What are the important dates for clinicians to keep in mind for reporting participation in Accredited CME Improvement Activities to CMS?

October 3, 2018 - CMS requires that clinicians attest to a minimum of 90 days participation in MIPS Improvement Activities. October 3, 2018, is therefore the final day to initiate engagement in an improvement activity for a 90-day minimum engagement period for Accredited CME Improvement Activities for 2018.

December 31, 2018 - 2018 MIPS performance period ends.

Is there any requisite group size?

No. Accredited CME Improvement Activities can be designed for a single clinician, a small team, a large group, or the entire membership of a professional society/community. 

What CME activities count as Accredited CME Improvement Activities?

Any accredited CME activity can be an Improvement Activity if it:

  • addresses a quality or safety gap;
  • uncovers educational needs that—when addressed—can help close the gap;
  • articulates what your participation in the activity seeks to improve;
  • includes methods to help achieve that improvement; and
  • evaluates the impact of the education on improving performance and/or quality

Can you give me some examples of CME improvement activities?

How do I know whether my learners are required to participate in In Accredited CME Improvement Activities to obtain the financial incentives associated with the Merit-based Incentive Payment System (MIPS)?

Clinicians can determine their status in the Quality Payment Program (QPP) by entering their 10-digit National Provider Identifier (NPI) number in this CMS lookup tool.

Clinicians in organizations that are participating in Advanced Alternative Payment Models (Advanced APMs) or meeting MIPS requirements through other methods [e.g., Qualified Clinical Data Registry (QCDR), Qualified Registry, Electronic Health Record (EHR)] may not be required to participate in additional Improvement Activities.

Is it true that our CME activities can be used to help clinicians meet reporting requirements (and benefit from associated financial incentives) for the Centers for Medicare and Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS)?

Yes. Activities that you already provide—such as improvement projects, weekly case conferences, quality committee meetings, personal learning plans, and self-assessment modules—can all meet the criteria for Accredited CME Improvement Activities that are required as part of MIPS expectations for clinicians.

What are the ABPath’s Part II requirements for physicians?

ABPath diplomates must obtain a minimum of 70 AMA PRA Category 1™ credits for each two-year period. At least 20 of the 70 credits must come from Self-Assessment Modules (SAMs). Eighty percent of these credits must be directly related to the diplomate’s scope of practice.

Are there evaluation requirements for ABPath SAM activities?

As a part of their collaboration with ACCME, the ABPath has expanded the acceptable types of assessments for SAMs. SAM activities are no longer limited to tests or quizzes as their evaluation mechanism. Providers are still required to ensure that the evaluation is relevant to the activity content and accurately demonstrates that the learner has engaged with that content. The evaluation must also include a passing standard and feedback to the learner. Learners must meet the passing standard in order to earn SAM credit.

What is a Self-Assessment Module?

The Self-Assessment Module or SAM is a type of CME activity defined by the American Board of Pathology. SAM activities must be accredited CME and must offer a robust evaluation component. Learners must successfully complete the evaluation in order to earn SAM credit.

Specific requirements for SAM activities can be found in the ABPath program guide.

Can I offer different types and numbers of MOC credits for the same activity?

The answer depends on the requirements of the certifying board. For ABIM, ABA, and ABPath, you may offer learners the opportunity to earn different numbers of credits for the same activity, depending on their engagement with the activity. You may also offer different types of credit, based on the activity, and learners’ engagement with the activity. To determine what specific credit combinations learners may earn, please refer to the relevant board’s program guide.

How soon should providers register activities for MOC?

Providers are encouraged to register their activities for MOC as far in advance of the activity start date as possible. This allows learners to find the activity on It also allows providers to enter participant data quickly after the event occurs. For information about activity registration deadlines, please see the relevant board’s program guide.

Do I need to use different approaches to resolve conflicts of interest for planners than I use for other persons in control of content, such as authors, speakers and reviewers?

Yes. Some mechanism(s) that providers employ to resolve conflicts of interest for authors, speakers, and reviewers (e.g., peer-review of content) do not address the role(s) that planners have in controlling decisions that occur before content is developed for a CME activity. This influence may include choosing topics and faculty for the CME activity. To resolve conflicts for planners with relevant financial relationships, the provider needs to implement mechanisms that ensure independence in the planning process, itself, prior to the development of educational content and instruction.

Do the examples need to be four different innovations or would four examples from three innovations be sufficient (e.g., one webinar, two enduring materials, one M&M conference)?

Implementing a new format or a series of new formats of activities into your CME program could be considered one innovation. To meet the expectations for this criterion you would need to describe and demonstrate three additional innovations, as well as how each of the innovations contributes to your ability to meet your CME mission.  

How does ACCME audit ABIM Practice Assessment activities?

The ACCME will notify you if you are selected for an MOC audit and will ask you to complete a structured abstract for the activity that was selected for audit. Upon review of your submission, the ACCME will notify you if additional information is needed and/or the results of the audit in terms of compliance with the requirements.

What additional information must be reported in PARS to register an activity for ABIM Practice Assessment MOC?

Providers are required to enter the typical activity-related fields in PARS, and if the activity is eligible to offer ABIM Practice Assessment Points, the provider must attest to meeting the ABIM’s requirements, indicate which ABIM specialty(ies) the activity is best designed for based on the content of the activity, and how many MOC points will be offered. Please note that activities can be registered for ABIM Medical Knowledge points, Practice Assessment points, and/or Patient Safety Credit in any combination.

What additional information do I need to collect from my learners so that they can earn points for ABIM Practice Assessment activities?

The same learner information would be required as is currently collected for ABIM Medical Knowledge activities: The physician learner’s first and last name, date of birth (mm/dd), date of completion of the activity (mm/dd/yyyy), and the number of MOC points earned. In addition, providers must also indicate the MOC credit type(s) for which points were earned (i.e., Medical Knowledge, Practice Assessment, Patient Safety).

For Criterion 32, how often does the provider need to conduct a “periodic analysis to determine the effectiveness of the support strategies, and plans improvements?” Would including a question in a performance evaluation sixty days after the activity asking how often the learner used the tool meet the criterion?

It is up to the provider to determine the most appropriate interval or intervals for assessing the effectiveness of its support strategies. The ACCME expects that this assessment would occur at least once for each strategy during the accreditation term. The provider should additionally demonstrate how the support strategy evolved following the analysis.

Regarding Criterion 32: What are examples of how a provider conducts periodic analysis to determine the effectiveness of strategies designed to reinforce or sustain change?

The provider might evaluate how many learners are accessing support strategies, how many learners are using the reminders and/or patient education materials, or how many learners are logging into networking opportunities post-activity to engage with faculty or other learners. The provider might survey the learners to find out if the support strategies were helpful in reinforcing change, and if not, what might be more effective/helpful.

If a provider uses a Maintenance of Certification (MOC) tracking system that helps learners track which educational pieces they need to maintain their certification and offers suggestions for finding the education they need—in effect, giving them feedback on gaps for their professional certification—would this meet the spirit of Criterion 31?

The spirit/intent of C31 is for the provider to develop—with the learner—a learning plan with individualized feedback that will help the learner to address their own personal practice gaps—those areas of knowledge, skill, or performance that need improvement. To that end, a tracking system related to credit or MOC requirements, while useful, would not meet the intent of this criterion. The provider should be able to demonstrate that the learning plan differs meaningfully between learners. 

For Criterion 29, can observed behavior be self-reported?

Individuals or groups of learners can self-report and/or self-assess their communication skills, but the accredited provider must also include external observation with feedback to the learner – for example with a faculty member, a peer observer, or a standardized patient.

Which definition of public or population health should providers use?

