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Joint Providership Policy

General Information As the largest organization of interdisciplinary health care professionals, the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is dedicated to education and certification for physicians, nurses, and others involved in the health care field. ABQAURP believes ongoing continuing medical education in new research, identified problem areas in clinical practice, and quality assurance, utilization management, risk management/patient safety, and managed care fields are eligible for continuing education (CE) credit consideration. When a CE activity is consistent with ABQAURP’s educational mission and goals on a local, regional or national scope, ABQAURP will consider becoming the accredited provider, through a Joint Providership (JP) relationship. Joint Providership (JP) is a process in which an accredited provider and a non-accredited organization collaborate to plan and implement an accredited continuing education activity. ABQAURP is an accredited Continuing Medical Education (CME) provider by the Accreditation Council for Continuing Medical Education (ACCME) and can provide nursing contact hours (CEU) through the Florida Board of Nursing. ABQAURP can also assist with obtaining other forms of CE credit (i.e. AAFP credit, AAPA credit, CCMC clock hours, etc.) for an additional fee. ABQAURP is responsible for ensuring compliance with the ACCME’s Essential Areas and Policies, Standards for Commercial Support, and the American Medical Association (AMA). The AMA and other ACCME member organizations have entrusted the ACCME with maintaining the quality of CME in the United States. As the accredited provider, ABQAURP is required to demonstrate direct involvement in all JP activities. A member of ABQAURP’s CME Committee must be involved from the initial stages to ensure all requirements are in compliance and to monitor the activity’s planning, implementation and outcomes measurement.

A. Planning Committee The accredited provider and the joint provider have control of CME needs identification, determination of educational objectives, selection and presentation of content, selection of all persons and organizations in a position to control the content of the CME, selection of educational methods, and evaluation of the activity. To maintain educational independence from commercial interests, a commercial interest cannot have control/influence over any of the aforementioned items. A commercial interest is “any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.” Providers of clinical service directly to patients are not considered to be commercial interests. Within the context of this definition and limitation, the following types of organizations are free to control the content of CME:

501(c) Non-profit organizations (Note: 501(c) organizations are screened for eligibility. A 501(c) organization, as an advocate for 'commercial interests', is not eligible to serve in the role of joint provider, but can be a commercial supporter.)

Government organizations

Non-health care related companies

Liability insurance providers

Health insurance providers

Group medical practices

For-profit hospitals

For-profit rehabilitation centers

For-profit nursing homes

Blood banks

Diagnostic laboratories

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Everyone in a position to control the content of an educational activity must disclose all relevant financial relationships with any commercial interest. The ACCME defines relevant financial relationships as “financial relationships in any amount occurring within the past 12 months that create a conflict of interest.” Anyone refusing to disclose relevant financial relationships will be disqualified from being a planning committee member, teacher, and/or an author of CME, and cannot have control of, influence over, or responsibility for, the development, management, presentation, or evaluation of the CME activity.

B. Speaker Information and Disclosure The joint provider must provide speaker CV or biographical sketches with full mailing information and email addresses to ABQAURP. The ACCME requires the disclosure of the existence of any financial interest or any other relationship a speaker has with the manufacturer(s) of any commercial product(s) and/or providers of commercial services discussed in an educational presentation. All disclosures must be requested at least one month prior to the activity to allow for possible conflict(s) of interest to be identified and resolved. Once a speaker’s presentation has been reviewed and approved, the presentation may not change. Changes in presentations or speaker will incur additional fees. A speaker who refuses to disclose relevant financial relationships will be disqualified from being a speaker or author of CME/CEU. He/she cannot have control of, or responsibility for, the development, management, presentation or evaluation of the CME/CEU activity. (Note: No response is considered a refusal and the session(s) will not be accredited.) ABQAURP can assist in contacting the faculty to obtain their financial disclosure, CV/biographical sketches, and educational material (i.e. presentation, handouts, etc.) if full contact information is received from the joint provider at least thirty (30) days prior to the activity start date. ABQAURP would then address any questions/concerns directly, thereby alleviating the joint provider from being an intermediary in regard to the aforementioned needs. If an ABQAURP representative is attending the activity, a last minute disclosure form may be obtained on-site. The ABQAURP representative must be present at these sessions to verify a verbal disclosure is made prior to the beginning of the presentation. If the on-site disclosure(s) presents a conflict of interest that cannot be resolved, the session(s) will not be accredited and the joint provider must inform participants. If an ABQAURP representative is not attending the activity, a joint provider representative must be present to complete a verbal disclosure form to record the disclosure made and attest to the accuracy. If an ABQAURP representative is requested to attend the activity, all travel and hotel expenses are to be incurred by the JP organization. All presentations must be reviewed by ABQAURP prior to the commencement of the CME/CEU activity. The Joint Sponsor must provide ABQAURP with the presentations at least ten (10) business days prior to the CME/CEU activity for review to resolve any potential conflict(s)/bias(es). If a resolution is not achieved, the presentation will not be accredited. Relationships, which must be disclosed, include, but are not limited to:

