The Sunshine Act & CME: Archive Of The #CMEreg Chat

Something special happened on Twitter today. Amongst the Whitney Houston tributes, the Jeremy Lin-sanity, and the hoopla of a holiday created to sell more candy, cards, and flowers, a group of individuals concerned about the CME industry got together to learn and advocate for the profession they care for.

A special thanks to Chris Lamond and Andy Rosenberg from the CME Coalition for guiding us through the in’s and out’s of the Sunshine Act and its potential impact on the CME community. Below is the archive from this special edition #CMEreg chat.

theCMEguy	Welcome to #CMEreg. All discussions herein are assumed to be personal opinion & not that of current, past, or future employers.
theCMEguy	Today’s #CMEreg chat is about the hot topic of the moment for CME providers: the Sunshine Act & CME
theCMEguy	We are fortunate to have Chris Lamond and Andy Rosenberg from the CME Coalition with us. They’ll be tweeting as @cmecoalition #cmereg
theCMEguy	The format for today’s #CMEreg chat will be a Q&A with @cmecoalition: I will start with a question for @cmecoalition and they will respond
theCMEguy	After @cmecoalition’s response, time is free for other related Q’s, comments, discussions from others. Please stay on topic #CMEreg
theCMEguy	After a period of time, I will bring up next Q for @cmecoalition. There will be 3 main Q’s that will be addressed (Q1, Q2, Q3) #CMEreg
BrianSMcGowan	@theCMEguy #cmereg …looking fwd to learning!
theCMEguy	We’ll start with Q1 in just a minute. For now, lets take a moment for everyone on the chat to introduce themselves. #CMEreg
theCMEguy	I’m Derek in northwest Philly, moderating #CMEreg
kenny_cox	Kenny from Springfield Mo – looking fwd to the session – #cmereg
SusanHYarbrough	@theCMEguy will there be an archive of this tweetchat? #CMEreg
beth333SP	Hello Andy & Chris! @theCMEguy: we have Chris Lamond and Andy Rosenberg from the CME Coalition. They’ll be tweeting as @cmecoalition #cmereg
theCMEguy	SusanHYarbrough: @theCMEguy will there be an archive of this tweetchat? #CMEreg>>  Yes!
greyelmy	Heather Guerrero with Gilead Sciences, Foster City, CA #CMEreg
BrianSMcGowan	Brian here working out of my car before a series of meetings…real distance learning. #cmereg
beth333SP	Beth Brillinger, Director of Accreditation for CME Outfitters. Just outside of Philadelphia #CMEreg
theCMEguy	FYI : there will be an archive of this chat posted on my blog later on cmeconfession.wordpress.com #CMEreg
ChargeAheadMktg	Glenn, Milford, CT. lurking & watching while multitasking. #cmereg
spelletier	Sue Pelletier is here, trying to catch the whole chat but forced to multitask #cmereg
theCMEguy	Are you guys at @CMEcoalition ready? #CMEreg
BrianSMcGowan	assuming tweets are personal opinion and not that of past current or future employers? #cmereg
CMECoalition	#cmecoalition here and excited to answer any and all questions #cmereg #cmereg
theCMEguy	@BrianSMcGowan You obviously missed my first tweet 🙂 #cmereg
reginamotarjeme	Regina Motarjeme, out of Denver, with Medikly #cmereg
theCMEguy	.@CMECoalition: #cmecoalition here and excited to answer any and all questions #cmereg >> Great let’s get started!