The ACCME does not require providers to use a particular definition of public or population health. As one suggestion, a 1988 Institute of Medicine (IOM) report offered a condensed definition of public health as “fulfilling society’s interest in assuring conditions in which people can be healthy.” (Committee for the Study of the Future of Public Health, 1988, p.19) [Institute of Medicine (1988). The Future of Public Health. Washington, D.C.: National Academy Press.] 

Are honoraria paid to planners, faculty, authors, or speakers in accredited CME activities considered to be a financial relationship with an ACCME-defined commercial interest if the CME activity receives commercial support? Should these payments be disclosed to the provider/learners per Standards 2 and 6?

No. Standard 3 of the ACCME Standards for Commercial Support: Standards to Ensure the Independence of CME Activities requires that all commercial support received by an accredited provider for a CME activity be controlled and disbursed solely by the accredited provider, including payments to planners, authors or faculty/speakers. In contrast, any payments from ACCME-defined commercial interests to persons outside of accredited CME would be subject to disclosure as financial relationships (with a commercial interest) per Standard 2.1.

Can I engage patients as planners and teachers in CME activities without compromising privacy and confidentiality?

Patients are often important contributors to educational activities and we encourage providers to engage patients as planners and faculty. Providers should seek appropriate guidance from institutional policies and practices concerning the protection of confidential and private information when including patients in CME activities. The Health Insurance Portability and Accountability Act (HIPAA) does not prohibit the use of patients as faculty, planners, or learners in accredited CME as long as their permission has been received.

Would the inclusion of the interdisciplinary membership on the CME Committee count toward Criterion 23?

Not necessarily. Interdisciplinary has a different meaning than interprofessional. Interdisciplinary refers to multiple specialties – for example, cardiologists, endocrinologists, and nephrologists. Our intent with Criterion 23 is for CME providers to include multiple professions —not only multiple disciplines of medicine. For example, including  nurses, pharmacists, radiology techs, social workers, and physicians (or at least two of these professions) in the planning and delivery of education for the healthcare team would meet the expectations of Criterion 23.

What is a “relevant financial relationship” described in Standard 2 of the ACCME Standards for Commercial Support?

Relevant financial relationships are financial relationships in any amount, which occurred in the twelve-month period preceding the time that an individual was asked to assume a role controlling content of the CME activity, and which relate to the content of the educational activity, causing a conflict of interest. The ACCME considers financial relationships to create conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest.

What constitutes "patient or community health" in Criterion 38?

Patient or community health are the health characteristics or outcomes related to individuals or to groups of individuals within a geographic location, service area, or other grouping. Health and health outcomes can include incidence and/or prevalence of disease, mortality, vaccinations, nutrition, and social determinants (for example, healthy behaviors, safe environment). 

Is collaboration in the process of healthcare quality improvement in Criterion 37 limited to a single institution where care is provided?

No, collaboration is not limited to a single institution. Collaboration can occur within, or in connection with, a healthcare institution such as a hospital or health system, but it can also occur more broadly across systems of care. The ACCME interprets "system performance" broadly and the CME provider can choose how, and with whom, it collaborates in the processes of healthcare quality improvement.

Can compliance with Criterion 37 be achieved at the activity level?

Yes. You would need to show that, through your CME activities, you are collaborating in the process of healthcare quality improvement and demonstrate that the activity/activities resulted in healthcare quality improvement at least twice during the accreditation term.

I use a follow-up survey as a measurement tool. Do I need to measure improvement in the majority of survey respondents or the majority of total learners to comply with Criterion 36?

For Criterion 36, the majority of learners whose performance has improved would be calculated based on those learners who respond to the follow-up survey. The provider should ensure there are appropriate mechanisms in place to optimize the response rate. Note that providers can use follow-up surveys or a variety of methods to obtain this data.

What constitutes performance change in Criterion 36? Is there a minimum level of performance change that must be demonstrated?

In Criterion 36, change in performance refers to measured changes in a learner’s or learners' behavior (e.g., higher patient communication ratings, fewer coding errors, greater participation in team meetings, more appropriate prescribing, etc.). Providers can set their own specific goals and targets for the performance improvement objective. The provider can also choose the most appropriate mechanisms to measure performance change, and how much change in learners is acceptable.

When calculating the size of our program to determine the standard for measuring compliance under the Menu of Criteria for Accreditation with Commendation, do we include the activities that we jointly provide with nonaccredited organizations? We are concerned that joint providers may have difficulty meeting some of these expectations.

Yes, the total number of activities you've provided across the term of accreditation (four or six years) includes both directly provided and jointly provided activities. It may be helpful to consider how some of your collaborations with joint providers could help you achieve some of the goals of the new commendation criteria.

What kind of completion documentation do I have to provide to activity participants?

If requested by the participant, the provider must provide the participant with written documentation (eg, that could be downloaded or provided in hard copy), to include the name of the activity and the provider; the participant name; the participant’s ABP ID number; the date of completion of the activity; and the PARS activity identifier; in addition to a statement that the activity has been approved for ABP MOC Part 2 credit along with the number of MOC points awarded.

Where can I find a diplomate’s ABA ID number, and how many digits is it?

Diplomates’ ABA ID numbers are eight digits that begin with the number three (for example, 3555-5555).  They are not the same number that is printed on diplomates’ certificates, nor is it their membership number with a specialty society.  If you do not have a diplomate’s ABA ID, you will need to get it from the physician. Diplomates can locate their ID number by logging into their personal portal account on the ABA website at or by calling the ABA’s Communications Center at (866) 999-7501 Monday through Friday from 8 a.m. to 5 p.m. ET.

How do I determine the number of MOC points available for my ABIM MOC activity?

For most CME activities that are registered for ABIM MOC points, the number of CME credits will be the same as the number of MOC points.  However, it is possible that a large activity might only have certain sessions that qualify for MOC points.  In that case, the number of MOC points will be less than the number of CME credits that could be earned.

What records do I need if my activity is selected for audit related to the American Board of Pediatrics (ABP) Lifelong Learning and Self-assessment for MOC Part 2 CME Provider Program requirements?

Please see Table 2 in the ABP Lifelong Learning and Self-Assessment for MOC Part 2 CME Provider Program Manual for a detailed list of materials you will need to submit if your activity is audited. Accredited Providers should complete the ABP’s audit checklist (see Appendix B of the ABP MOC Program Manual) for each activity registered for MOC credit and retain this document along with any other relevant materials in the event the activity is selected for audit.

What is required to register accredited CME activities to count for the American Board of Pediatrics (ABP) Lifelong Learning and Self-assessment for MOC Part 2 CME Provider Program?

Any CME provider accredited directly by the ACCME, by a Recognized State Accreditor, or by Joint Accreditation for Interprofessional Continuing Education can register a CME activity for the ABP Lifelong Learning and Self-assessment for MOC Part 2 CME Provider Program in PARS by attesting that the activity meets the requirements and policies of the program. See the Program Manual for further information



What is required to register accredited CME activities to count for Maintenance of Certification in Anesthesiology Program (ABA MOCA 2.0)?

Any CME provider accredited directly by the ACCME, by a Recognized State Accreditor, or by Joint Accreditation for Interprofessional Continuing Education can register a CME activity for the Part 2 (Lifelong Learning and Self-Assessment) component of the ABA’s MOCA 2.0 program in PARS by attesting that the activity meets the requirements for ABA. The CME activity must:

What is ABA’s MOCA Content Outline and who can answer my questions about it?

The ABA’s MOCA content outline provides a framework for categorizing medical education content relevant to practicing anesthesiologists.  For each registered activity for MOCA 2.0, you will select at least one or a maximum of two content areas that best describe the content of your activity. The ABA can answer questions about its MOCA content outline.  Contact the ABA at

Who are the health professions students described in Criterion 25?

