As the dust begins to settle around the regulations for the Centers for Medicare and Medicaid Services’ Physician Payment Sunshine Act (PPSA) and the August 1 effective date looms ever closer, it appears that there is one key issue that CME providers will need to focus on: plated meals vs buffets.
I…I really don’t have too much to say about this. Frankly, it seems kind of ridiculous that I’m even writing a blog post about it. But, over the past week, I’ve received communication from four separate commercial supporters identifying their requirements of grantees, that were directly attributed to the PPSA. Every single one of them addressed the issue of plated meals vs buffets. Two of the organizations are including a clause in their LOA’s indicating that grant funds may not be used for meals unless it a buffet. The other two organizations sent out emails indicating that funded CME activities with plated meals would need to be reported for individual covered recipients. These emails included Excel files with templates of the information that would need to be collected from each of these covered recipients. The templates contained over 20 data points for each individual. Yikes.
Trust me – I’m no expert on the reporting requirements of the PPSA, but it seems like these requirements for meal reporting are based on this FAQ from the CMS. In particular, the last sentence states:
The excluding characteristic for meals is when allocating the cost of the meal among covered recipients in a group setting where the cost of each individual covered recipient’s meal is not separately identifiable.
It appears that most organizations are equating “not separately identifiable” with “buffet line”. However, some are being even more specific and also setting a number of participant threshold for whether or not the meals need to be reported, regardless if it’s a buffet or plated (e.g. buffet with >50 participants does not need to be reported; buffet with <50 participants does).
So, where does this leave us? After getting a look at the data fields CME providers will be required to collect for reportable meals, I think it’s pretty clear that most providers will do whatever it takes to avoid the need to collect that data from each participant. So: Plated meals are out. Buffets are in. Small dinner meetings are probably out, too.
As August 1 approaches, I’m sure we’ll be hearing from even more commercial supporters about their reporting requirements. So far, I’m inclined to look at the “plated meals vs buffet” issue, shrug my shoulders, and say, “Meh.” But, if a few of these organizations come along and require that every meal be reported – just to be on the safe side – then it’s a whole new ballgame*. Then we’re talking about the potential end of satellite symposia (can you imagine collecting the needed participant information from a 600 person dinner symposium at ASCO or ASH?)
As always, I find these types of issues incredibly frustrating, depressing, sad, and a little amusing, all at the same time. To think that an important educational event might not happen because the logistics of reporting who ate the lemon-pepper chicken are to complex, boggles my mind. Maybe I’m just naive and don’t understand the importance of this type of reporting. Maybe changing meals from plated to buffet will have some sort of long-lasting educational impact. Maybe people will get more exercise walking through a buffet line instead of having someone bring their food to them.
*UPDATE (7-29-13): Of course, the morning after I write this, I get an email from a commercial supporter saying they will no longer provide support for ANY meal costs in a CME activity. Here we go…