theCMEguy	Q1: Can you give us a brief overview of the Sunshine Act and how it relates to CME?  #CMEreg
BrianSMcGowan	@theCMEguy i disclose that i did… #cmereg
CMECoalition	Welcome everyone.  Thanks for joining us.  New rule expands Sunshine Act to cover indirect CME payments. #cmereg #cmereg
jjuch	John J out of New Jersey #CMEreg
CMECoalition	CME will be responsible to report all payments : burdensome & large fines. Result :industry stops sponsoring CME : patient suffers. #cmereg
BrianSMcGowan	@CMECoalition – wow that makes a bunch of assumptions, no? how do you get from a to z? #cmereg
theCMEguy	@CMECoalition Have you spoken directly with people from industry about this? #CMEreg
BrianSMcGowan	@CMECoalition can we agree that industry does not ‘sponsor’ CME – they support it. word choice is critical here. #cmereg
CMECoalition	under the rules manufacuterers report if “aware” of ultimate recipient of support #cmereg
beth333SP	proposed Sunshine Act = change in perception of CME – equates independent med ed w promotional med ed #CMEreg http://t.co/odLgOkGv
spelletier	@CMECoalition report all payments to industry, right? #cmereg
CMECoalition	@beth333SP agreed.  100% #cmereg
jjuch	@cmecoalition  can you give examples of what types of payments would need to be reported? honoraria? faculty travel? meals?  #CMEreg
CMECoalition	@BrianSMcGowan yes, many, including our membership which is growing and are very concerned about this.   #cmereg
spelletier	@beth333SP That’s one of the problems all right #cmereg
beth333SP	TRUE! Vernacular is important @BrianSMcGowan: @CMECoalition Industry does not ‘sponsor’ CME, they support it word choice is critical #cmereg
CMECoalition	@BrianSMcGowan Yes. You are correct. #cmereg
theCMEguy	I think a lot of these questions will be answered in Q2. So let’s move on to that quickly and then we’ll do a few more questions #cmereg
CMECoalition	@spelletier Yes, that’s correct. Industry is responsible for reporting to feds but will require providers assistance. #burdensome #cmereg
spelletier	@cmecoalition what exemptions are there for reporting reqts? #cmereg
theCMEguy	Q2: If it is passed, how will the Sunshine Act impact CME providers? #CMEreg
CMECoalition	@jjuch  all of the above plus booths, grants to cme providers… #cmereg
beth333SP	Q2 Wondering how MD’s feel about grant supported CME honoraria being reported as direct payments by Pharma? #CMEreg #MDchat bit.ly/zQy8MK
BrianSMcGowan	what kind of booths? .@CMECoalition: @jjuch  all of the above plus booths, grants to cme providers… #cmereg”
CMECoalition	@spelletier exemptions are if covered entity is “unaware” of the ultimate beneficiaries of the payment, ed materials for patients #cmereg
CMECoalition	@spelletier also…incidental refreshments #cmereg
theCMEguy	@BrianSMcGowan @CMECoalition @jjuch I would assume this means exhibit booths, no? #cmereg
CMECoalition	@beth333SP great question: we fear a chilling effect on their participation.   #cmereg
BrianSMcGowan	t2 what guidance has there been on the accounting that will be required –> how do you divide multiple supporters/block grants? #cmereg
CMECoalition	@theCMEguy yes, exhibit booths. #cmereg
jjuch	@beth333SP Q2 …and how faculty will feel when their travel to speak at a CME-certified event appears as a “payment” #CMEreg
beth333SP	CME Outfitters has sent a survey to our physician faculty, interesting responses re Sunshine Act  #MDchat #CMEReg http://t.co/odLgOkGv
CMECoalition	@BrianSMcGowan great question.  unclear and potentially unworkable.  Needs to be a focus for comments to HHS. #cmereg
BrianSMcGowan	medical societies will be immediately paralyzed by their soft accounting practices…maybe this is a good thing? #cmereg
theCMEguy	@jjuch @beth333SP And not just a payment. My understanding is that it will link back to a specific product, too. Am I right? #CMEreg
CMECoalition	@jjuch that is our fear also.  And what about attendees?  #cmereg
BrianSMcGowan	@beth333SP do you have results to share? #cmereg
CMECoalition	@theCMEguy hard to imagine how they could do that but possible.   #cmereg
StMarysCME	What will this mean for hospital CME providers? #cmereg
BrianSMcGowan	linking grants to products may be easier for some than others…to be transparent…perhaps this is part of the confusion. #cmereg
theCMEguy	.@StMarysCME: What will this mean for hospital CME providers? #cmereg>>  Good question!
