As you may know, more than a year ago the ACCME began requiring that “stock ownership” in privately held companies be mitigated differently than with publicly traded organizations. As such planners or faculty reporting that they own stock in any amount with a privately help Ineligible Company be treated as if that person “owns” the company. This means that the person is not eligible to participate in CME/CE activities when the products relate to the presentation.
The ACCME has indicated that they intend to enforce this requirement despite the difficulties many providers are having making the determination and having to replace the planner or faculty. They have indicated that a few bad apples in the CE Community have been using the complexity of organizational structures to hide these relationships. This is important if you are jointly providing the activity with a non-accredited entity.
Be aware that developing procedures for making this determination is important. If you have questions or need assistance, don’t hesitate to contact Steve Passin, president, at passin@passinassociates.com.
General Overview of This Issue The Accreditation Council for Continuing Medical Education (ACCME) has indicated that when people involved in accredited CE own stocks in privately held companies, they must be treated as owners of those companies.
Here is the rule from ACCME:
Individuals who own stock (not through a mutual fund or pension plan)in privately held ineligible companies are considered owners or employees and therefore must be excluded from controlling content or participating as planners or faculty in accredited CE, unless they meet the exceptions to the exclusion described in Standard 3.2.
Individuals who own stock in publicly traded ineligible companies are not considered owners or employees. As described in Standard 3, the provider is expected to determine if the relationship is relevant to the educational content. If so, the provider needs to take steps to mitigate the relationships and disclose the relationship to learners.
This means that unless there is clear evidence that one of the three exceptions to the rule can apply, such planners and presenters must be disqualified from participation in an accredited activity.
As a reminder, here are the three possible exceptions to the rule:
When the content of the activity is not related to the business lines or products of their employer/company.
When the content of the accredited activity is limited to basic science research, such as pre-clinical research and drug discovery, or the methodologies of research and they do not make care recommendations.
When they are participating as technicians to teach the safe and proper use of medical devices, and do not recommend whether or when a device is used.
This is an area we have observed that both the ACCME and Joint Accreditation (JA) are rigidly enforcing. Hence, our recommendation is that if the reported relationships with privately held companies are present, be conservative and replace the planner or presenter with some one that has a mitigable financial relationship or no relevant financial relationships.
Deciding of a Relationship is with a Privately Held Company
Remember that you cannot rely on the person with the conflict to determine how to mitigate. As the accredited provider, it is your responsibility to reach a judgment. Some steps to consider include:
Google the company. In the ‘about us’ section of their website, you should be able to tell if the company is publicly traded or privately held.
If Google is not definitive, then consult your organization’s financial experts to ask for help.
Also, consider consulting the activity’s course director for input.
When looking at relevance in terms of the products the manufacturer produces and their relationship to the topics of the activity, always be conservative and if there is any potentially relevant relationship, disqualify and replace!
Thinking of applying for your initial Interprofessional Joint Accreditation (Joint Accreditation)? If so, consider these best practices to ensure a successful result:
The shift from an individual accreditation, such as Accreditation Council for Continuing Medical Education (ACCME) to Joint Accreditation is not just a conceptual exercise. It takes 18 months of advance planning!
Essentially, to successfully attain JA, you must operate as if you are already accredited by JA insomuch as you must understand and implement the JA Criteria for Accreditation and the Standards for Integrity and Independence in the educational activities you offer. This will enable you to demonstrate to JA a mastery of their requirements.
Don’t rely on another organization with whom you may be partnering to demonstrate compliance because they may not be up to speed on the requirements. You need to understand them and master them.
Develop your own JA Planning Guide. One builds this Guide based on the Planning Criteria (JA Criteria 4-10) and Standard 3 of the Standards for Integrity and Independence to be able to collect the correct information about planner and faculty financial relationships with ineligible companies, and then vet those disclosure forms to determine which reported relationships are relevant to your CE activity.
Remember that planning JA activities does not take place in silos in which you inquire about needs from physicians, and then inquire about needs from nurses, etc. ALL planners must be on an even playing field and communicate with each other about their roles, functions, and impact on patient care.
Remember that you must plan a minimum of 25% of your total educational activities by and for the healthcare team.
Start immediately to add new evaluation questions that measure the impact on your healthcare team – both to measure improvements in Skills/Strategy (intent to change) and Performance (actual implementation in practice 2-4 months after the educational activity).
Be aware that JA activities must be interactive so that your attendees learn with, from, and about each other. This is the essence of JA.
Interested in JA Accreditation with Commendation? This also takes many months of advance planning to achieve compliance with the seven advanced commendation criteria you select to demonstrate. Be wide-eyed about what each commendation criteria requires, take an honest look to see if you are already compliant for each criterion or if you can be compliant. Create a Tracking Sheet to manage your commendation progress.
This follow-up article discusses how to align ABMS Member Boards’ MOC practice assessment and patient safety credit to your CME activities, which aligns with the ABMS Member Boards’ MOC program requirements.
This article discusses how to add ABMS MOC Part II: Lifelong Learningcredit to your CME activities, which aligns with the ABMS MOC program requirements for Part II credit obtained from participation in certified CME activities. Additional opportunities for aligning MOC credit to your activities for other MOC Part II requirements, such as self-assessment and patient safety or MOC Part IV Practice Improvement, will be addressed in subsequent newsletters.
