Sometimes there’s less to life than meets the eye. Take the final rule issued last Friday by CMS on reporting CME (for continuing medical education) payments under the Physician Payments Sunshine Act.

Under that act drug and device manufacturers are generally required to report payments to physicians. But payments to CME speakers have always been exempt, provided the event is accredited by one of five specified organizations. Back in July CMS proposed eliminating the exemption. That produced an outcry from the CME trade group, called the CME Coalition.

The final rule does, in fact, eliminate the exemption. But the CME Coalition is no longer complaining.  In fact, it applauded the announcement. Why? Because CMS issued a statement that payments will continue to be nonreportable, provided the payer (i.e., the drug or device manufacturer) doesn’t “require, instruct, direct, or otherwise cause the continuing education event provider to provide the payment . . . to a covered recipient”—in other words, if the manufacturer doesn’t specify the physician who is to receive the payment.

That’s essentially what the about-to-be-repealed CME exemption said. So in practical terms, there’s no difference between the old rule and the new one. On top of that, most of these payments would be exempt from reporting requirements under an altogether different exemption.  That’s the exemption for payments when the manufacturer is unaware of the identity of the recipient and doesn’t learn it by the end of the second quarter of the year after the payment.

You’re probably thinking that once the manufacturer sees the agenda and speaker list for the CME event, it wouldn’t qualify for this exemption. But CMS issued a statement back in July confirming otherwise, so long as the manufacturer has granted the sponsor “full discretion” to choose the speakers.