Service as a paid or non-paid consultant or employee; Significant personal holdings (by the speaker and/or spouse/partner) in any commercial entity which provides

financial support for this CME/CEU activity, or products or services related to the subject matter of the CME/CEU activity;

Receipt of financial support from a commercial firm or other source (consultant, research, educational grant, speaker’s bureau, honoraria, royalties, commissions, etc..); or

Research or institutional support.

Disclosures Relevant to Potential Commercial Bias A speaker must disclose the following information to learners in regard to any relevant financial relationship(s):

Speaker name;

Commercial interest(s) name; and

Nature of the relationship the speaker has with each commercial interest.

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Prior to their presentation, each speaker shall disclose any real or perceived relationships, which are pertinent to the subject matter and could potentially be interpreted as biasing a presentation. A speaker with no relevant financial relationship(s) must inform the learners no relevant financial relationship(s) exist. Timing of Disclosure Disclosure to learners is to occur prior to the beginning of the educational activity. There are a variety of methods to achieve this (i.e. disclosure statement on the title slide of a presentation, listed in the syllabus, etc.). Examples of disclosure statements are below:

(Dr. Smith) has indicated he/she is a (Insert Disclosure, example Salaried Employee of Company XYZ). Or

(Dr. Smith) has indicated he/she has no relevant financial relationships to disclose in regard to the content of his/her presentation.

C. Practice Gaps CE activities sponsored by ABQAURP are meant to foster the continuing professional development of physicians and other health professionals. However, these activities are not simply meant to provide “education for education’s sake”. Rather, the educational offerings are intended to increase competency, influence behavior, and improve patient outcomes. The joint provider must describe the practice gap in two to three sentences: For example: The physicians of the world do not know how to do this intervention safely across all nations in the absence of First World operating rooms. An educational gap is expressed as the difference between current practice and best practice. The underlying cause(s) of the educational gap may be further explained as the needs assessment.

Needs assessment data can be documented by using meeting minutes, quality assurance data, correspondence, etc. and should support the practice gap identified above. Identified needs describe how the education will help close the educational gap. (Professional practice gap: the lack of understanding, the lack of knowledge, and the lack of strategy to intervene). The need for each CE activity must be substantiated. Identification and assessment of educational needs provide the basis for formulating objectives and planning educational activities. The joint provider must indicate at least two methods have been used to identify the need for each activity. Documentation regarding the gap identification (needs assessment) must be attached to the JP Application for each activity. Examples include: Expert Consensus

◦ Faculty perception ◦ Consensus of experts and education committee members ◦ Advice from authorities in the field

Participant Feedback ◦ Target audience survey ◦ Previous CME/CEU activity evaluation data

Research Findings ◦ Data from outside sources (health statistics) ◦ Health Sciences library request data ◦ Patient care audits/QI data ◦ Institutional/organizational mandate ◦ Medical literature review ◦ Mortality/morbidity data ◦ Other (must specify)

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Desired results are expected outcomes in terms of changed physician/clinician knowledge, skills, performance in practice and/or patient health status based upon the identified needs. The joint provider must provide results/outcomes expected.

D. Educational Design The choice of program design must be based on the needs, the type of professionals attending the program and their learning preferences, and other logistical and financial considerations. The educational design must be linked to the needs, objectives, and target audience.

E. Learning Objectives The joint provider must provide learning objectives for each session. Every activity must state the learning objectives in the printed brochure (or other promotional material) and in the syllabus or handout materials. Objectives should be derived from the needs assessment, relate to the intended audience, and be able to measure post-activity in terms of physician/clinician competence, performance, change in practice and/or patient heath care outcomes. Learning objectives should be stated in terms of a measureable action verb; what the attendee can expect to “take away” from the activity and implement in the practice setting. The objective should be able to complete the phrase “At the conclusion of the session, the attendee should be able to …” Improved Knowledge: Participants should be able to summarize the content and discuss its application in clinical practice Competence: Participants should be able to apply the content in a simulated practice environment (intend to implement in their practice) Performance: Participants actually apply the content in their practice setting (applied and changed performance instituted in practice) Learning objectives need to be clear and in sufficient detail to:

(a) Assist the planner in designing the activity; (b) Assist the speaker in preparing presentations that fit with the overall purpose; (c) Provide a benchmark for the evaluation of the activity; and (d) Assist the participant in deciding whether or not to attend the activity.

