Welcome to our February edition of AOE Compliance Connection, AOE’s monthly newsletter. Featured in this month’s edition are tips for managing enduring activities after the 3-year mark, information about the ACCME’s Call for Feedback regarding the integrity and independence of accredited continuing education, and AOE’s board updates and calendar features.
We enjoyed connecting with many of you at last month’s 44th Annual Alliance for Continuing Education in the Health Professions Conference! Compiling our notes from the various sessions our staff attended, we created a “highlights” piece that can be accessed here.
Enduring Activities: What Happens After 3 Years?
The ACCME policy on Content Validity of Enduring Materials states that: “Providers that produce enduring materials must review each enduring material at least once every three years or more frequently if indicated by new scientific developments. So, while providers can review and re-release an enduring material every three years (or more frequently), the enduring material cannot be offered as an accredited activity for more than three years without some review on the part of the provider to ensure that the content is still up-to-date and accurate. That review date must be included on the enduring material, along with the original release date and a termination date.”
What does all this mean for accredited providers that produce enduring materials?
Annual Review
As a best practice, it is recommended that accredited providers review enduring material on an annual basis. Conducting an annual review ensures activity content is up-to-date and accurate and that the latest scientific developments are addressed. It also helps to ensure that the content is still relevant for the target audience. This process could be streamlined through utilization of a standardized annual review form for enduring materials. This would ensure that key components are reviewed, and feedback is provided, if applicable.
Three Years: Review, Update and Re-Release
At the three-year mark, most activities that have endured are retired or revamped. If it is determined the content is still relevant and rooted in current, identified professional practice gap(s) and corresponding educational need(s), then the activity could be re-released. This would involve initiation of the activity planning and implementation processes. Content would undergo a thorough review and update to ensure the most up-to-date scientific evidence is incorporated.
Ultimately, accredited providers must ensure that the content of enduring material activities remains relevant and up-to-date even after initial launch. For more tips and tools regarding management of enduring activities see AOE in the Spotlight: Managing Enduring Activities.
CME Integrity & Independence: ACCME’s Call for Feedback
The latest ACCME call for feedback centers on the independence and integrity of CME. The ACCME is calling on stakeholders to review the rules (i.e. the Standards for Commercial Support) that currently safeguard the independence and integrity of accredited CME for physicians and other healthcare professionals.
A Task Force on Protecting the Integrity of Accredited CE has been convened in order to oversee the process, comprised of members from various backgrounds, including members of the public along with representatives from CME providers. The task force will ensure the continued relevance, effectiveness and integrity of the current Standards for Commercial Support by identifying new challenges pertaining to disclosure, conflicts of interest, and commercial support. CME Stakeholders will also be asked to submit suggested revisions to the existing Standards for Commercial Support and supplemental policies such as the definition of a commercial interest.
The ACCME has opened their call for feedback until 5:00 PM CST on March 8, 2019, and welcomes responses from: accredited CE providers, accreditors in the health professions, healthcare leaders, government agencies, commercial supporters, clinicians, patients, and the public.
You can download an information packet, along with the current Standards, related policies and specific survey questions here.
Accreditation Board Bulletin
Part of the service AOE provides to readers are weekly compliance tips and monthly CME/CE community news for each of the three key boards.
ACCME
Navigating the definition of a commercial interest is a common compliance topic for accredited CME/CE providers. First, it is important to understand what the ACCME considers a commercial interest. The ACCME (as well as the ACPE and the ANCC) defines a commercial interest as “any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.” There are, however, specific types of organizations that the ACCME exempts from this definition; you can find a list of these organization types here.
Knowing the definition of a commercial is critical for providers when ensuring compliance with the ACCME’s Standard for Commercial Support (SCS) 2: Resolution of Personal Conflicts of Interest. Providers must be able to document that everyone in a position to control the content of a CME activity has disclosed all relevant financial relationships with any commercial interest. Specifically, SCS 2.1, states that a relevant financial relationship with a commercial interest exists when the relationship is:
- financial in nature,
- has occurred in the last 12 months and
- the individual has the opportunity to control content
Providers must employ a mechanism to collect disclosure information regarding relevant financial relationships with commercial interests for each individual in a position to control content of a CME activity. The ACCME recognizes a few different methods:
- Verbal disclosure, then record the data in a document or database
- Electronic disclosure (e-mail, web-based platform, etc.)