beth333SP	Why yes, I do, a few written comments 4 now, small sample size so far @BrianSMcGowan: @beth333SP do u have results to share? #cmereg
Shea_McCarthy	Did Congress intend for these restrictions on CME when the passed the Sunshine Act? #CMEreg #MDchat
CMECoalition	@StMarysCME Hospital CME providers will also be impacted.  potentially massive tracking and reporting burden…e.g., grand rounds #cmereg
jjuch	Given how different systems are for putting in grants, can you imagine all the systems for putting this info in? Ugh!!! #CMEreg
beth333SP	#CMEreg #MDChat CMEO Physician survey resp to Sunshine Act: .Slap in the face to legitimate, ethical CME providers”
BrianSMcGowan	the accounting ‘should’ be the easy part to ‘do’…but the message it sends is misguided and the effort would be overwhelming. #cmereg
beth333SP	#CMEreg #MDChat CMEO Phys resp to Sunshine Act: .Rule would potentially contribute to bias by ensuring faculty were aware of support source”
CMECoalition	@Shea_McCarthy We were told at the time that Congress intended to capture ONLY direct payments to docs, exempting CME #cmereg
spelletier	@beth333SP I’d be curious to see the responses to yr physician survey #cmereg
CMECoalition	@Shea_McCarthy We are currently talking with Members and hill staff to weigh in – CME Coalition members are on hill this week #cmereg
BrianSMcGowan	so what are the benefits of the Sunshine Act for the CME community? #cmereg
StMarysCME	I’m afraid this would be the end of many hospital CME programs.  The straw that breaks the overburdened CME coordinator’s back #cmereg
theCMEguy	@spelletier @beth333SP I believe she’s tweeting out some of the responses now… #cmereg
ChargeAheadMktg	@beth333sp on the survey, and also IYO, are the faculty responses so far concerned or “oh ok whatever”? #cmereg
jjuch	@beth333SP “contribute to bias…” interesting? not exactly what the people pushing this reporting were going for #CMEreg
beth333SP	#CMEreg CMEO Phys resp to Sunshine Act: .Wht better way 2 elim bias than cut the link, and wht better way 2 intro bias than to re-est link?”
CMECoalition	@BrianSMcGowan right on…huge burden leading to uncertain future #cmereg
spelletier	@theCMEguy yup, see them now–got behind 😦 #cmereg
theCMEguy	@StMarysCME I believe there are many who share this exact same concern. That’s why we’re doing this! #cmereg
beth333SP	yup @theCMEguy: @spelletier @beth333SP I believe she’s tweeting out some of the responses now… #cmereg
CMECoalition	@BrianSMcGowan We think there is NO upside as written/drafted.   #cmereg
BrianSMcGowan	@beth333SP that is a bizarre comment…so not knowing who the supporter is better? –> points to ignorance of many faculty #cmereg
CMECoalition	@theCMEguy This is one of the reasons CMECoalition was founded.   #cmereg
theCMEguy	Great questions and discussion everyone! I’m going to introduce the last topic to keep things moving along #cmereg
beth333SP	#CMEreg and the next comment from physicians is a long one, sorry about that. But it is also funny (sorry in advance to attorneys)
CMECoalition	@theCMEguy Many who are concerned have joined us in this fight…we need many more to keep the heat on regulators #joincmecoalition #cmereg
theCMEguy	I’ll wait til @beth333SP is done first… 😉 #CMEreg
BrianSMcGowan	@CMECoalition so either the authors see a benefit that u disagree w/ OR  the authors are blind to the facts? which is it? #cmereg
Shea_McCarthy	@CMECoalition What’s the best way to contact lawmakers regarding the #CMEreg? Does HHS accept public comments?