Consider the following suggestions before listing the learning objectives:

1. Keep learning objectives brief and clear. The use of a clear, targeted verb provides a direction about the expectations of the speaker with the prospective learner(s).

2. Keep learning objectives to specific statements of what prospective learners will be able to perform at the conclusion of the educational activity. All learning objectives should focus upon the prospective learner and indicate expectations of performance or understanding of the educational content.

3. Designate the learning objective toward exactly what prospective learners need to do to demonstrate understanding of the educational activity. This could include references and resources provided to the prospective learner.

Do!

Link a practice gap cause (identified need) with a desired result

Make objectives specific and measurable

Focus on learner’s behavior

Begin with an action verb (see Addendum B) Don’t!

Use vague, non-measureable verbs to begin objectives (i.e. appreciate, know, learn, understand, believe)

F. Target Audience

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The joint provider must describe the target audience for each CME/CEU activity. Who is the primary target audience, both general and specific, that will help close the identified educational gap(s)?

G. Desirable Physician/Clinician Attributes Learning objectives must be able to demonstrate desirable physician/clinician attributes as indicated by the Institute of Medicine Core Competencies, ACGME/ABMS Competencies, and/or ABMS Maintenance of Certification (Addendum E provides examples).

H. Activity Evaluation

Joint Sponsor must use ABQAURP’s online Activity Evaluation and Attendance Verification program to obtain continuing education credits. The joint provider must provide ABQAURP with the full attendee list, including complete contact information (i.e. address, email address, etc.). ABQAURP will provide, at least one week prior to the start of the activity, a one-page flyer providing instructions to obtain continuing education credits. The joint provider must reproduce the flyer and provide it to attendees. ABQAURP will send a follow-up email to all attendees post-activity, provided an attendee list with contact information is received within two (2) weeks of the activity, as a reminder to complete the online Activity Evaluation and Attendance Verification to earn continuing education credits. Attendees requesting CME/CEU credit will be required to use ABQAURP’s online verification and evaluation tool. Attendees will have 30 days post-activity to request credits; final date will be included within the flyer. Attendees will be charged a $25.00 non-refundable processing fee for requesting credit after the deadline date. A compilation of evaluation comments will be provided sixty (60) days post-activity to the joint provider and speaker(s).

I. Commercial Support Commercial Support (CS) 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/CEU activity. A commercial interest is not eligible for ACCME accreditation but may support an activity within the strict guidelines of the ACCME. “An entity that produces, markets, resells, or distributes health care goods or services consumed by, or used on, patients” is considered a commercial interest as defined by the ACCME. Disclosure to ABQAURP prior to requesting the grant/funding (see addendum C for CS Agreement) of any potential financial relationships with a commercial interest is mandatory; non-compliance with this component will cause the activity’s accreditation to be revoked. In the interest of balanced and unbiased scientific presentations, all educational activities supported in whole or in part by an educational grant must be in strict compliance with ACCME Standards for Commercial Support (SCS). All commercial support funds (not exhibit and/or marketing funds) solicited on behalf of the activity must be applied through and received by ABQAURP. The joint provider may develop a grant proposal under the direction of ABQAURP; however, as the accredited provider, ABQAURP is responsible for appropriate management of these grants according to the ACCME's SCS. An essential part of complying with these standards is ABQAURP distributing the funds. A 5% administration fee will be incurred. A fee must be charged for securing exhibit space and the fee must be consistent for any exhibitor, regardless of the organization’s involvement in the provision of an educational grant for the CME/CEU activity. Exhibits are never a condition for the receipt of an educational grant (commercial support). Should an exhibit be requested or any other marketing arrangements, a separate agreement must be entered into with the appropriate party from the commercial interest. The ACCME does not consider providers of clinical service directly to patients to be commercial interests. Within the context of this definition and limitation, the following types of organizations are free to control the content of CME:

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501(c) Non-profit organizations (Note: 501(c) organizations are screened for eligibility. A 501(c) organization, as an advocate for 'commercial interests', is not eligible to serve in the role of joint provider, but can be a commercial supporter.)