The term “health professions students” refers to students of any of the health professions (e.g, medicine, nursing, pharmacy, physician assistants, and others), across the continuum of healthcare education, including professional schools (e.g., nursing, medical, pharmacy schools) and graduate education (e.g., residency and fellowship programs). 

Can you explain what “patient/public representatives as faculty/planners” means in Criterion 24?

Criterion 24 encourages the accredited provider to utilize patients, their families, and other members of the public as planners and faculty members in accredited CME. Providers have broad latitude in how they define the roles of planners and faculty – as appropriate to their CME program and activities.  For example, a patient or public representative could serve on a planning committee to advise the provider, could be a speaker, or could be a participant in a case-based discussion during an accredited CME activity.

What is an “interprofessional team,” as described in Criterion 23?

An interprofessional team is comprised of team members from two or more different professions (e.g., nurses and physicians, physicians and community health workers, social workers and psychologists, pharmacists and respiratory therapists) who learn with, from, and about each other to enable effective collaboration and improve health outcomes.

Can I achieve Accreditation with Commendation using criteria from both the current Accreditation with Commendation Criteria (16-22) and the Menu of New Criteria for Accreditation with Commendation?

No. Providers have the choice of using either  Option A: Commendation Criteria (C16-C22) or Option B: Menu of New Criteria for Accreditation with Commendation (C23-C38) to seek Accreditation with Commendation. However, providers need to select one option and cannot combine criteria from the two different options during the reaccreditation process.

Can I pursue Accreditation with Commendation using the current Accreditation with Commendation Criteria (C16-C22), or do I have to use the Menu of New Criteria for Accreditation with Commendation?

Providers that will receive accreditation decisions between November 2017 and November 2019 will have the choice of using either Option A: Commendation Criteria (C16-C22) or Option B: Menu of New Commendation Criteria (C23-C38) to seek Accreditation with Commendation. Providers that will receive accreditation decisions after November 2019 must use Option B if they wish to seek Accreditation with Commendation.

Can you explain the purpose of including rationale, critical elements, and standards for the new criteria for Accreditation with Commendation?

Accredited CME providers asked, through their feedback and comments, the ACCME to include additional information – in terms of explanation and measurement expectations – in support of any new commendation criteria. In order to be responsive to that feedback, the ACCME is including rationale for each criterion, the critical elements required to demonstrate compliance, and the standards for measuring compliance.

Can you explain the menu approach for the new criteria for accreditation with commendation?

The Menu of New Criteria for Accreditation with Commendation includes 16 criteria divided into five categories (Promotes Team-based Education, Addresses Public Health Priorities, Enhances Skills, Demonstrates Educational Leadership, Achieves Outcomes). To achieve Accreditation with Commendation using this menu, CME providers need to demonstrate compliance with any seven criteria of their choice, from any category—plus one criterion from the Achieves Outcomes category—for a total of eight criteria.

What does “limited” registration mean?

Registration is “limited” for activities that are designed primarily for the accredited provider’s faculty, staff, membership, or another specific audience. For information about whether you may register for an activity with limited registration, please contact the accredited provider directly.

What kind of CME activities can I find in the ACCME’s CME Finder?

Currently, only activities that are registered for American Board of Anesthesiology’s Maintenance of Certification program (ABA MOCA), American Board of Internal Medicine’s Maintenance of Certification program (ABIM MOC), American Board of Pediatrics Maintenance of Certification program (ABP MOC), or are compliant with the FDA’s ER/LA Opioid Analgesics REMS are included in CME Finder.

How will information about my CME activity that counts for MOC be provided to learners?

As a benefit of registering CME activities for MOC using ACCME’s Program and Activity Reporting System (PARS), accredited providers agree to have information about their activities made available to the public via ACCME’s CME Finder search tool ( CME Finder is a resource for board certified physicians to search for accredited CME activities that are available for MOC through the collaboration between ACCME and several specialty boards, including the ABA, ABIM, and ABP.

What is the ACCME’s CME Finder?

ACCME’s CME Finder is a web-based search tool designed to help health care professionals find accredited CME activities that meet their needs.  Users can search for information about currently available CME activities that have been registered for American Board of Anesthesiology’s Maintenance of Certification program (ABA MOCA), American Board of Internal Medicine’s Maintenance of Certification program (ABIM MOC), American Board of Pediatrics Maintenance of Certification program (ABP MOC), or are compliant with the FDA’s ER/LA Opioid Analgesics REMS.

When I develop a journal-based CME activity, do I need to collect information about relevant financial relationships from the authors of the journal article, identify and resolve their conflicts of interest, and disclose their relevant financial relationships to learners?

No. If you are creating a journal-based CME activity, the ACCME does not expect you to identify and disclose to learners the relevant financial relationships of the article’s authors and editors or to resolve their conflicts of interest. That process is handled by the journal editors. Disclosure by authors is a standard component of published articles, and the editorial review process manages the resolution of any conflicts of interest.

How will I know that my participant data has been validated by the specialty board?

When you submit participant completion data, PARS will verify the participant's information against simple validation rules, and if verified, will transmit the record to the specialty board(s) for further validation. After the specialty board(s) completes its validation of the data, the participant record status will change to "accepted" or "rejected" within 24 hours.  If a record is rejected, you will be notified via email, and the reason for rejection will appear in PARS. Depending on the reason for rejection, you may be able to correct the data and resubmit.

How do I use PARS to report MOC points for an accredited CME activity?

Reporting Maintenance of Certification (MOC) points for an accredited CME activity is a straightforward two-step process.

  • First, an accredited CME provider registers the activity in ACCME's Program and Activity Reporting System (PARS) – – for a participating specialty board's MOC program.
  • Once the activity is registered in PARS, the second step is for the CME provider to enter and submit participant completion data into PARS.

What happens if the participant information that the CME provider reports for an MOC activity in PARS does not match the diplomate’s information held by their specialty board?

If the participant data submitted via PARS does not match the information in a diplomate's specialty board record, PARS will not be able to confirm the participant’s identity and will not accept the completion record. The provider will be notified immediately via a validation error message in the PARS interface or in the batch upload report, depending on what data submission method is being used. The provider will subsequently need to enter corrected data to submit the record successfully. 

How do I provide feedback to the learner?

Feedback can be provided in several ways. Evaluation results can be used as feedback. This is best achieved by correcting misconceptions and incorrect responses, showing learners the correct or optimal response, and providing an explanation as to why the correct answer is the best. This can be done live and at the same time as the activity, or asynchronously. During a live activity, a case conversation where faculty share with learners the appropriateness of the decisions they made and the appropriateness of the case outcome can be considered feedback to participants.

How do I develop a passing standard?

A passing standard can be set according to the intent of the evaluation. The passing standard is determined by the provider. When using a post-test as part of evaluation, the activity planners and/or faculty can determine the minimum number of items that the learners would need to answer correctly to demonstrate that they have adequately absorbed the content of the activity.

How do I use shared responses as an evaluation mechanism?

Shared responses refer to the dialogue that is shared among participants in a discussion group. For example, this might be an appropriate assessment method when learners work collaboratively through a case, or come to a shared resolution to an ethical problem. The accredited provider should be attentive to what is said and by whom, and observe for individual learner participation, engagement, and contributions.

How do I use written responses as an evaluation mechanism?

Written responses can be responses to a variety of prompts. The questions can be as broad as "What would you do differently as a result of what you learned?" and "What will you keep doing or stop doing as a result of the learning that has occurred?" to more narrowly focused questions such as "What would you do next for this patient in this situation?" Those written responses can be evaluated for concordance to an ideal response. When appropriate, it may be adequate to have the learner write a meaningfully reflective statement.

How do I use a longer form test as an evaluation mechanism?

Longer form tests refer to assessment instruments that comprise several different testing modalities, such as multiple-choice items, items that require the learner to draw a process, and/or fill-in-the-blank written or spoken responses. An answer key is essential in order to use this modality effectively.