beth333SP	#CMEreg #MDChat Physician survey resp to Sunshine Act: .If phys and CME prov’s must report than so too must ambulance chasing attorneys”…
beth333SP	#CMEreg #MDChat Physician survey resp to Sunshine Act: .(contd) who are the saviors of humanity against the evil empire of medicine!”
theCMEguy	@BrianSMcGowan @CMECoalition So Maybe your question is, what benefit do the authors see in this for CME? #cmereg
CMECoalition	@BrianSMcGowan more likely the latter and so do congressional folks we have been meeting with. bipartisan support on hill #cmereg
theCMEguy	Q3: What can CME providers do now? #CMEreg
beth333SP	#CMEreg #MDChat CMEO Physician survey resp to Sunshine Act: .Is trying to help busy colleagues keep up w new advances really that bad?”
PSB_CME	#cmereg I think that it’s not as time consuming as people fear…just that it’s scary
theCMEguy	@Shea_McCarthy @CMECoalition An answer to this is coming shortly… #cmereg
beth333SP	#CMEreg #MDChat CMEO Physician survey resp to Sunshine Act: .Time for some well designed outcomes studies to address this disturbing issue”
jjuch	@BrianSMcGowan “…blind to the facts” and knowing what certified CME is and what we do as providers gets my vote #CMEreg
beth333SP	#CMEreg that’s all I have for now – re comments from our faculty…
CMECoalition	@theCMEguy We don’t think HHS knows enough about benefits of CME.  They beleive more transparency alwasy = better. #cmereg
CMECoalition	@jjuch certified is key and needs to be reinforced in public comments.  #cmereg
spelletier	@theCMEguy benefit is transparency, right? Tis better 2 know who gets paid by whom, thinking goes. Prob is the why is omitted? #cmereg
CMECoalition	Is everyone here planning on sending in public comments to HHS?  We hope so. For help go to http://t.co/dVvzEt14 for resources #cmereg
BrianSMcGowan	not sure who is more naive, the authors of the Sunshine act or the faculty who have their head in the sand to risk and bias. #cmereg
CMECoalition	@spelletier exactly right. they believe transparency always equals better policy.  #cmereg
theCMEguy	@CMECoalition And the due date for sending in comments is…? #cmereg
BrianSMcGowan	#TOTD #needRealExamples .@PSB_CME: #cmereg I think that it’s not as time consuming as people fear…just that it’s scary”
SusanHYarbrough	@CMECoalition submitting our response today! #cmereg
CMECoalition	@theCMEguy deadline is 2/17. Our resource center on website has all the details. #cmereg
spelletier	Assumes all financial rels are inherently bias-inducing, even with regs in place. Need to separate certified from promo #cmereg
beth333SP	YES , we are involved in multiple waves @CMECoalition: planning on sending public comments to HHS? http://t.co/w2YWmmTX #cmereg
BrianSMcGowan	@CMECoalition …but you don’t agree that more transparency is always better? #cmereg
CMECoalition	@SusanHYarbrough Great!  Thanks.   #cmereg
ChargeAheadMktg	#TOTD RT @briansmcgowan not sure who is more naive, authors of the Sunshine act or faculty who have head in the sand to risk & bias. #cmereg
theCMEguy	@CMECoalition Do public comments make a difference? #CMEreg
jjuch	Will be submitting comments tomorrow #CMEreg
CMECoalition	@BrianSMcGowan Not when there is so much burdensome redundancy with already established CME conflict protections/rules #cmereg
beth333SP	Be transparent about who selects content & faculty 2 @BrianSMcGowan: @CMECoalition …but u don’t agree that more transp is better? #cmereg
BrianSMcGowan	seems that the right step is to create polished case studies of what this Act would mean “in a day in the life…” #needstories #cmereg
CMECoalition	@theCMEguy Yes! Process is set up to avoid unintended consequences. HHS must hear from a lot of impacted parties. #cmereg