Government organizations

Non-health care related companies

Liability insurance providers

Health insurance providers

Group medical practices

For-profit hospitals

For-profit rehabilitation centers

For-profit nursing homes

Blood banks

Diagnostic laboratories In-kind contributions are any resources and/or services, usually with cash value, donated or loaned to the joint provider for the activity. In-kind contribution examples:

Equipment loan Brochure distribution Provision of staff time to work in, or for, your program (marketing materials design, etc.) Provision of a place to conduct meetings and training Provision of tuition credits Access to a publicity expert and mechanism, printing department, or other needed resources Access to the time of a grant writing or research expert not in the joint provider organization

All educational activities supported by one or more commercial entities must have an appropriate written agreement on file and must disclose the role of the commercial supporter for each activity. ABQAURP or the joint provider can send the Written Agreement for Commercial Support (CS) to the Commercial Supporter(s). Each completed CS agreement must by signed by ABQAURP and the Supporter (see addendum C). Written agreement for Commercial Support must:

Include terms, conditions, and purposes of the commercial support

Indicate agreement between the commercial supporter and the provider (the educational partner(s) are optional)

Specify the commercial interest that is the source of commercial support

Be signed by the commercial supporter and the accredited provider The Commercial Supporter and ABQAURP sign a Written Agreement for Commercial Support as an attestation of abiding by all requirements of the ACCME Standards for Commercial Support of Continuing Medical Education. Identifying Commercial Support activity The source of all support, monetary and in-kind, from commercial interests must be disclosed to learners by acknowledgment on printed and/or electronic announcements and brochures. ‘Disclosure’ must never include the use of a trade name or a product-group message. Sample disclosure:

Monetary Support Disclosure

“<insert name of Joint Sponsor organization> gratefully acknowledges the financial support provided by <insert name of commercial interest(s)>”.

In-kind Support Disclosure “<insert name of Joint Sponsor organization> gratefully acknowledges the <insert specific information about the

actual support, e.g. equipment loan> provided by <insert name of commercial interest(s)>”. Separation of promotion from education

Arrangements for commercial exhibits or advertisements cannot influence planning or interfere with the presentation, nor can they be a condition of the provision of commercial support for CME/CEU activities.

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Educational materials, part of a CME/CEU activity, such as slides, abstracts, and handouts, cannot contain any advertising, trade name, or product-group message.

Exhibits, etc. cannot be in the educational space. Scientific Integrity and Commercial Support The following represents a summary of the ACCME SCS. It is the ultimate responsibility of ABQAURP to ensure compliance with the following ACCME SCS. The joint provider must comply with each in accordance with ABQAURP’s accreditation of the activity. The joint provider agrees the content and presentation of educational material for the activity will:

◦ Be for scientific and educational purposes only and will not promote a company’s products directly or indirectly

◦ Be free of commercial influence in the planning, as well as, in the design and production of the educational activity

◦ Not enhance the specific proprietary interests of any commercial entity through the use of slides, reference materials and/or handouts in print, electronic, or other media

◦ Give a balanced view of therapeutic options, use generic drug names and/or trade names of the products of several companies and be objective in reporting research

◦ Reflect total control by presenters, which includes no “scripting”, emphasis, or influence by a company or its agents

◦ Adhere strictly to principles of the highest quality, scientific integrity, and selection The joint provider agrees to (in regard to the commercial support provided for the activity):

◦ Ensure the arrangements for commercial exhibits will not influence activity planning or interfere with CME/CEU presentations, nor are a condition of commercial support

◦ Ensure no commercial materials will be displayed, nor will sales activity be allowed, in the same room(s) as the CME/CEU activity

◦ Ensure funds from a commercial source are in the form of an educational grant for support of programming, catering, production of syllabus, or other support of the course. The terms, conditions, and purposes of such grants must be documented in a signed agreement

◦ Ensure exhibits and marketing opportunities are never a condition for the receipt of an educational grant ◦ Ensure no other funds from a commercial source are paid to the director, faculty, or others involved with the

CME/CEU activity ◦ Ensure funds provided by a commercial source will not be used to pay expenses for non-course faculty, and

that social events do not compete or take precedence over an educational event. ◦ Acknowledge commercial support in printed activity materials; however, no reference will be made to specific

products or services unless the support is “In-kind” support and then the nature of the support must be disclosed to learners

◦ Report to each commercial supporter, upon their request, information concerning the expenditure of funds following the CME activity

◦ Comply with AMA guidelines on “Gifts to Physicians” and must not compete with nor take precedence over educational events in any commercially supported ancillary event

J. Accreditation Statements Once your activity has been reviewed and approved for accreditation by our CME committee, ABQAURP will provide the appropriate accreditation statement for use on your website, announcements, brochures or any documents that CME is noted. ABQAURP must approve all activity announcements PRIOR TO BEING RELEASED and/or PRINTED to ensure proper accreditation statements have been included. All activity changes, additions, substitutions, etc.., must be discussed with, and agreed upon, by ABQAURP. Once promotional materials have been approved, ABQAURP must receive a final copy. ABQAURP must review and approve all materials associated with the activity prior to their release or designation of AMA PRA Category 1 Credit(s) ™ will be withdrawn. ABQAURP must be clearly recognized as a joint provider. Pending accreditation statements are NOT allowed.

