AOE Compliance Connection

AOE’s monthly newsletter that offers accreditation board bulletins for the ACCME, ACPE, and ANCC, along with updates on the Physician Payments Sunshine Act, highlights of AOE services, and information on upcoming activities and educational opportunities.

AOE Compliance Connection – May 2020 Newsletter

Welcome to the May 2020 edition of AOE Compliance Connection, AOE’s monthly newsletter. This month, AOE’s newsletter features two important reports, one regarding the changing Standards for Integrity and Independence and one pertaining to the ACCME Commendation Criteria. Additionally, you’ll find board updates for the ACCME, ANCC, and ACPE, along with an updated calendar of CME/CE events. Follow us on Twitter and Facebook for weekly compliance tips and other timely updates!


Updating the Standards for Integrity and Independence: Executive Summary and Comments

In April, the ACCME published the Executive Summary and Comments on the Standards for Integrity and Independence. The call for comments, which opened January 7 and closed February 21, resulted in 344 responses to the online survey and responses via email and letter. As seen in the ACCME’s graphic below, responses from every provider type comprised the 344 responses, of which 75% (n=251) are accredited CE providers.

The report can be read in detail here, but the feedback gathered can be summarized by saying that the feedback was overwhelmingly positive. Providers confirmed that the proposed Standards meet the ACCME’s goals. However, some feedback was constructive and posed new questions for consideration.

What are the next steps in this year long process? The ACCME Board of Directors reviewed the feedback during their March meeting. They plan to move forward with the new Standards, but determined some modifications are needed based on feedback received. To allow for these modifications, the adoption and implementation of the revised Standards has been delayed temporarily and a final version of the Standards is expected before the end of 2020.


ACCME Releases Report Re: Menu of Criteria for Accreditation with Commendation

In its April 30, 2020 ACCME Report, the ACCME released its Menu of Criteria for Accreditation with Commendation Transition Report. The report provides background information on the Menu of Criteria for Accreditation with Commendation, data from the two-year transition period, lessons learned, and minor modifications made to five Commendation Criteria (C30, C33, C36, C37, C38).

Data and Analysis from the Two-Year Transition Period

During the transition phase from November 2017 to November 2019, Accredited Providers going through Reaccreditation had the option to respond to the original Commendation Criteria, Option A: C16 – C22, or the New Menu of Criteria for Accreditation with Commendation, Option B: C23 – C38. Over the course of the transition period, 28 ACCME-accredited providers and 17 state-accredited providers applied for Accreditation with Commendation under the new menu (C23 – C38) with 30% and 35%, respectively, demonstrating success. To date, there has been one cohort of Accredited Providers who applied for Accreditation with Commendation after the transition phase. There were 41 Accredited Providers eligible to apply and 16 (39%) applied with 5 demonstrating success.

Key Takeaways

  • According to the ACCME, all provider types have successfully achieved Accreditation with Commendation. This includes government or military organizations, insurance companies, managed care companies, schools of medicine, hospitals/healthcare delivery systems, non-profits (physician membership organizations) and publishing/education companies.
  • Each criterion has been selected by at least one provider and at least one ACCME-accredited provider has been found in compliance with each of the criteria. 
  • The report highlights common reasons for non-compliance for various criteria. The following is pulled verbatim from the report.

Minor Modifications

  • Criteria 33, 37 and 38 originally indicated that providers should submit “at least two” projects (C33) or examples (C37 and C38). For each criterion, some providers submitted more than two examples, not all of which met the Critical Elements. This required more work for providers, surveyors and the Accreditation Review Committee (ARC) members and also gave some providers more opportunities to demonstrate compliance. All three criteria now limit the number of examples to two.
  • For Criterion 30, not all providers interpreted the term “technical and procedural skills” as “psychomotor skills.” The ACCME has since added “psychomotor” to the language of the Rationale and Critical Elements.
  • Criterion 36 originally required that provider demonstrate that in at least 10% of activities the majority of learners’ performance improved. This resulted in a breadth of data. The ACCME has since aligned C36 to other criteria that require an attestation to meeting the criterion in at least 10% of activities and providing evidence/examples based on program size (Small: 2; Medium: 4; Large: 6; Extra-Large: 8).


Accreditation Board Bulletin

Part of the services that AOE provides to readers are weekly compliance tips and monthly CME/CE community news for ACCME, ANCC and ACPE.


In light of the COVID-19 Pandemic, many accredited providers are deciding to transition their planned live activities to a virtual format. This has led to many inquiries related to exhibitors/sponsorships of the virtual meeting and ensuring compliance with ACCME’s Criterion 9, Standard for Commercial Support (SCS), Standard 4.

The main point for all providers to keep in mind is that any advertising, exhibiting, or promotional materials must be separate from the education to ensure compliance with SCS, Standard 4. The commercial promotion must not be visible on the same screen or be inter-mixed between computer "windows" or screen of the educational content. Furthermore, the CME content must not be presented on a site owned by an ACCME-defined commercial interest. Additionally, the learner must choose to engage with the promotion and not be forcefully directed to commercial promotion.

Just as with a live-in person activity, commercial promotion cannot occur directly before, during or after an educational component of an activity. The ACCME provided an example of providers that have created "virtual exhibit spaces" that can be accessed via a link that redirects the learner to an outside page where the learner may interact with the commercial exhibitors/sponsors. When utilizing this type of format, it must be made clear to the learner that they are choosing to leave the educational content. No matter the format you use for your educational activity, the rules surrounding commercial promotion and CME remain the same: Separation is key.


As with other accreditation boards, accredited ANCC providers are required to ensure that the expectations of the ANCC criteria for accreditation are consistently applied to their program, including a well-defined instructional design approach, which is fundamental to developing high-quality continuing education.

When auditing accredited providers, the ANCC reviews how a Nurse Planner identifies and measures change in knowledge, skills, and/or practice of the target audience that are expected to occur as a result of participation in the educational activity (EDP 3). In addition, and closely related the ANCC reviews how the summative evaluation data for an educational activity are used to analyze the outcomes of that activity and how this information guides future activities (EDP 7).

There is a direct correlation between EDP 3 and EDP 7. Evaluation and outcomes should be considered by the provider unit in early planning phases. Put another way, the provider unit should begin with the “end” in in mind, so that an appropriate evaluation method is identified to appropriately measure change in learners’ knowledge, skills and/or practice, based on the professional practice gap(s), underlying educational need(s) and learning objectives of the activity. There should always be consistent alignment across each component of activity planning, and a well-defined instructional design process will help ensure this alignment.


The ACPE recently announced plans to launch an accreditation option that includes Commendation criteria. As does the ACCME currently, the ACPE will soon be using a menu approach for recognition for Accreditation with Commendation in order to be as flexible as possible to its range of provider types.

Scheduled to launch on January 1, 2021, the commendation option will provide accredited CPE providers the chance to demonstrate that they surpass the minimum accreditation requirements. The Commendation criteria, rubric, and the process to pursue Accreditation with Commendation will be distributed soon.

Upcoming Activities/Education Opportunities

  • CME for MOC: Using PARS to Your Advantage
    May 26, 2020, Online
  • AAMSE Annual Conference
    July 15-17, 2020, Austin, TX
  • ACCME August 2020 Accreditation Workshop
    August 6-7, 2020, Chicago, IL
  • ACPE CPE 2020 Conference: Commitment to Excellence
    September 29-30, 2020, Chicago, IL
    Registration Information TBD
  • ANCC National Magnet Conference and Pathway to Excellence Conference
    October 7-9, 2020, Atlanta, GA


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