theCMEguy	@BrianSMcGowan That’s a good idea #cmereg
CMECoalition	@BrianSMcGowan Agreed: that is what we are doing in our comments and on the Hill.   #cmereg
beth333SP	BSM, Wanna spearhead that? @BrianSMcGowan: seems that the right step is to create polished case studies #needstories #cmereg
theCMEguy	What happens after the window for public comments closes? #CMEreg
beth333SP	I hear u are a good writer… BSM, Wanna spearhead that? @BrianSMcGowan: create polished case studies #needstories #cmereg
CMECoalition	@theCMEguy HHS will review all comments and post final rule. After comment period we can meet with HHS (can’t now) #cmereg
StMarysCME	When would these new regs go in to effect? #cmereg
CMECoalition	@theCMEguy We will also get Congress more engaged via letters, etc… #cmereg
CMECoalition	@StMarysCME 2013, as its drafted now. #cmereg
theCMEguy	@CMECoalition What is Congress’s role in this process? #CMEreg
jjuch	what are the chances that the final rule will be changed from current form? #CMEreg
CMECoalition	@theCMEguy Congress can also pass a law (or limit funding for) overturning the final rule..lots congress can do. #cmereg
theCMEguy	.@CMECoalition: @StMarysCME 2013, as its drafted now. #cmereg>>  Is it in effect as soon as they make a final ruling?
CMECoalition	@jjuch if we get quality arguments submitted and hill pressure to HHS we have a reasonable chance to impact the rule. #cmereg
CMECoalition	@theCMEguy No, final rule will dictate the implementation date.  Right now 2013. they could delay it but not likely at this point. #cmereg
spelletier	@cmeCoalition do you have template of main points ppl can use to draft responses? #cmereg
BrianSMcGowan	@beth333SP not sure I know enough to lead the effort but I will help…#cmereg
CMECoalition	Strength in numbers.  Please consider helping in the effort to overturn this rule and join the coalition for the prolonged fight.  #cmereg
jjuch	@CMECoalition “quality arguments and hill pressure to HHS we have a reasonable chance” so submitting comments is really important! #CMEreg
theCMEguy	Any final questions for @CMECoalition before we wrap-up #cmereg chat for today?
spelletier	@BrianSMcGowan @beth33SP likewise, would be glad to help #cmereg
CMECoalition	@spelletier Yes, our model comments are on our webiste’s Sunshine Act Resource Center.   #cmereg
theCMEguy	.@spelletier: @BrianSMcGowan @beth33SP likewise, would be glad to help #cmereg>>  I sense a G+ hangout brewing…
theCMEguy	.@CMECoalition: @spelletier Yes, our model comments are on our webiste’s Sunshine Act Resource Center.   #cmereg>>  http://t.co/y0AEa3ke
beth333SP	#CMEReg There are some great resources for info and action http://t.co/odLgOkGv & CME Coalition site http://t.co/rkuMdLg9
theCMEguy	Thank you all for participating in today’s #cmereg chat! A special thanks to @CMECoalition for joining us!
CMECoalition	Submitting public comments will be important to this effort.  Please take the time to get involved. #cmereg
beth333SP	#CMEreg Thank you CME Coalition for your involvement. Everyone needs to get involved by responding to CMS and writing our own local govt
theCMEguy	I’ll monitor the #CMEreg hashtag if anyone else has questions and pass them on to @CMECoalition
spelletier	Final question: Any way to get out ahead of the next wave before it gets to this point? #cmereg
theCMEguy	I’ll also be posting an archive of the chat at cmeconfessions.wordpress.com later today or tomorrow #cmereg
theCMEguy	@spelletier What do you mean by “next wave”? #cmereg
CMECoalition	@spelletier Yes, educating policy makers about the value of CME.  That is why we started the Coalition. Lots of catch up to do.  #cmereg