If the joint provider is advertising CME/CEU credits, all promotional materials must include the following elements:

Statement of overall objectives for the activity

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Session descriptions (this area may include the objectives)

List of faculty

Agenda/schedule to include date and times

Clear information concerning fees, and, if appropriate, what the fee covers

Statement of commercial support

Accreditation and designation statements clearly identifying the accrediting provider (ABQAURP) Sample CME Accreditation Announcement “This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and (the name of your organization). ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.” The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this (learning format – see

examples below) for a maximum of ____ AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. AMA approved learning formats:

o Live activity o Enduring material o Journal-based CME activity o Test-item writing activity o Manuscript review activity o Performance Improvement (PI) CME activity o Internet Point of Care activity

Sample CEU Accreditation Announcement Should the activity also be awarded nursing contact hours, a separate designation statement should be included in all CME activity announcements. The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is an approved provider with the Florida Board of Nursing to provide continuing education for nurses. ABQAURP designates this activity for contact hours through the Florida Board of Nursing, Provider # 50-94.”

K. Accreditation Fee ABQAURP charges a fee for its services. The joint provider must provide a $400 deposit upon submission of the application. Once the activity is reviewed and approved for continuing education, ABQAURP will advise of the final accreditation fee, less the $400 deposit. After the accreditation fee is established, ABQAURP will only proceed with the accreditation process upon receipt of the remaining balance. If the activity is denied accreditation, the $400 deposit is non-refundable and non-transferable. The accreditation fee represents the oversight and involvement in the planning process by the ABQAURP Education Department and members of the CME Committee, as well as maintenance of expertise in the rules and responsibilities as derived from the ACCME and the American Medical Association (AMA), and the fees required to maintain accreditation. In conjunction with the accreditation fee, ABQAURP will advertise the CME/CEU opportunity on the ABQAURP website and will provide a one-time use, membership mailing list as an additional resource for the joint provider to attract attendees. ABQAURP reserves the right to send a designated ABQAURP representative to each activity to ensure compliance with the ACCME's Essential Areas and policies and to assist with the general administration of the activity, as needed. If an ABQAURP representative is sent to your activity, a 6’ table near registration will be required for use by the representative. The joint provider is responsible for reasonable travel expenses and accommodations for one (1) ABQAURP representative, which is a separate cost in addition to the accreditation fee.

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1-3 Sessions Up to 40 registrants $1540.00

4-7 Sessions Up to 40 registrants $1815.00

8-10 Sessions Up to 40 registrants $2090.00

11 – 15 Sessions - Complex JP I Up to 40 registrants $3300.00

16-20 Sessions – Complex JP II Up to 40 registrants $3740.00

Over 20 Sessions – Complex JP III Up to 40 registrants *Starting at $3740.00

* Complex Joint Providership III fees begin at $3,740.00 with a maximum of 20 speakers or sessions. A fee of $110 will be incurred for each speaker or session over the maximum number of 20 due to the complexity of the comprehensive evaluation.

Additional Fees $825 Expedited Review Fee – All applications submitted less than eight (8) weeks prior to the commencement of the activity.

$25 Administration Fee** – Speaker OR session topic change $100 Administration Fee** – Speaker AND session topic change ** Applies only after the CME/CEU activity has been approved for accreditation based on the credit hours applied for and the initial speaker(s) and session topic(s) submitted.

$20 Additional Registrant Processing Fee – Joint Sponsor will be additionally billed for activities with more than 40 registrants. The Joint Sponsor has 30 days from the date of the additional billing to submit payment. $1,200 - $4,200 Enduring Material – setup and maintenance charges for monthly evaluations for a 24 month period. $250 Streaming Video - setup charges (when in addition to live conference) $750 Grant Submission – Submit grant documentation for commercial support on behalf of joint provider. Preliminary approval of accreditation for most activities can be determined within four (4) business days contingent upon: receipt of the deposit, completed and signed application to include all requested documentation and the size of the activity. ABQAURP must be provided with all required documentation at least eight (8) weeks prior to the event to complete the entire accreditation process.