How might I use fill-in-the-blank questions as an evaluation mechanism?

Fill-in-the-blank questions refer to items that are completed by the learner(s). The format includes a leading statement with a missing word or words that are then completed by the learner(s). These responses can be collected using a variety of methods, including audience response systems or evaluation forms.

How might I use multiple-choice questions as an evaluation mechanism?

Multiple-choice questions can be used in a variety of ways. They are typically used as mini-case simulations that present a clinical vignette and a question (the "lead in") followed by a discrete range of possible responses, one of which is correct. These can be readily scored using audience response systems, computer score sheets, or manually. Instructions for writing effective multiple-choice items can be found at

If I am registering my CME activity for ABIM medical knowledge points in PARS, how will ABIM know that my learners should also receive the optional patient safety MOC credit for their participation?

Once you have attested that your activity meets the American Board of Internal Medicine’s (ABIM) Medical Knowledge Assessment Recognition Program requirements, ACCME’s Program and Activity Reporting System (PARS) will prompt you to indicate whether or not you are seeking the optional patient safety Maintenance

If I have multiple sessions at our annual meeting that I would like to register for points in ABIM’s MOC program, do I need to enter them as separate activities in PARS?

No. As has always been the case, accredited providers should report any multi-session annual meeting as a single CME activity in ACCME Program and Activity Reporting System (PARS). When registering an annual meeting activity for the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program, you can adjust the number of MOC points to accurately reflect only the sessions that meet the requirement.

How do I report participant completion data for regularly scheduled series such as grand rounds or tumor board conferences?

Per ACCME data reporting instructions, accredited providers should report multi-session regularly scheduled series (RSS) for example, grand rounds, tumor boards, and morbidity and mortality conferences as a single activity in the Program and Activity Reporting System (PARS). If the entire RSS or a portion of the series meets the American Board of Internal Medicine (ABIM) requirements, it can be registered for Maintenance of Certification (MOC).

What is an RPC ID?

The REMS Program Companies (RPC) assigns an ID (RPC ID) to each activity for which it provides commercial support.  Accredited providers that offer RPC- supported REMS activities are responsible for entering the RPC ID in the designated field in the REMS section of the activity web-fill form in the Program and Activity Reporting System (PARS).  This ensures that their RPC-supported activities can be identified and reported to the RPC and, ultimately, to the FDA. If you are an accredited provider that has received commercial support from the RPC for REMS activities and you have questions abo

Are there any circumstances when employees of ACCME-defined commercial interests can be in a position to control the content of accredited CME?

The use of employees of ACCME-defined commercial interests as faculty and planners or in other roles where they are in a position to control the content of accredited CME is prohibited, except in the specific situations specified here. The ACCME has identified 3  special-use cases where employees of ACCME-defined commercial interests can have a specific, limited role in accredited CME activities.

Can we use tabs, links, or other electronic mechanisms to transmit disclosure information to learners as required by Standard for Commercial Support 6?

Yes. Effective April 2015, providers can use tabs, links, or other electronic mechanisms to make disclosure information available to learners, just as they have always been able to make disclosure available via a tabbed section in a printed syllabus. Regardless of the method of disclosure, all required ACCME information specified in Standard for Commercial Support 6: Disclosures Relevant to Potential Commercial Bias must be transmitted to the learner prior to the learner beginning the CME activity and should be clearly marked, accessible, and useful for learners. 

If the content of a CME activity is not related to the products or services of an ACCME-defined commercial interest, do I still need to obtain information regarding the financial relationships of those that control the content of the CME activity, per Standard 2.1?

No. Standard 2.1 requires the provider to identify relevant financial relationships of those who control the content of a CME activity in order to identify conflicts of interest. Two things must be present for there to be a conflict of interest: financial relationship(s) with an ACCME-defined commercial interest(s) and the ability to control content related to products/services of the commercial interest(s).

Our regularly scheduled series activity (e.g, pediatric grand rounds) includes many sessions that address different professional practice gaps and educational needs. Can we submit a single structured abstract for the entire series?

Yes. The Structured Abstract is intended to streamline, clarify and make more explicit ACCME’s expectations for verifying Performance-in-Practice. Using the fill-form fields on the structured abstract, the provider should state information representative of the entire series. It is permissible for the provider to summarize, or abstract, information from multiple sessions into brief statements on the abstract document. 

Our annual meeting is a very complex CME activity, with multiple tracks addressing several professional practice gaps and educational needs. Do we have to use a single structured abstract to submit our performance-in-practice evidence for this activity?

No. The Structured Abstract is intended to streamline, clarify and make more explicit ACCME’s expectations for verifying Performance-in-Practice. A single Structured Abstract can be used to for complex activities, however, you can also prepare separate structured abstracts for different tracks of a large annual meeting. Providers taking this approach should be sure that each structured abstract includes the required information and attachments.

Can you explain the ACCME 2006 Accreditation Criteria as they relate to a provider's process for continuous quality improvement?

The 2006 Accreditation Criteria are founded on Shewhart and Deming’s “Plan, Do, Study, Act” model for continuous improvement. This is reflected both in those accreditation criteria that are concerned with the improvement of a provider’s overall CME program, as well as criteria that guide the provider in planning and implementing CME activities to support continuous improvement of their learners’ practice and/or patient outcomes.

We make disclosure of commercial support as required by Standard 6.4 to our learners on our online registration portal. The opening screen includes the names and logos of our commercial supporters. Is that acceptable?

No. Logos of ACCME-defined commercial interests are not permitted in the disclosure of commercial support. The ACCME considers the disclosure of commercial support, as well as other information required by the ACCME such as disclosure of relevant financial relationships, to be part of the educational materials.

The April 2014 update to Standard 4.3 says that “Educational materials that are part of the CME activity” cannot contain corporate logos of an ACCME-defined commercial interest. What does the ACCME mean by “educational materials”?

Educational materials are those materials used by the accredited provider in the transfer of education to learners (for example, handouts, slides, educational content, abstracts that are part of the education itself) as well as materials that contain information required by the ACCME to be made known to the learner as part of Criterion 7, ACCME Standards for Commercial SupportSM: Standards to Ensure Independence in CME Activities, Standard 6.

Why did the ACCME change Standards 4.3, 6.4, and the Commercial Support Acknowledgment Policy to prohibit the use of ACCME-defined commercial interest logos in educational materials and disclosure of commercial support?

The ACCME made these modifications in March 2014 because it determined that the logos of ACCME-defined commercial interests —as a form of corporate branding —are not appropriate in either educational materials or in the disclosure of commercial support of accredited continuing medical education.

Can accredited providers include components in their CME mission statements in addition to the expected results described in Criterion 1?

Yes. Accredited providers can choose to include components in their CME mission statements in addition to those specified in Criterion 1. However, during the accreditation process, providers’ mission statements will be evaluated only to ensure that the mission statement includes “expected results articulated in terms of changes in competence, performance, or patient outcomes that will be the result of the program.”

Can accredited providers continue to use a monitoring system for regularly scheduled series (RSS) to demonstrate compliance with accreditation requirements?

Yes. Providers may choose any quality assurance method that works for them in order to ensure that their regularly scheduled series (RSS), and all their activities, are planned and presented in compliance with accreditation requirements. However, the ACCME does not require providers to use a monitoring system for RSS–or for any of their activities.

When are accredited CME providers expected to implement the change in terminology from “sponsorship” to “providership” in their CME materials?

The ACCME expects accredited providers to discontinue the use of the term “sponsor” (e.g., jointly sponsored, joint sponsorship, directly sponsored, direct sponsorship) for new materials published after January 1, 2015. Please note that this change in terminology applies to accreditation statements for directly and jointly provided activities, as well as other materials.

