Conflict of Interest Reporting Form |
Description and Demographic Information
It is important to assure the public that education received by physicians and other health care professionals through whom patient care decisions are made is conducted with the highest integrity, scientific objectivity and in the absence of bias. A conflict of interest exists when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the product or services of that commercial interest.
The Accreditation Council for Continuing Medical Education (ACCME) holds providers of CME responsible for collecting information from speakers, planners, moderators, and panel participants, and mitigating any conflicts prior to the activity. The intent of the conflict of interest mitigation process is to assure that any financial relationships with commercial interests and resultant loyalties do not supersede the public interest in the design and delivery of continuing medical education activities for the profession.
The Accreditation Council for Continuing Medical Education (ACCME) holds providers of CME responsible for collecting information from speakers, planners, moderators, and panel participants, and mitigating any conflicts prior to the activity. The intent of the conflict of interest mitigation process is to assure that any financial relationships with commercial interests and resultant loyalties do not supersede the public interest in the design and delivery of continuing medical education activities for the profession.
CRITERIA FOR DISCLOSURE OF CONFLICTS OF INTEREST
Please disclose ALL financial relationships that you have had in the past 24 months with ineligible companies (see definition below).
For each financial relationship, enter the name of the ineligible company and the nature of the financial relationship(s). There is no minimum financial threshold; we ask that you disclose all financial relationships, regardless of the amount, with ineligible companies. You should disclose all financial relationships regardless of the potential relevance of each relationship to the education.
*Companies that are ineligible to be accredited in the ACCME System (ineligible companies) are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Examples of such organizations include:
Please disclose ALL financial relationships that you have had in the past 24 months with ineligible companies (see definition below).
For each financial relationship, enter the name of the ineligible company and the nature of the financial relationship(s). There is no minimum financial threshold; we ask that you disclose all financial relationships, regardless of the amount, with ineligible companies. You should disclose all financial relationships regardless of the potential relevance of each relationship to the education.
*Companies that are ineligible to be accredited in the ACCME System (ineligible companies) are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Examples of such organizations include:
- Advertising, marketing, or communication firms whose clients are ineligible companies
- Bio-medical startups that have begun a governmental regulatory approval process
- Compounding pharmacies that manufacture proprietary compounds
- Device manufacturers or distributors
- Diagnostic labs that sell proprietary products
- Growers, distributors, manufacturers or sellers of medical foods and dietary supplements
- Manufacturers of health-related wearable products
- Pharmaceutical companies or distributors
- Pharmacy benefit managers
- Reagent manufacturers or sellers
For more information, visit: https://www.accme.org/faq/what-accmes-definition-ineligible-company
Of special note:
- Relationships with governmental agencies (e.g., the NIH) and organizations that do not make or own drugs or devices do not have to be disclosed.
- Honoraria (fee-for-service) or consulting funds from a CME provider, even though those funds may have been provided through an educational grant from a commercial interest, do not have to be disclosed.
In accordance with ACCME requirements, failure to provide disclosure information in a timely manner will result in the disqualification from involvement in a CME-certified activity.
Of special note:
- Relationships with governmental agencies (e.g., the NIH) and organizations that do not make or own drugs or devices do not have to be disclosed.
- Honoraria (fee-for-service) or consulting funds from a CME provider, even though those funds may have been provided through an educational grant from a commercial interest, do not have to be disclosed.
In accordance with ACCME requirements, failure to provide disclosure information in a timely manner will result in the disqualification from involvement in a CME-certified activity.