L. Honoraria and Reimbursement Policy ACCME requires written policies and procedures governing honoraria and reimbursement of out-of-pocket expenses for planners, teachers and authors. Additionally, the provider, the joint provider, or designated educational partner must pay directly any teacher or author honoraria or reimbursement of out-of–pocket expenses in compliance with the provider’s written policies and procedures. The joint provider has the option of using the ABQAURP policy (outlined below) or your own policy. If using your own policy, a copy of your policy must be provided with the application. ABQAURP Honoraria & Reimbursement Policy As a member supported, non-profit organization, ABQAURP requests a speaker’s expenses be covered by their own organization. If expenses are not covered by the speaker’s organization, prior approval must be received by ABQAURP. ABQAURP reserves the right to find a replacement speaker. If an activity receives commercial support, ABQAURP enforces the ACCME procedure to verify commercial support funds designated for honoraria and expenses, as outlined in the “Written Agreement for Commercial Support.” ABQAURP must maintain/receive a detailed reconciliation of the commercial support funds at the conclusion of the activity. Honoraria and expenses are paid from the net revenue of the activity. If a JP organization does not have its own policy, it is encouraged to use ABQAURP’s policy. The Chairman of the Board must approve any changes to the following for ABQAURP Board of Directors. The Managing Director must approve any changes to the following for ABQAURP staff.

1. Airfare a. Reimbursable expenses

i. 21-day advance purchase

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ii. Coach airfare b. Non-reimbursable expenses

i. Less than 21-day advance purchase ii. First class airfare iii. Additional* &/or overweight baggage fees

*Additional applies to more than one standard luggage piece. 2. Lodging

a. Reimbursable expenses i. Standard room at host hotel ii. Length of speaking engagement stay (usually 1 night)

b. Non-reimbursable expenses i. Phone charges ii. Internet charges iii. Movies iv. Alcohol v. Mini-bar items vi. Business center expenses

3. Transportation to/from airport a. Reimbursable expenses

i. Personal vehicle – mileage to/from airport (current standard IRS rate) ii. Airport shuttle iii. Hotel shuttle iv. Standard taxi service v. Rental vehicle – economy class only (only applicable for Board & Staff members)

b. Non-reimbursable expenses i. Limo service ii. Rental vehicle – any other class above economy

4. Meals & Entertainment a. Reimbursable expenses

i. Business related (following items must be detailed on the expense report) 1. Where 2. With whom 3. Business purpose

ii. $60/day maximum b. Non-reimbursable expenses

i. Alcohol 5. Honoraria

a. ABQAURP requests speakers to waive all fees b. Not to exceed $2,000 c. Prior approval required

6. Miscellaneous Expenses a. Tips (not to exceed 20% of documented expense)

i. Airport ii. Transportation iii. Hotel

ABQAURP requires all expense reports to be submitted within 10 business days following the activity.

M. Estimate and Final Budget JP organizations are responsible for submitting an estimate budget with application. A final budget identifying significant sources of income is required sixty (60) days post-activity. Significant sources of income include: income from commercial support, advertising and exhibit fees, tuition and registration fees, internal budget allocations, and any other source that represents > 20% of total income.

N. Signature**

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This Policy is not intended to imply any exclusion of the requirements for the ACCME’s Essential Areas and policies and Standards for Commercial Support, but is intended as an amplification of some of those requirements. My signature attests I have the authority to enter into this agreement. I have fully read and understand the completed application and will abide with the application requirements to maintain compliance with the ACCME Essential Areas and policies as well as the Standards for Commercial Support. I agree to follow all ABQAURP policies/requirements associated with the provision of continuing education credit for this activity. I have read the ABQAURP Joint Providership Policy and I agree to abide by the stated guidelines. ABQAURP reserves the right to withdraw providership of this activity, at any time, if the requirements have not been fulfilled.

Signature of Organization Representative Date

Printed Name of Representative / Title

Addendum A FACULTY/PLANNER DISCLOSURE FORM As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) must insure balance, independence, objectivity, and scientific rigor in all its individually sponsored or jointly sponsored educational activities. All faculty, planners and advisors involved in a sponsored activity are expected to disclose to the activity audience any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation. This disclosure is valid until the end of the current calendar year with the explicit understanding the faculty, planner and/or advisor will notify ABQAURP and/or the activity host of any changes and the need for a corrected disclosure attestation.

Name:

Title of your presentation:

Date of Activity:

Activity Host:

Your role in this CME activity: Presenter Author Moderator Panel Planner Advisory

DISCLOSURE The intent of this disclosure is not to prevent a speaker with a relevant financial or other relationship from making a presentation, but rather to provide listeners with information from which they can make their own judgments. It remains for the audience to determine whether the speaker’s interests or relationships may influence the presentation with regard to exposition or conclusion. Conflict exists when you have a financial interest in a company and the opportunity to affect the CME content about that company’s product or service as related to your control over the educational content at this activity. Have you (or your spouse/partner) had a personal financial relationship in the last 12 months with the manufacturer of the products or services that will be discussed in this CME activity?

