Letters

Neurosurgery Urges CMS to Maintain the Current Open Payments CME Exemption

  • Drugs and Devices

Re: Medicare Program; Revisions to Payment Policies under the Physician Fee
Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY
2015; CMS-1612-P

Dear Ms. Tavenner:

On behalf of 4,000 practicing neurosurgeons in the United States, the American Association of
Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) appreciate the
opportunity to comment on the proposal to eliminate the exemption for continuing medical education
(CME) from Open Payments reporting, which was included in the above referenced Notice of
Proposed Rulemaking (NPRM). We have submitted comments related to the quality and payment
provisions in separate comment letters.

The AANS and CNS strongly oppose the elimination of the Open Payments CME exemption.
Whether the exemption is duplicative or not, the proposed elimination represents a complete reversal
of a policy that was included in the Sunshine Act final rule, which had been thoroughly reviewed and
vetted by all stakeholders. If your proposal is adopted, it would have a chilling effect on appropriate
and vital industry support of CME, and would expose physicians and physician organizations to
additional unnecessary administrative hassles associated with the Open Payments reporting and
verification system.

As members of the Council of Medical Specialty Societies (CMSS), we fully endorse the comments
that CMSS submitted to CMS and would like to take this opportunity to highlight the following points:

  • Accrediting Organizations. CMS states that it has been asked by several groups to be
    recognized as accrediting organizations. This could be easily done by CMS and would in no
    way imply an endorsement by the agency. Such is the case in other instances where
    Medicare recognizes the organizations who set standards for various health care
    stakeholders, including the Joint Commission (hospitals), state medical licensing boards
    (physicians) and the Accreditation Council for Graduate Medical Education (residency training
    programs). Recognizing groups that accredit and certify continuing medical organization is no
    different. It is imperative that CMS recognize the distinction between accredited and certified
    CME offered by healthcare professional organizations for the improvement and maintenance
    of knowledge and skills, as opposed to those programs promoted directly by industry. The
    elimination of the CME exemption would actually blur the lines, rather than bolster accredited
    CME conducted under the Accreditation Council for Continuing Medical Education’s (ACCME)
    Standards for Commercial Support: Standards to Ensure Independence in CME Activities.
    Should CMS wish to consider other accreditors or other equivalent standards, a mechanism
    exists to do so. An inter-professional coalition of accreditors of continuing education in the
    health professions called, Joint Accreditation, has been convened since 2009 and is a
    collaboration of ACCME, the Accreditation Council for Pharmacy Education (ACPE), and the
    American Nurses Credentialing Center (ANCC). This is the function of professional self regulation, does not require additional governmental regulation, and could easily be recognized by CMS for the purposes of the Open Payments CMS exemption.

Read full letter here