As a CME provider accredited by an ACCME-Recognized Accreditor (state/territory medical society), does the ACCME’s February 2014 simplifications of its accreditation requirements and processes apply to my organization?

Yes. The February 2014 changes to ACCME’s accreditation requirements and processes apply to all accredited providers within the ACCME accreditation system. ACCME Recognized Accreditors are responsible for implementing these changes for intrastate providers. Please check with your accreditor about the implementation process.

What is the FDA requirement for long-term evaluations of the prescriber training component of the ER/LA Opioid Analgesics REMS?

The FDA has required long-term evaluations of the ER/LA prescribers who complete REMS-compliant CE activities. Specifically, the FDA is requiring the evaluation of knowledge retention and practice change in ER/LA opioid prescribers 6-12 months after completing the REMS-compliant CE activity. The long-term evaluations will be separate and different from any post-tests that might be conducted by accredited CE providers immediately after all REMS-compliant CE activities.


How is the continuing education community addressing prescription drug abuse?

The CE community addresses prescription drug abuse in many ways. One way is by developing and presenting education that is explicitly part of the RPC-funded ER/LA Opioid Analgesics REMS that meets all the specific REMS requirements.  Another way is through the activities offered by accredited CE providers on a wide range of important topics to educate healthcare professionals about  prescription drug safety, and drug abuse prevention, intervention, and treatment.

What is an FDA Risk Evaluation and Mitigation Strategy?

The Food and Drug Administration Amendments Act of 2007 gave the FDA the authority to require manufacturers of drugs and biological products to put in place special programs if the FDA determines that safety measures are needed beyond the professional labeling to ensure that the benefits of products outweigh their risks.  The manufacturers then implement FDA-monitored actions to address those risks.  The FDA calls each of these a Risk Evaluation and Mitigation

Can providers be required by potential commercial supporters to share the list of expected authors or speakers with commercial supporters, during the process of applying for an educational grant?

No. The ACCME cannot control what a commercial interest asks of an accredited provider but there is no CME reason for the provider to share the names of speakers/authors with commercial supporters.  An accredited provider that submits to the requirement of a commercial supporter to supply the names of speakers and authors could be participating in a process whereby the commercial supporter is controlling the selection of speakers and authors in accredited CME.

Do I need to obtain disclosure of relevant financial relationships directly from the spouse or partner of a person who is in a position to control the content of a CME activity? (Standard for Commercial Support 2.1)

No. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.  The ACCME expects that providers will communicate to everyone who is in a position to control of content of an educational activity that the individual’s disclosure of relevant financial relationships must include:

What are examples of those in control of content as described in Standard for Commercial Support (SCS) 2.1?

SCS 2.1 requires that the accredited provider “must be able to show that everyone who is in a position to control the content of an education activity has disclosed all relevant financial relationships with any commercial interest to the provider.”  If someone in connection to the activity has the opportunity to affect the content, they are “in control of content.”  Those individuals in a position to control the content of an e

What is the difference between significant financial relationships and relevant financial relationships?

First it is important to understand how the ACCME defines a financial relationship. Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.

How do I update my organization's contact information in PARS?

All of the users associated with your organization in PARS have the ability to edit organizational contact information on the “Profile” tab in PARS.  Contact information for individual users may be edited within the "Profile" tab under "Contacts".

How should an accredited provider manage and report funds received from commercial interests to reserve space for a CME activity that is held in conjunction with another organization’s meeting?

All funds that originate from ACCME-defined commercial interests and are paid to reserve space to hold accredited CME activities (sometimes called satellite symposia) in conjunction with other organizations’ meetings are considered commercial support. As with all commercial support, these funds must be paid directly to the accredited provider responsible for the activity or to a designated nonaccredited joint provider.

Is it acceptable for an accredited provider to include product-specific content in an activity based on the FDA ER/LA Opioid Analgesics REMS blueprint?

Yes. There is no ACCME prohibition against including product-specific content in accredited CME. Accredited providers can develop and distribute product-specific content for activities based on the FDA blueprint for the Extended-Release and Long-Acting (ER/LA) Opioid Analgesics Risk Evaluation and Mitigation Strategy (REMS) because the blueprint was developed and issued independent of the control of any ACCME-defined commercial interest. As with any CME activity, accredited providers must comply with the ACCME accreditation requirements.

Does the ACCME information about the ER/LA Opioid Analgesics REMS apply to all REMS?

No. The ACCME information applies only to the ER/LA Opioid Analgesics REMS. The ACCME appreciates that the FDA recognizes the value of accredited  education and believes that accredited CME should be considered as a strategic asset to all those trying to improve drug safety. Since 2009, the ACCME has supported the role of accredited CME as a strategic asset to REMS FDA-approved products, provided the proper controls are in place to ensure independence. The ACCME will be ready to respond if the government calls on accredited CE to support implementation of other REMS.

What is the ACCME's role in the ER/LA opioid Analgesics REMS?

The ACCME views the FDA ER/LA Opioid Analgesic  REMS as an important initiative for addressing  a critical public health and patient safety concern. The ACCME believes that accredited CME can be an important factor in the success of this REMS and all REMS that involve continuing professional education.

What is the role of accredited continuing education in the FDA ER/LA Opioid Analgesics REMS?

In the Extended-Release and Long-Acting Opioid Analgesics REMS, one of the elements to assure safe use is an education program for prescribers about the risks of opioid medications as well as safe prescribing and safe use practices. The ER/LA Opioid Analgesics REMS requires the manufacturers to provide commercial support to accredited CME so that it is available free of charge or at nominal cost to prescribers. However, the participation of accredited providers is completely voluntary – as is the participation of prescribers in REMS education.

What is the FDA REMS for Extended-Release and Long-Acting Opioids?

The FDA delivered its Risk Evaluation and Mitigation Strategy (REMS) for extended-release and long-acting (ER/LA) opioid analgesics to the manufacturers in 2012.  According to the FDA news release the REMS "is designed to ensure that healthcare professionals are trained in how to properly prescribe these medicines and how to instruct their patients about using them safely."  It has two components: a medication guide and elements to assure safe use.

In an electronic CME activity, can we provide the disclosure information that is required in the Standards for Commercial Support by SCS6 via a link which participants can click on, if they choose?

No. For CME activities in which the learner participates electronically (e.g., via the Internet), all required ACCME information specified in Standard for Commercial Support 6: Disclosures Relevant to Potential Commercial Bias must be transmitted to the learner prior to the learner beginning the CME activity.

What do I need to know about the "Attestation" section of the Program Summary tab?

Each year, information is collected, summarized, and published as a service to accredited providers, other members of the community, and the public via the Program and Activity Reporting System (PARS). At the conclusion of each Reporting Year, a provider is required to submit information about their activities that took place during the year as well as financial data about their overall Program.

How is an internet searching and learning activity defined?

Internet searching and learning activities are based on a learner identifying a problem in practice and then accessing content in search of an answer from sources on the Internet that are facilitated by a provider. For the purpose of data collection, the ACCME includes AMA-defined point of care CME as a form of internet searching and learning.

How is a performance improvement activity defined?

Performance improvement activities are based on a learner’s participation in a project established and/or guided by a provider in which a learner identifies an educational need through a measure of his/her performance in practice, engages in educational experiences to meet the need, integrates learning into patient care and then re-evaluates his/her performance.

How do I report Test Item Writing in PARS?

Test Item Writing activities may consist of either of the following processes:  

  1. When questions are written for an ‘item pool’ from which they are later drawn to build a variety of ‘tests’, then building the questions for a single pool is one activity (ex. the Pediatric Item Writing Committee of the National Board of Medical Examiners; or the Second Year Clerkship exams at your medical school); or 

How is a journal-based activity defined?