NO - Skip to Declaration YES - Please list your disclosures below and complete resolution section

Commercial Interest

Nature of Relevant Financial Relationship (Include all those that apply)

What was Received 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.

For What Role? Employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and ‘other activities (please specify).

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RESOLUTION OF CONFLICT OF INTEREST- Please indicate below how the conflict of interest will be resolved. I will support my lecture and clinical recommendations with the “best available evidence” from the medical literature. I will refrain from making recommendations regarding products or services, e.g., limit talk to pathophysiology, diagnosis, research

findings and/or limit talk to comparison of products. I will recommend an alternative speaker for this topic for the planning committee’s consideration. I will submit my talk in advance to allow for adequate peer review. I will divest myself of this financial relationship. As an advisory and/or planning member, to the best of my ability, I will ensure that any speakers or content I suggest is independent of

commercial bias.

DECLARATION: I will uphold academic standards to insure balance, independence, objectivity and scientific rigor in my role in the planning, development or presentation of this CME activity. In addition, I agree to provide verbal disclosure prior to my presentation at the activity.

Signature: Date:

Glossary of Terms

Commercial Interest

The ACCME defines A ‘commercial interest’ is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Bias is an inclination of temperament or outlook to present or hold a partial perspective and a refusal to even consider the possible merits of alternative points of view. People may be biased toward or against an individual, a topic, a race, a religion, a social class, or a political party. Biased means one-sided, lacking a neutral viewpoint, not having an open mind. Financial relationships

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. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner. Relevant financial relationships ACCME focuses on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling content of the CME activity. ACCME has not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME defines “’relevant’ financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Conflict of Interest Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship.

Addendum B

Verb Worksheet for Preparing Learning Objectives

Behavioral Verbs for Writing Objectives in the Cognitive,

Affective and Psychomotor Domains

Some Verbs for Use in Stating Cognitive Outcomes

Knowledge Comprehension Application Analysis Synthesis Evaluation

define discuss compute distinguish diagnose evaluate

list describe demonstrate analyze propose compare

recall explain illustrate differentiate design assess

name identify operate compare manage justify

recognize translate perform contrast hypothesize judge

state restate interpret categorize summarize appraise

repeat express apply appraise plan rate

record convert use classify formulate choose

label estimate practice outline arrange decide

predict organize

Some Verbs for Use in Stating Affective Outcomes

13

Receiving Responding Valuing Organization Value Complex

sit erect answer join adhere act

reply greet share integrate practice

accept read complete organize discriminate

show report follow influence

Some Verbs for Use in Stating Psychomotor Outcomes

Perception Set Guided Response Mechanism Complex Adaptation Origination

identify react display display display adapt create

detect respond manipulate manipulate manipulate revise compose

differentiate start work work work change arrange

perform write operate

Bad words that should not be used as cognitive objectives! know really know understand appreciate become

learn thinks critically approach improve grow

increase expand horizons grasp the significance of

Addendum C WRITTEN AGREEMENT FOR COMMERCIAL SUPPORT

The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is committed to presenting CME/CEU activities that promote improvements in the quality of health care and are independent of the control of commercial interests. As part of this commitment, ABQAURP has outlined in this written agreement the terms, conditions, and purposes of commercial support for its CME / CEU activities. Commercial Support is defined as financial, or in-kind, contributions given by a commercial interest which is used to pay all or part of the costs of a CME / CEU activity.

Please type or print legibly.

Title of CME Activity:

Location:

Date:

Name of Commercial Interest:

Address: '

City, State, Zip:

Telephone: Fax: Contact Person:

The above company wishes to provide commercial support for the named CME / CEU activity by means of:

1. An educational grant in the amount of $ for support of the CME / CEU activity.

2. An educational grant in the amount of to be used for the following:

Terms, Conditions, and Purposes

Independence 1. This CME / CEU activity is for scientific and educational purposes only and will not promote any specific proprietary business

interest of the Commercial Interest. 2. The accredited provider and joint provider are responsible for all decisions regarding the identification of educational needs,

determination of educational objectives, selection and presentation of content, selection of all persons and organizations that will be in a position to control the content of the CME, selection of education methods, and the evaluation of the activity.

Appropriate Use of Commercial Support 3. The accredited provider and joint provider will make all decisions regarding the disposition and disbursement of the funds from

the Commercial Interest. 4. The Commercial Interest will not require the accredited provider/joint provider to accept advice or services concerning

teachers, authors, or participants or other education matters, including content, as conditions of receiving this grant. 5. All commercial support associated with this activity will be given with the full knowledge and approval of the accredited

provider and joint provider. No other payments shall be given to the director of the activity, planning committee members, teachers or authors, joint provider, or any others involved with the supported activity.

