

In July of this year CMS signaled a major reversal of policy and said it would eliminate the CME exemption from the Sunshine Act. This raised a furor in industry and among third-party CME producers and medical education companies. In late October it appeared that the CME exemption would stand. But then yesterday CMS updated its Open Payments website to clarify its final rule. The statement makes clear that even indirect payments to physicians must be reported as long as industry becomes aware of the names of physician speakers.

“It would be almost be unimaginable for a case where the company did not learn the identity of the physicians speaking,” Daniel Carlat, the former director of the Prescription Project at Pew Charitable Trusts, told Modern Healthcare's Jaimy Lee.

But, writes Lee, industry will not need to report CME payments that come from unrestricted grants to an organization in which the organization but not the funder decides whether the funding is used for CME. One possible result of this change is that commercial CME and medical communication companies will suffer but nonprofit medical organizations and societies may benefit, since they may more plausibly receive unrestricted grants for educational purposes. The largest single producer of commercially-supported CME is WebMD, through its Medscape division.

The new rule will not go into effect until 2016. The first reports will then appear in 2017.