Clarifying CME Sunshine Act Payments

Physician Payment Sunshine Act

Today, we’re going to be talking about the Physician Payment Sunshine Act. There’s been a lot of confusion or misinterpretation of the Physician Payment Sunshine Act and how it relates to CME, and we’d like to help clarify those issues. First, we’re going to clarify two issues related to reporting as well as the Sunshine exempt payments related to CME. As well, we will provide some information on the new Sunshine Act Resource Center.

CME Grants and Indirect Payments

Several reports have said that CME grants are exempt because they’re indirect payments, but this isn’t true and it’s a little bit of a misreading of the bill. In fact, indirect payments under the Physician Payment Sunshine Act are those payments that are reportable. There are several sunshine exempt payments of which CME grants qualify that are not reportable, however there is a little bit of a catch here.

Indirect payments are those payments that are reportable under the Physician Payment Sunshine Act. A CME grant specifically in the Physician Payment Sunshine Act language is not an indirect payment, and it is sunshine exempt (meaning not reportable) when the funding meets three conditions. First, the CME activity or education must meet accreditation board standards, most specifically ACCME. Second, the manufacturer does not select the speaker or provide identified individuals as potential speakers, and third that the manufacturer doesn’t directly pay the speaker. Now in the CME enterprise we know that CME that meets ACCME requirements doesn’t allow manufactures to select speakers. However, the federal government wanted to go the extra mile and decided to include this additional language, which again was already addressed by ACCME guidelines and requirements.

Changes with the Sunshine Act

There are two specific changes around speakers and meals for CME activities that have been funded via grants that we should all expect. At an abundance of caution, we probably shouldn’t be naming any potential faculty in future grant requests. Why? Because we don’t want there to be any possibility that pharmaceutical companies or other commercial interests had any knowledge or influence over speaker selections. Meals also have their own set of language under the Physician Payment Sunshine Act. Plated meals with a value of over $10, where the commercial supporter knows who is attending, are actually reportable. In addition, plated meals with a value of less than $10, where the commercial supporter knows who is attending, need to be tracked for potential future reporting. What’s the result here? Most organizations will now try and invoke the “buffet” rule. The buffet rule says that if there is a large event (and large hasn’t been defined in the Physician Payment Sunshine Act), a buffet has been served, and no one knows who is coming or going to the meal, then the meal for that CME event is exempt from reporting.

Sunshine Act Resource Center

The resource center includes a question and answer document, a reporting matrix, as well as a legal memorandum that interprets the sunshine act. The “Sunshine Act Resource Center” was developed by the CME Coalition, a group that Global is an active member of. We highly encourage you to check out the CME coalition and the resource center, as well as consider joining the coalition. The CME coalition was instrumental in developing the exemptions that are included in the Physician Payment Sunshine Act, and the resource center is a great point of reference for any questions related to the Physician Payment Sunshine Act.

To obtain CME Coalition Physician Payment Sunshine Act materials referenced in this blog, contact the CME Coalition. As always, for any questions about CME or the Physician Payment Sunshine Act, feel free to contact us here.