6. The accredited provider/joint provider will, upon request, furnish the Commercial Interest documentation detailing the receipt and expenditure of the commercial support.

Commercial Promotion 7. Product-promotion material or product-specific advertisement of any type is prohibited in or during the CME activity. The

juxtaposition of editorial and advertising material on the same products or subjects is not allowed. Live or enduring promotional activities must be kept separate from the CME activity. Promotional materials cannot be displayed or distributed in the education space immediately before, during, or after a CME activity. Commercial Interests may not engage in sales or promotional activities while in the space or place of the CME activity.

8. The Commercial Interest may not be the agent providing the CME activity to the learners.

Disclosure 9. The accredited provider and joint provider will ensure that the source of support from the Commercial Interest, either direct or

“in-kind,” is disclosed to the participants in program brochures, syllabi, and other program materials, and at the time of the activity. This disclosure will not include the use of a trade name or a product-group message. The acknowledgment of commercial support may state the name, mission, and clinical involvement of the company or institution and may include corporate logos and slogans, if they are not product promotional in nature.

The Commercial Supporter and ABQAURP agree to abide by all requirements of the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support of Continuing Medical Education.

WRITTEN AGREEMENT FOR COMMERCIAL SUPPORT - Continued

Name of Accredited Provider: The American Board of Quality Assurance Utilization Review Physicians, Inc. (ABQAURP)

Contact Person: Deborah Naser Email Address: dnaser@abqaurp.org

Phone Number: (727) 569-0190 x118 Fax Number: (727) 569-0195

Name of Commercial Interest: XYZ Device Manufacturer Address: City, State, Zip:

Contact Person: Email Address:

Phone Number: Fax Number:

Educational Partner (if applicable): ABC Surgery Centers, Inc. Address: City, State, Zip:

Contact Person: Email Address:

Phone Number: Fax Number:

Agreed by Authorized Representatives Commercial Supporter Accredited Provider (ABQAURP)

Signature and Date Signature and Date Renee Willoughby Print Name Print Name Managing Director Title Title

Educational Partner (If applicable)

Signature and Date

Print Name

Title

Addendum D Reconciliation sheet can be obtained from the ABQAURP website forms page http://www.abqaurp.org/joint-provider-support.asp

Addendum E

EXAMPLES OF DESIRABLE PHYSICIAN ATTRIBUTES Institute of Medicine Core Competencies Provide patient-centered care-identify, respect, and care about patientsʼ differences, values, preferences, and expressed needs; relieve pain and suffering; coordinate continuous care; listen to, clearly inform, communicate with, and educate patients; share decision making and management; and continuously advocate disease prevention, wellness, and promotion of healthy lifestyles, including a focus on population health Work in interdisciplinary teams–cooperate, collaborate, communicate, and integrate care in teams to ensure that care is continuous and reliable. Employ evidence-based practice–integrate best research with clinical expertise and patient values for optimum care, and participate in learning and research activities to the extent feasible Apply quality improvement-identify errors and hazards in care; understand and implement basic safety design principles, such as standardization and simplification; continually understand and measure quality of care in terms of structure, process, and outcomes in relation to patient and community needs; and design and test interventions to change processes and systems of care, with the objective of improving quality Utilize informatics-communicate, manage, knowledge, mitigate error, and support decision making using information technology ACGME/ABMS Competencies Patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Medical knowledge about established and evolving biomedical, clinical, and cognate (e.g., epidemiological and social behavioral) sciences and the application of this knowledge to patient care Practice-based learning and improvement-involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care. Interpersonal and Communication skills that result in effective information exchange and teaming with patients, their families, and other health professionals Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system for health care and the ability to effectively call on system resources to provide care that is of optimal value ABMS Maintenance of Certification Evidence of professional standing-such as an unrestricted license, a license that has no limitations on the practice of medicine and surgery in that jurisdiction. Evidence of a commitment to lifelong learning and involvement in a periodic self-assessment process to guide continuing learning Evidence of cognitive expertise based on performance on an examination. That exam should be secure, reliable and valid. It must contain questions on fundamental knowledge, up-to date practice-related knowledge, and other issues such as ethics and professionalism Evidence of evaluation of performance in practice, including the medical care provided for common/major health problems (e.g., asthma, diabetes, heart disease, hernia, hip surgery) and physicians behaviors, such as communication and professionalism, as they relate to patient care.