What is an ineligible company?

An ineligible company is an organization whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients, and is NOT eligible to provide CME credit. Providers of clinical services directly to patients are not considered ineligible companies.

What is an eligible company?

Eligible companies include, but are not limited to:

• Advocacy organizations
• Ambulatory procedure centers
• Blood banks
• Diagnostic labs that do not sell proprietary products
• Electronic health records companies
• Government contractors or consultants
• Government or military agencies
• Group medical practices
• Health law firms
• Health profession membership organizations
• Hospitals or healthcare delivery systems
• Infusion centers
• Insurance or managed care companies
• Journals, including peer-reviewed scientific journals
• Medical accreditation agencies
• Medical certification agencies
• Nursing homes
• Pharmacies that do not manufacture proprietary compounds
• Preventive and public health service providers
• Publishing or education companies
• Rehabilitation centers
• Schools of medicine or health science universities
• Software or game developers

What do I do if it is unclear if a company I have a relationship with is eligible or ineligible?

The ACCME provides a set of self-assessment questions that can help an organization determine whether it falls under the definition of an ineligible company. These questions are listed below:

1. Does your organization produce, market, sell, re-sell, or distribute healthcare products used by or on patients?
2. Does your organization advocate for, or on behalf of, an ineligible company?
3. Does your organization develop or assist in non-accredited education with ineligible companies?
4. Does your organization have a parent company that engages in any of the above?
   • produces, markets, sells, re-sells, or distributes healthcare products used by or on patients, and/or…
   • advocates for, or on behalf of, an ineligible company?
   • develops, or assists in the development of, non-accredited education in collaboration/partnership with ineligible companies?
5. Does your organization have a sister company (a separate legal entity which is a subsidiary of the same parent company that owns or fiscally controls an organization) that:
   • produces, markets, sells, re-sells, or distributes healthcare products used by or on patients, and/or…
   • advocates for, or on behalf of, ineligible companies?
     develops, or assists in the development of, non-accredited education in collaboration/partnership with ineligible companies?

If yes to #5:

1. Does your organization share management, employees, or governance structure with the sister company?
2. Are any owners, employees, or agents of the sister company involved in the planning, development, or implementation of educational content?
3. Does the sister company control or influence, in whole or in part, the operations of your organization?

If your organization answers yes to any of these questions, it would likely be defined by ACCME as an ineligible company. If after answering these questions your organization still has questions regarding its status, you may wish to request that the ACCME conduct a corporate structure review.

An organization may contact the ACCME directly at info@accme.org to request that ACCME perform a corporate structure review. There is a $4,000 fee for a corporate structure review.

If I have a relationship with an ineligible company, does it mean that I’m ineligible to hold a leadership role or other key position with AACAP?

Maybe. Please refer to AACAP’s Policy on Management of Individual and Organizational Relationships with External Entities: Transparency, Disclosure, and Mitigation of Conflict of Interest, which outlines several tiers of leadership. The top leadership positions (Tier One) cannot have any relationships with ineligible companies. Tier Two roles cannot include employees of ineligible companies. For all other leadership roles, in most cases relationships with ineligible companies can be mitigated. 

If I have stock or equity in a privately held ineligible company, am I considered an employee?

Yes. This would disqualify you from having a leadership role in Tier One or Tier Two per AACAP’s Policy on Management of Individual and Organizational Relationships with External Entities: Transparency, Disclosure, and Mitigation of Conflict of Interest. 

If I have mutual funds in ineligible companies, do I need to disclose that?

No.

Do I need to disclose my employer?

Yes. In most cases, your employer is an eligible company and should be disclosed in Part 2.

If my institution receives my grant funding, do I need to disclose?

Yes. Research funding should be disclosed by the principal or named investigator, even if the institution receives and manages the funds.

Do I need to disclose funding from a federal grant?

Yes. The federal government is considered an eligible company and should be disclosed in Part 2.

Is it a conflict if I have a leadership role with another medical society?

Maybe. It depends on the nature of the role and your AACAP role, but typically these conflicts can be mitigated

Do I need to disclose relationships for my adult children?

No. Immediate family is defined as a spouse or domestic partner.

How far back should I consider relationships for this disclosure?

24 months.

How can I update my disclosure if I have a new relationship?

Please complete a new disclosure form if you have a new relationship.

How often do I need to disclose to AACAP?

Once a year and whenever you have a new relationship. Note that the disclosure processes for CME submissions and JAACAP article submissions are separate from this process.  

What is the mitigation process?

Please refer to page 7 of AACAP’s Policy on Management of Individual and Organizational Relationships with External Entities: Transparency, Disclosure, and Mitigation of Conflict of Interest.

What are examples mitigation strategies?

• Disclosing these relationships when actively discussing a related topic
• Recusing from discussions related to disclosed relationships
• Recusing from voting if the subject matter is related to disclosed relationships
• Divesting from the disclosed relationship
• Being unable to serve in the applied-for, elected, or appointed leadership role

What can I do if I disagree with the suggested mitigation?

Appeals of the mitigation strategy by the COI Group or unit leader may be made to the AACAP Secretary, who may appoint an ad hoc committee to hear the appeal in their stead. The decision by the Secretary or ad hoc committee is final.

Why does AACAP need all of this information?

Decisions by AACAP leaders on behalf of AACAP have far-reaching significance and consequences. Relationships with external entities may result in real or perceived conflicts of interest that impact an individual’s opinion, and full disclosure is necessary to maintain the integrity of AACAP activities. To identify and mitigate potential conflicts of interest, AACAP requires all individuals in leadership roles and other key positions to disclose relationships on an annual basis or when new relationships arise.