The American College of Cardiology (ACC) Annual Scientific Session is the kind of meeting where late-breaking trial results generate national headlines. The big meeting is also well known for its creative learning formats including poster sessions that attendees can hear on their cell phones or view on large plasma screens.

But the assemblage, which draws roughly 28,000 healthcare professionals, is one of a number of meetings around the country that is drawing attention in the CME community for another reason: it may be out of compliance with rules governing organizational financial relationships. In order to reserve space for satellite educational events held during the ACC national session, companies must pony up for booth space in the college’s exhibition, ACC Expo. That seems to contradict the Standards for Commercial Support (SCS) from the ACCME, which prohibit promotion as a condition of commercial support for CME activities.

“The reason [satellite space is] linked to exhibitors is we wouldn’t allow RJ Reynolds to hold a symposia that says, ‘Smoking is good.’ There has to be some type of [vetting],” said Kay Ferris, ACC director of corporate relations.

Joseph Green, PhD, who joined the ACC a year ago as VP for professional development and chief learning officer, will re-examine the controversial rule, and may end up changing it, but not until the ACC’s 2009 meeting, Ferris told MM&M.

Indeed, the college, and other associations with similar conditions, may need to look for a different screening mechanism. CME grantors are becoming increasingly critical of the approaches societies take in allowing companies to sponsor satellite events. The price for space, called a slot fee, is typically quite large (ACC charges $50,000).

Moreover, the charge to reserve a room “comes directly to the commercial supporter from the association before any grant request is submitted,” noted Pamela Mason, director, Medical Education Grants, AstraZeneca.

As such, the ACCME is not in tune with it. “That exchange of money is not recognized by the ACCME,” said Murray Kopelow, MD, chief executive of the Accreditation Council for CME. “The specialty society has no responsibility or accountability for those activities in the context of accreditation.”

The business relationship between the commercial supporter and the association is separate from the accredited provider and therefore beyond the council’s purview, he pointed out.

But it’s a complicated area. “There is a lack of consistency across the board in how the associations/specialty societies handle satellite symposia,” Mason noted. “There are a variety of approaches, from the society handling all aspects to the involvement of a [medical education and communications company]. Some are certified for credit while others are not.”

Those that are certified sometimes throw CME credit in with other promotional perks for the grantor as “what you get” for the slot fee. Grantors may ask the MECC to account for the fee by making it part of the grant.

“What’s going wrong with how satellites are being handled by most associations is they’re letting the business side run what the educational side should be responsible for,” said Eric Peterson, VP, Academy for Healthcare Education, an accredited provider.

But societies may be able to reconcile those two interests. Mason pointed to a different approach that many associations are taking now: requesting a grant from a commercial supporter with all costs associated with the educational activity included in the request.

“It is important that all aspects of a conference’s educational activities certified for credit including satellite symposia conform to the ACCME [SCS],” Mason said, calling for more guidance on appropriate models.

Is there a way for societies to ensure only appropriate companies get access to satellite slots, and do it within the guidelines? “I think there’s got to be a way,” Ferris said. However, she couldn’t say for sure what changes are in store at ACC. “It could be that Dr. Green takes the approach that he doesn’t really want to do any [satellite symposia] at all. Maybe it just gets too sticky, regardless.”