A journal-based activity includes the reading of an article (or adapted formats for special needs), a provider stipulated/learner directed phase (that may include reflection, discussion, or debate about the material contained in the article(s)) and a requirement for the completion by the learner of a pre-determined set of questions or tasks relating to the content of the material as part of the learning process.

How is an internet enduring material activity defined?

An internet enduring material activity is available when the learner chooses to complete it.  It is “enduring,” meaning that there is not just one time on one day to participate in it.  Rather, the participant determines when he/she participates.  (Examples:  online interactive educational module, recorded presentation, podcast).

How is an enduring material activity defined?

An enduring material is a printed, recorded, or computer-presented activity that may be used over time at various locations and which, in itself, constitutes a planned activity. In an enduring material the provider creates the content.

How is a course defined?

A course is a live activity where the learner participates in person. A course is planned as an individual event. Examples: annual meeting, conference, seminar.

How is a learning from teaching activity defined?

Learning from teaching is a descriptive label for a type of activity. (The identification of activity types allows the reporting of data and information on the range of educational formats offered nationally.  This helps dispel the myth that accredited CE is mostly lecture, or didactic, in format.)

What's the difference between "knowledge," "competence," "performance" and "patient outcomes"?

Accredited providers are required to understand the issues with knowledge or competence or performance that underlie a professional practice gap. Problems with knowledge, competence or performance that underlie a professional practice gap — and design an educational activity to intervene — and to design and to measure — in terms of changes in competence, performance or patient outcomes. The patient outcome or the outcome is like the professional practice gap, those are analogous.

Can you provide me with some solid examples of the type of data that would be acceptable in meeting Criterion 12, "The provider gathers data or information and conducts a program-based analysis on the degree to which the CME mission of the provider has been met through the conduct of CME activities/educational interventions."

Let us say a CME provider set its mission so that the expected result of its program of CME was to change competence and was, "To enable learners to develop strategies for the identification of patients with drug addiction."

Examples of a sample of the type of data that would be acceptable in meeting Criterion 12 would be:

"When we started, none of our learners could ask the right screening questions, did ask the right screening questions, or identified a patient with drug dependence in their practice." 

What are some examples of non-educational strategies as mentioned in Criterion 17?

Examples of a "non-educational strategy to enhance or facilitate change as an adjunct to activities or educational interventions" would be, 1) implementing a mechanism to send reminders to participants following CME activities (e.g., "Don't forget to..." or "Have you incorporated...?"), or 2) working with others to facilitate a peer to peer feedback system to reinforce new practices, or 3) incorporating new questions about the new practices into patient satisfaction questionnaires.

What resources does the ACCME have in place to assist providers (and other stakeholders) with meeting the ACCME's standards for continuing medical education?

The ACCME is committed to ensuring that accredited providers have tools and resources to help them meet ACCME policies and standards. Educational opportunities include resources available through the ACCME website ( and training-focused workshops and other meetings. For more information, visit the Education section on our website.

Does the ACCME require hospital-based CME programs to become part of their organization's Quality Improvement Department?

No. Criterion 21 requires that the provider, "participates within a institutional or system framework for quality improvement", but does not specify the manner in which this is achieved. Criterion 21 is required to achieve Accreditation with Commendation (Level 3), however noncompliance with Criterion 21 is not held against providers seeking Full Accreditation (Level 2). For examples of provider practices that achieve compliance with Criterion 21, see the ACCME's Provider Examples of Compliance and Noncompliance.

Do I have to document compliance with all criteria for each activity?

No, you do not. Some Criteria address your overall CME program, while others relate to CME activities. For each CME activity, you need to demonstrate compliance with Criteria 2 - 6, which address educational planning and delivery. In addition, you need to demonstrate compliance with the ACCME Standards for Commercial Support SM (Criteria 7 - 10). Criterion 11 requires that providers evaluate changes in learners' competence or performance or patient outcomes, in order to be able to analyze those changes achieved as a result of the overall program's activities.

In Criterion 2, what is meant by "professional practice gap?"

This is an ACCME adaptation of an Agency for Healthcare Research and Quality (AHRQ) definition of a gap in the quality of patient care where the gap is "the difference between health care processes or outcomes observed in practice, and those potentially achievable on the basis of current professional knowledge."

Criteria 1 and 3 refer to "changes in competence, performance, or patient outcomes" but Criterion 2 refers to educational need in terms of "knowledge, competence, or performance." Can CME providers offer activities that are designed to change knowledge?

Yes. CME providers can offer activities designed to change knowledge. The emphasis now is on the CME provider knowing the "educational needs that underlie the professional practice gaps of their own learners." ACCME believes that the path to closing the gap will be through modifications to one, or more, of physicians' knowledge, competence, or performance. ACCME expects that CME providers and learners will analyze the gaps in order to understand the causes so as to determine what might be the best or most appropriate educational intervention.

With respect to Criterion 2, must educational need for each activity be grounded in actual data that has been collected and analyzed?

Criterion 2 requires that the educational needs that underlie the professional practice gaps of learners be incorporated into the CME activities. However, the CME provider does not have to collect that needs data. There are many, many sources of needs data that relate to professional practice gaps. Determining if that data is relevant to the actual learners is a task for the CME provider. The ACCME's announcement of the Updated Criteria included some references that might be a place for the CME provider to start.

Must the source of an educational need be grounded in one of the American Board of Medical Specialties' (ABMS) core competencies?

Needs assessment is about understanding the basis for a 'professional practice gap' - in terms of an underlying problem with knowledge, competence or performance-in-practice. A provider may want to further understand the underlying problem in the context of one or more of the competencies - so an educational need may be grounded in one or more of ABMS' core competencies. There are other competencies that have been promulgated that might be useful for the CME provider to consider, e.g., the IOM competencies, specialty - specific competencies.

Does CME have to give "equal time" to all modalities of therapy (e.g., surgical vs. medical)? Does CME have to give "equal time" to all formulations of a drug or all products in a class of products?

CME must be free of commercial bias. CME must not promote products or services. CME must promote improvements in healthcare. A "balanced view" means that recommendations or emphasis must fairly represent, and be based on, a reasonable and valid interpretation of the information available on the subject (e.g., "On balance the data support the following..."). A "balanced view of therapeutic options" also means that no single product or service is over represented in the education activity when other equal but competing products or services are available for inclusion.

If we have taken appropriate steps to resolve conflicts of interest what is there left to disclose?

Informed learners are the final safeguards in assuring that a CME activity is independent from commercial influence. Regarding personal conflicts of interest, CME providers are to have in place mechanisms to identify and resolve conflicts of interest. While these mechanisms should greatly reduce the potential for conflicts of interest to affect CME content, a potential for influence remains. Disclosing to learners the relevant financial relationships that were present and resolved assists learners in assessing the potential for bias in information that is presented.

In SCS 6.1, the ACCME says that included in disclosure to the learners should be the nature of the relationship the person has with each commercial interest. What does the ACCME mean by nature of the relationship?

The nature of the relationship means the role they play or service they provide in exchange for some form of compensation (e.g., independent contractor including contracted research, consulting, promotional speaking and teaching, membership on advisory committees or review panels and board membership). ACCME has not set a minimum dollar amount for relationships to be relevant.

Is disclosure of commercial support different than disclosure of financial relationships?

Yes. Commercial support is financial, or in-kind, contributions given by a commercial interest, which is used to pay all or part of the costs of a CME activity. This is money given to the provider to support the activity. In contrast, financial relationships are between an individual being asked to assume a role controlling content of the CME activity and a commercial interest and occur outside of the CME activity (e.g. a teacher or author of participating in a CME activity is paid by a commercial interest to speak).

Where can advertising appear related to educational events?