- Disclosure form, have each individual complete their own form
For more information about the definition of a commercial interest, and examples of compliance and non-compliance, visit the ACCME’s Compliance Library.
Annual Reporting Reminder:
All ACCME Accredited Providers must complete annual reporting by April 1, 2019. The required annual report is to be submitted to PARS and must include activity data from January 1, 2018 through December 31, 2018.
ANCC
Financial revenue, or in-kind support, for continuing nursing education (CNE) accredited activities is primarily classified into three categories: commercial support, sponsorships and vendors. Though inherently different, it is common for providers to confuse the three.
The key in deciphering between commercial support and sponsorships lies with the ANCC definition of a commercial interest, “Any entity producing, marketing, reselling, or distributing health care goods or services consumed by or used on patients.”
Per the ANCC, commercial support is financial support (including in-kind contributions) given by commercial interests which is used to pay for the costs of a CNE activity, either in full or part. On the other hand, an ANCC-defined sponsor is an organization that does not meet the definition of commercial interest that provides financial or in-kind support to a CNE activity. Sponsorships may come from organizations such as foundations and companies that do not meet the ANCC-definition of a commercial interest, and commercial support may come from organizations such as pharmaceutical companies and medical equipment manufacturers and sellers. Please note, neither commercial supporters nor sponsors may be providers or joint providers of a CNE activity.
The ANCC defines the category of financial revenue as vendors. Neither a commercial supporter nor sponsor, a vendor pays fees for space to exhibit their services or products. This matter is a private business dealing between the CNE provider and the vendor. In this situation, other providers or joint providers can be vendors.
If an accredited CNE provider has acquired commercial support or sponsorships, a written agreement must exist between the two. This agreement should specify the description and amount of the monetary or in-kind support received and should be signed by both the provider and the commercial supporter/sponsor. As well, any and all commercial support and sponsorships are to be disclosed to learners prior to the start of the activity.
To learn more, refer to the ANCC’s Content Integrity Standards for Industry Support in CNE Activities.
Annual Reporting Reminder:
All ANCC Accredited Providers must complete annual reporting by April 1, 2019. The required annual report is to be submitted to NARS and must include activity data from January 1, 2018 through December 31, 2018.
ACPE
What happens when an accredited CPE provider needs to update an activity after it’s already launched? The ACPE allows for changes to be made, but often, these changes will incur a fee.
The ACPE will charge a late fee for assisting in changes to an Activity Description Form (ADF) (and also for assistance in the situation of an ADF that was never submitted). In these cases, payment will need to be made prior to the ADF being updated. The specific changes that incur fees include:
- Credit hour changes
- Title modifications
- Release/expiration date
- Type of activity
- Typos
- Sequence number
- Topic designator
- Joint providership information
- Adding additional format
- Backdating activity information
Providers may request updates to the ADF through the Provider Web Tool, and supply the information about the requested change. Once ACPE receives the request, the invoice will be sent and payment processed. At that point, they will “open the system” to allow for the requested change to be made, and related participant data to be entered (if applicable).
More information about late fees and updates to the ADF can be found in the CPE Policies and Procedures, located here.
- ANCC Primary Accreditation New Applicant Workshop
February 20, 2019, Silver Spring, MD
Read More >> - ANCC Primary Accreditation Accredited Provider Workshop
February 21, 2019, Silver Spring, MD
Read More >> - 2019 SACME Annual Meeting
February 26 – March 1, 2019, Charleston, SC
Read More >> - CNE Symposium
April 23-24, 2019, Lake Buena Vista, FL
Read More >> - ANCC Pathway to Excellence Conference
April 24-26, 2019, Orlando, FL
Read More >> - ACCME 2019 Meeting
April 30-May 2, 2019, Chicago, IL
Read More >>
