Two things happened today that got my inner Grandpa Simpson worked up. For starters, it’s a return to my old nemesis, the Sunshine Act. A tired topic, for sure, but we all might as well get used to it because we’re only going to get more. I finally set aside a little time to read through the CME Coalition’s Continuing Medical Education (CME) Programs: Compliance Guide for Sunshine Rule, and I highly recommend it to anyone with questions about the PPSA and CME. It’s an excellent resource. In reading it, though, I came across one example that caused me to murmur “You’ve got to be kidding me!” in disbelief. Check out example 8 on page 18 (the emphasis is mine):
Dr. Rosen attends a Sunshine-exempt CME event with 100 fellow doctors. The meal provided is plated and valued at $40. Pharmaco and Mother Goose Pharma both provided support for the event, but were unaware of the names of the physician-attendees and as a result, chose not to report any of the meal cost as “indirect payments.” Six months later, a Pharmaco sales rep met Dr. Rosen at a holiday party, where Dr. Rosen remarked, “Six months ago, I attended the most wonderful CME course that was supported, I believe, by your company. The chicken was outstanding.” Now, Pharmaco has awareness that it provided a $20 meal to Dr. Rosen and is responsible for reporting it, or could face penalties. To avoid this, Pharmaco could have taken care of the reporting requirements at the start, and made themselves aware of the physician-participants at the time. As a practical matter, manufacturers should consider reporting all such plated meals in excess of $10 as indirect payments.
Wow. That’s just crazy. That a company could choose not to report plated meals as indirect payments – and be correct in doing so – but then be required to report it or face penalties because someone says half a year later, “Awesome chicken cordon bleu at that CME session you supported”, is ridiculous. I admit that it does help give me a little insight into why many companies are simply saying that plated meals will be reportable, period. Why risk it?
The other thing that has gotten my grumpy old man ire up is the state of kid’s socks today. I’m serious. Here’s an example:
What’s up with that? I posted the following to my Facebook page to express my distress at this latest trend.
A heartfelt plea to the youth of today. I see you walking down my streets. I see the back-to-school pictures your parents post on Facebook. I see them, and I am sad. I am sad because I see your socks. Your socks of varied colors, pulled up somewhere between mid-shin to just-below-the-knee. Do you not realize the battles fought by I and others of my generation (X, if you will) for the right to wear our white socks scrunched down? The struggles we faced in convincing our parents to stop buying knee high tube socks with candy-colored stripes across the top in favor of socks no higher than our ankles? We were unified in this fight against bad foot fashion and we were victorious. But now, all that hard work appears to be for naught. Our blood, sweat, and tears swept away by a pair of long fluorescent green Nike socks with black vertical stripes. Just one more example of progress wrought by the passion of a generation, rendered moot by the siren call of crass commercialization.
It leaves me shaking my head. Time for a glass of warm milk, some Matlock reruns, and a nice nap. And get off my lawn!
Confessions of a Medical Educator 
Derek, that example you pointed out doesn’t register on the crazy meter. What’s crazy is where can you get a plated meal for $40 and how on earth does the food at the Christmas party get reported?
…and, doesn’t a private conversation in a social situation constitute something that the pharma rep does not have to discuss with anyone else? At the very least, docs will need to learn that they shouldn’t talk about the meals at CME events….
They’ll just stop taking meals. Maybe this is all just a big scheme to address the obesity problem in America… 🙂
While taking on kids’ socks, please tell them to pull their pants up so we can’t see their underwear!
Need to keep their pants low to hide their socks…
We’ve gathered together to mourn our old friend Common Sense–who never let us down and kept us from any number of ridiculous situations. Such a senseless death…
Bingo!
And so here’s the kicker – one would assume that the CME provider has a registration list with the names of all those who came to engage in education. Just because Pharmaco and Mother Goose Pharma don’t ask for the list doesn’t mean it isn’t available. Sunshine says companies can’t play the “don’t ask don’t tell game” – and many companies are saying sayonara to plated meals for this very reason. The sales reps knowledge didn’t change the meal from nonreportable to reportable – in all likelihood it should have been a reportable expense from the get go.
Yes – that is an excellent point. I already have providers asking me, what if we simply don’t give that list to the supporters, then they won’t have it, won’t know, and thus, it won’t be reportable. I think anytime you’re “hiding” information, you’re playing with fire…
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