ACCME insists on the separation of education from all promotional activities, materials and messages. Many providers create a print or text based document that goes along with an activity and provides information that is supplementary to the education content - like reproductions of slides, graphics or other handouts. These documents, in print or electronic, are an integral part of the education and as such cannot have any advertising, corporate logo, trade name or a product-group message of an ACCME-defined commercial interest associated with them.

Our program book has abstracts in it but we give no CME credit for the abstracts - there is no problem having advertising in the program book, correct?

It would depend on what the program book, with abstracts, is used for in relation to the CME activity. If the abstracts are referenced during the activity or serve as a component of the content, then there can be no advertising in the program book. If the abstracts are not referenced as part of the CME content, and appear in the program book with all other logistical information about the activity, then there can be advertising.

Since the updated SCS do not mention off-label usage, does that mean that disclosure for off-label uses is no longer required or that discussion of off-label uses is not allowed in a CME activity? (SCS 5.1)

Discussion of off-label uses are certainly allowed in CME activities. However, providers are no longer required to have a mechanism in place to ensure that off-label or investigational uses are disclosed as such. The ACCME adopted content validation statements in 2002 that are expectations of providers with regard to any recommendations for clinical care.

What kind of documentation of commercial support is expected?

ACCME expects to be able to review income and expense statements for all CME activities. These statements must reflect:

Significant sources of income: Including income from commercial support, advertising and exhibit fees, tuition and registration fees, internal budget allocations and any other source that represents greater than 20% of total income.

Is it acceptable to say, "In exchange for $5,000 of commercial support and $5,000 in exhibit fees, we will produce the CME activity and as a commercial supporter you will get an acknowledgment and a 4 x 4 sq ft booth in the exhibit hall. Can we itemize both the commercial support and the promotional fees in the same written agreement?

No, in this scenario the commercial interest is giving commercial support and buying promotional and sales opportunities. The commercial interest should buy advertising and promotion opportunities with resources designated for that purpose. If an agreement for advertising or promotion is struck between the two parties it must be outside the written agreement for commercial support described in Standard 3 of the SCS.

Does SCS 4.2 represent a change for enduring materials?

This is a more detailed description of the requirements that must be followed if there is advertising in enduring materials. There can be advertising before and after the CME content of an enduring material but those advertisements cannot be related to the content of the CME and cannot have been paid for by the commercial supporter.

What does ACCME mean by space or place related to SCS 4.2?

Twenty years ago, most CME occurred in a lecture hall. Now, learning activities occur in many different environments including electronic media, and ACCME intends that all of these places and spaces of CME activity need to be protected from encroachment by advertising, sales or promotional activity.

Can providers pay some of the expenses of people who are both faculty and learners?

Yes - but CME providers need to be sure that these people have bona fide teaching roles. In the United States, physician learners are not to be given compensation or reimbursement for attending CME activities (see Opinion 8.061 of the Council on Ethical and Judicial Affairs of the American Medical Association). It is unacceptable for anyone other than the Provider, or its agents, to receive direct financial benefit from commercial support.

What does the ACCME mean by "control" in its expectation that a provider make certain decisions free from the "control" of a commercial interest?

The ACCME expects that the provider makes decisions related to the planning and implementation of CME activities without being directed or influenced by commercial interests.

A provider will be found in Noncompliance with SCS 1.1 and SCS 3.2 if the provider enters into a commercial support agreement where the commercial supporter specifies the manner in which the provider will fulfill the requirements of the ACCME's Elements, Policies and Standards. (Applicable to all electronically, digitally or manually signed written agreements executed after January 1, 2008.)

If disclosure information cannot be analyzed in a timely fashion, is it appropriate for the activity or presentation to go on without formal CME credit?

ACCME has never recommended withholding CME credit at the last minute as an alternative to producing CME that is in compliance with accreditation requirements. It does not seem fair to the physician learners. Assuming that in this scenario there is financial relationship information to disclose to the learners, a mechanism to resolve conflicts of interest could still be put in place.

Can faculty take an active role in the provider's mechanism(s) to resolve conflicts of interest?

Yes . Resolving conflicts of interest means individuals taking explicit actions prior to the educational activity to create CME content that is valid and free of commercial bias -- even in the presence of relevant financial relationships. In the construct of the current CME system, the development and presentation of CME content is most often the responsibility of teachers/authors. Therefore, the ACCME considers teachers/authors to be a part of the accredited provider.

We use "peer review" as our mechanism to resolve conflicts of interest. We read the content of each presentation, looking for commercial bias and content that is not supported by evidence. Does this resolve conflict of interest?

No . "We read the content of each presentation, looking for commercial bias and content that is not supported by evidence" is a mechanism to identify commercial bias and invalid content but it does nothing to change the content so that the bias is gone and the content is valid. As described, it is a monitoring or screening process. If used before the activity it is a screening process -- and action needs to be taken to revise the content if commercial bias or invalid content are identified.

What is commercial support?

Commercial support is financial, or in-kind, contributions given by a commercial interest, which is used to pay all or part of the costs of a CME activity.

Can a commercial supporter direct the content of CME?

No. The provider must ensure that the content of the CME truly remains beyond the control of the commercial supporter. The process to develop the CME must be independent of the commercial interest. Providers must not allow commercial supporters to directly (SCS 1.1) or indirectly (SCS 3.2) control the content of CME.

Can a provider leave it up to an individual who controls content to determine if his/her relevant financial relationship creates a conflict of interest that needs to be resolved?

No. The provider cannot delegate the responsibility for resolving the conflict of interest to the person with the conflict of interest. However, an individual who controls CME content can be involved in the mechanism by being expected to take specific actions to resolve his/her conflict (ex: removing bias, using an evidence-based approach) under the supervision of the provider.

Can accredited CME activities that train on the use of medical devices or equipment include employees of ACCME-defined commercial interests?

Yes, with specific limits and expectations. Education on devices is a special-use case in accredited CME. Some equipment contains labeling requirements set by the Food and Drug Administration (FDA). These may include requirements for instruction prior to use. Employees of ACCME-defined commercial interests can demonstrate the operational aspects of the safe and proper use of a medical device within accredited CME activities.

Is it necessary to collect disclosure information on relevant financial relationships from a speaker each and every time the speaker participates in a CME activity?

No. It is not necessary to collect disclosure information on relevant financial relationships from a speaker, planner, or author each and every time that individual has control over the content of a CME activity. SCS Element 2.1 requires that the provider be able to show the ACCME that everyone who has control of CME content has disclosed all relevant financial relationships with any commercial interest to the provider.

When do relationships create "conflicts of interest?"

The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest.

Where is the "conflict?"

In accredited CME, when an individual's interests are aligned with those of a commercial interest, the interests of the provider are in "conflict" with the interests of the public. The interests of the people controlling CME must always be aligned with what is in the best interests of the public.

If at the first planning meeting for a CME activity, all committee members are asked to disclose, and each member responds that he/she has nothing to disclose (or disclose something), and this information is reflected in the minutes of the meeting - is that enough documentation that disclosure was sought?

Yes. That documentation would verify that the first step of a mechanism for identifying conflicts of interest is in place. That would document for ACCME that the Provider knew the relevant financial relationships of the Committee members. However, keep in mind that the provider would need to be able to show that there was an assessment of whether or not the information disclosed caused a conflict of interest and if so, what was done to resolve the conflict.

Why will the ACCME not allow commercial interests to act as joint providers? (SCS 1.2)

Joint providers are expected to routinely have a role in making decisions about the elements of the planning process specified in SCS 1.1. Since these decisions must be "made free of the control of a commercial interest" as per SCS 1.1, the joint provider cannot be a commercial interest. For further information on this topic, please click here to view the ACCME policy on joint providership.

How did the change in the definition of a commercial interest announced in August 2007 affect already accredited providers that might be owned by a commercial interest?

