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Why Requirement 3 Was Developed

Effective Date

Effective July 1, 2012, all ASHA Approved CE Providers must be in compliance with Requirement 3: Transparency in Course Planning, Delivery, and Marketing.


The CEB currently has conflict of interest (COI) and disclosure requirements. New Requirement 3 strengthens those requirements and adds some new required practices.

The movement to strengthen COI requirements across all CE accreditors was prompted by a number of highly visible reports criticizing health care practitioners and health care accredited CE providers as having too many ties to industry (device and product manufacturers, pharmaceuticals, service industry, etc.). The Accreditation Council for Continuing Medical Education (ACCME [PDF]) began to overhaul their COI requirements in 2004, with other revisions coming in 2006 and 2007, and some additional tweaks to their system in subsequent years based on pressure from outside entities. Other health care CE accreditors followed ACCME's lead. The American Nursing Credentialing Council and the Accreditation Council for Pharmacy Education [PDF] actually now use ACCME's standards for commercial support (COI standards [PDF]), and other accreditors in health care and non-health care arenas have variations on the ACCME standards. Recent reports petaining to conflict of interest and disclosure have been issued by the Senate Finance Committee (2009–2010), the Institute of Medicine (December 2009), the Josiah Macy Jr. Foundation (December 2009), and the Senate Committee on Aging (July 2009), to name just a few.

The CEB has spent the last 8 years carefully observing what other accreditors were doing to strengthen their COI requirements, and the CEB has learned from those observations about what best leads to transparency in course development, delivery, and marketing. As the CEB began working to strengthen its existing COI standards, the board also did a great deal of research. Then, in 2007 and 2008, the CEB contracted with two separate consulting firms who had expertise in CE standards and were familiar with COI issues. The CEB asked the consultants to determine what standards existed in all CE accreditors (not just health care) and which of those standards exemplified the outcomes that CEB wanted to achieve with its providers and participants (learners). After extensive research, the consultant groups reached the same independent recommendation, which they then presented to the CEB in the summer of 2008. They recommended that the CEB use the "gold standard" for COI requirements (instead of reinventing the wheel). That benchmark was the ACCME standards.

Following those consultants' recommendations, the CEB embarked on strengthening its existing COI standards modeled after the ACCME standards. In the summer of 2010, those standards (or requirements) were put out for peer review and feedback to over 10,000 people, including all of our CE Administrators and CE Providers. The CEB received over 2,000 responses and spent the next 6–9 months analyzing those responses and making changes to the requirement. The changes were substantial based on the feedback. Although some of the new requirement still mirrors the spirit of the ACCME standards [PDF], there are significant differences in this final version.

Timeline and Resources

To give CE Providers ample opportunity to comply with the new requirement, the CEB has set the full compliance date for July 1, 2012. We sent out a survey in April and May of this year asking CE Administrators for feedback about what resources you needed to help come into compliance. We received 224 responses to the survey. Some of you indicated that you already have compliant systems in place. Many others asked for us to develop templates, sample processes, and sample forms for use in your organizations. As a result, CEB and CE staff will develop model processes, templates, and forms to help providers implement this requirement. We will begin posting those resources to our website in early fall of 2011.

The CEB and CE staffs are committed to working with each of our providers who need help with this implementation. There will be a great deal of education, interactive discussion, and exchange of information throughout this implementation process. We will also be available to talk with providers about their individual situations and offer advice about how to set up processes to meet this requirement in their organizations. We will have Frequently Asked Questions on our website and sample processes to offer for those of you looking to create something new at your organization. We will also be educating our general membership, since many of them are presenters and on CE planning committees. Attendees need to understand the new requirement as well because it affects what they will hear in presentations, in print, and via other media, and will affect to some extent the placement of exhibits and marketing materials at and within courses. CE staff and the CEB are committed to working with all our various customers to make this a smooth implementation.

CEB Requirements

The complete set [PDF] of the 12 Requirements for ASHA Approved CE Provider Approval can be found on the ASHA CE website.

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