As of August 2007 the ACCME defined a commercial interest as "any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients." The ACCME worked individually with accredited providers that were affected by this definition as they transitioned to an independent corporate structure that is acceptable in the context of the ACCME's Standards for Commercial Support.

What is an example of a corporate structure that meets the ACCME's requirements for independence?

The ACCME offered several alternatives for corporate restructuring that met its requirements. For example, the ACCME determined that an accredited CME provider can have a sister corporation that is a commercial interest, as well as a parent corporation that is not a commercial interest, as long as each corporation is a separate legal entity and there are proper firewalls in place. The corporation that is the CME provider:

What am I required to put on an activity brochure?

For brochures, the ACCME does not have any rules or requirements for name placement, brochure content, cover design, interior layout, font size, or formatting. Brochure design and associated content are left to the provider's discretion. The accredited provider has the right to set criteria for its own standards in relation to its CME publications (both directly and jointly provided). The only ACCME requirement is that the correct accreditation statement be used somewhere within the brochure.

Does the ACCME accredit individual activities?

No. The ACCME accredits organizations that produce CME activities. The accreditation process includes the review of CME activities for the demonstration of compliance with the ACCME's requirements. For more information, see ACCME's description of the accreditation process for first-time applicants.

What should a provider do if an Internet CME activity from the current accreditation term is selected for documentation review, but this particular Internet CME activity has been "retired" and is no longer available on the Internet?

This activity still needs to be available for review by the ACCME - even if it has been "retired." When an Internet CME activity is no longer available online, the accredited provider may submit the internet activity saved to CD ROM or provide access to the activity on an archived web site.

Does the ACCME require me to issue credit certificates to physician participants?

No. The ACCME has no requirements about issuing credit and/or certificates. All credit-related questions should be referred to the organization that manages the credit. For example, the American Medical Association manages AMA PRA Category 1 Credit, and the American Academy of Family Physicians manages its own credit system.

As an accredited provider, we know that we need to provide accommodations to CME activity participants who request them under the Americans with Disabilities Act (ADA). Can you tell us more about the ACCME's expectations with respect to the ADA?

The ACCME expects that providers will have policies or procedures in place to accommodate learners with disabilities. The ACCME's policy in this regard states, "The provider must operate the business and management policies and procedures of its CME program (as they relate to human resources, financial affairs and legal obligations), so that its obligations and commitments are met."

What is the ACCME's process for accepting and handling complaints or inquiries about accredited providers' CME practices?

The ACCME has a multitiered accreditation process for evaluating CME providers’ compliance with the ACCME’s requirements. As an additional safeguard, the ACCME has a Process for Handling Complaints Regarding ACCME-Accredited Providers, which it uses to respond to complaints from the public and the CME community about ACCME-accredited providers’ compliance with accreditation requirements.

Will the ACCME make public the identity of providers that are the subject of complaints?

No. The complaints process and findings are kept confidential by the ACCME, with the exception of the ACCME's response to a lawful subpoena or other legal process. The ACCME does reserve the right to make public blinded examples and summaries from the complaints process for the purpose of educating providers and other stakeholders. This public information will not identify providers.

What content is acceptable for CME?

ACCME-accredited providers must provide CME that contains content which falls within the definition of CME. The content of such CME must not promote recommendations, treatment or manners of practicing medicine that are known to have risks or dangers that outweigh the benefits, or are known to be ineffective in the treatment of patients. Note that an organization whose program of CME is devoted to advocacy of unscientific modalities of diagnosis or therapy is not eligible to apply for ACCME accreditation.

How do we report in-kind support?

Report any in-kind (non-monetary) commercial support received for an activity by indicating the nature of the in-kind support. You should not estimate the dollar value of in-kind support. The following are the options in PARS to describe the nature of in-kind support:

What is the Program Summary?

The Program Summary is a summary of financial data attributable to your entire Program for the year.  It includes the following data fields that the provider is required to manually complete:

1.   Total advertising and exhibit income received in support of your Program

2.   Total registration fees received (includes registration, subscription or publication fees received from activity participants)

What is the difference between direct providership and joint providership of activities?

A directly provided activity is one that is planned, implemented and evaluated by the accredited provider.  Include co-provided activities (provided by two accredited providers) in this category if you are the accredited provider awarding the credit.  In contrast, a jointly provided activity is one that is planned, implemented and evaluated by the accredited provider and a non-accredited entity.

Related link: ACCME's Policy on Joint Providership


What is the significance of "Reporting Year?"

Annually, the activity data that is reported by providers is aggregated and published as an Annual Report that provides information to the community.  The “Reporting Year” indicates in which Annual Report the activity belongs.  Most providers operate on a calendar year basis, and for these providers the Reporting Year is equivalent to the year of the Activity Date (For instance, Activity Date = September 1, 2016, and Reporting Year = 2016).

What is the difference between "open" and "closed" activities?

An important concept in PARS is that of “open” and “closed” activities.  Open activities are those that have a minimum set of data entered for them:  specifically, activity name, activity type, activity date, and, if applicable, location.  Once these data about an activity are entered, the activity is “open”, and is saved to the database.

How do I delete more than one activity at a time?

If you need to delete more than one activity at a time from PARS, you may do so by visiting the View Activities screen and selecting the applicable Reporting Year. Expand the list of either closed and/or open activities, and click the Select for Deletion checkbox next to each activity that you want to delete. When you have selected the activities you want to delete from both the open and closed lists, click the Delete Selected Activities button that appears above the list of activities.

How do I copy activities in PARS?

If you provide the same activity in multiple locations (e.g., update course) or provide the same activity year after year (e.g., annual meeting), you can save time entering data about these activities by using the copy function in PARS. The copy function allows providers to select an existing activity and create a new activity that contains the same data for the following fields:


  • Activity Type

  • Activity Sub-category (if applicable)

  • Activity Title

How do I report Learning from Teaching in PARS?

When you report Learning from Teaching in PARS, aggregate your data for Learning from Teaching for all learners into one activity. For hours of instruction, specify the amount of time you believe a learner would take to complete their Learning from Teaching activity. The number of participants should equal the number of individuals who participated in this activity.

How do I report Internet Searching and Learning in PARS?

When you report Internet Searching and Learning in PARS, aggregate and report all your data for Internet Searching and Learning for all learners into one activity. For hours of instruction, specify the amount of time you believe a learner would take to complete their Internet Searching and Learning activity. The number of participants should equal to the total number of persons who participated in Internet Searching and Learning as an activity.

How do I report Performance Improvement in PARS?

When you report Performance Improvement in PARS, count each learning project as one Performance Improvement activity, regardless of whether or not it is created for an individual learner, or group of learners. For hours of instruction, specify the amount of time you believe a learner would take to complete the Performance Improvement activity. The number of participants should equal the total number of learners who participated in the learning project. 

How do I report Manuscript Review in PARS?

When you report Manuscript Review in PARS, report each journal for which the manuscript is being reviewed as an activity regardless of how many manuscripts there are and regardless of how many persons have reviewed manuscripts.  For hours of instruction, specify the amount of time you believe a learner would take to complete the Manuscript Review activity.  The number of participants should reflect the total number of learners engaged in reviewing manuscripts . 

How do I report Journal Based activities in PARS?

When you report Journal-Based activities in PARS, report each article as one activity. For hours of instruction, specify the amount of time required to complete the activity. The number of participants should equal the total number of individuals who completed the activity.

What is the co-provided accreditation statement?

There is no specific "co-provided" accreditation statement. If two or more accredited providers are working in collaboration on a CME activity, one provider must take responsibility for the compliance of that activity, and therefore, use the directly provided accreditation statement with its name. See the ACCME's Accreditation Statement Policy for a copy of the directly provided accreditation statement.

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