Following policies and procedures during program planning and implementation keeps programs on track to achieve high-quality results, as well as minimize the risk of non-compliance and disciplinary action. A BOC Approved Provider who is found to be non-compliant is placed on probation for a specified time period; usually a period of one year. If a BOC Approved Provider on probation is found to be non-compliant in a subsequent year, expired status is applied.
Actions Leading to Non-Compliance
Most issues of non-compliance are identified through the annual report, which essentially is an audit or a check to ensure each BOC Approved Provider is operating their educational programs in accordance with the “BOC Standards for BOC Approved Providers” and Policies & Procedures. To ensure success, BOC Approved Providers should become very familiar with the non-compliant list below and should reference this list when building programs Another helpful checklist is the “Checklist for Compliant Programming” under the Active Providers section of the BOC website.
There are a few areas that BOC Approved Providers could be found to be non-compliant and include annual report, program directory (10-day rule) and complaints (Athletic Trainer triggered investigation).
1. Annual Report
What is it?
To facilitate your annual report ONE past program will be randomly selected for review. Regardless of whether you had an CE events in the previous calendar year, you are still required to verify this by clicking on "Annual Report" in your BOC Approved Provider dashboard. If you do not click on this link and confirm, your provider account will expire on March 31, the date Annual Reports are due. Items of non-compliance denote critically important areas relevant in creating quality educational programs. Should a BOC Approved Provider not meet these critical expectations, their annual report will be denied placing them on probation (first offense) or expired status (consecutive second offense). A full explanation of status changes is found below. As you develop your educational programs, keep the items of non-compliance in mind. Non-compliance items listed below are solely related to your annual report.
Study the list below to develop your programs to specification:
Non-Compliance on Annual Report
Previously, there were several administrative requirements identified as items of non-compliance. For example, if a BOC Approved Provider did not include all seven items required on promotional materials or five items required on their certificates, they were marked as non-compliant and penalized, moving status to either Probation or Expired.
These administrative requirements will remain but the punitive consequence will be removed. The new focus on compliance will shift from a focus on the administrative aspects of CEU offerings to those items that most impact educational quality, such as the practice gap, learning objectives and participant assessment. For details, please refer to the below chart:
*Note: Items that were formally marked as non-compliant: These items are still required, however, the consequence of omission has been reduced. If items are omitted, BOC will remind BOC Approved Providers of the requirements, recognizing this to be a learning opportunity rather than a punitive event.
*These items are STILL required to appear, but do not carry punitive consequences.
Required CE Program Document
Required Items (must be found on document)
- Program content was practically useful, appropriate and adequately in-depth
- Achievement of stated learning objectives
- Effectiveness of teaching and learning methods
- Quality and effectiveness of faculty
- Usefulness of educational materials
- Perception of bias or commercialism
- Learning Objectives (three to five)
- Schedule and format
- Cancellation/refund policy
- Program faculty and credentials
- Number of contact hours/continuing education units (CEUs) that will be made available
- Sponsors (if applicable)
- Required materials and equipment (goes into effect beginning in 2022 with updated BOC Standards)
- Joint Providership Policy
- Conflict of Interest Policy
- Copyright Policy
- Nondiscrimination Policy
- Record Keeping Policy
- Fee/Cancellation/Refund Policy
- Faculty Payment
- Participant Name
- Program Title
- Completion Date
- BOC Approved Provider name, number, logo
- BOC Approved Provider CE Statement, including number of CEUs
CE Statement of Credit for Certificate
This is the statement that must appear on certificates disseminated to ATs:
Company Name (BOC AP#: PXXXX) is approved by the Board of Certification, Inc. to provide continuing education to Athletic Trainers (ATs). This program is eligible for a maximum of (#) Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.
Previously inconsequential items that will now put a BOC Approved Provider in a non-compliant status are:
Required CE Program Document
Required Minimum Acceptance Level Description
Explains the observed practice and what the practice should be. This is supported by the literature. The Gap should answer all of the following:
- What isn’t the AT doing that they should be doing?
- What doesn’t the AT know that this program will provide them?
- What is the patient’s unmet need?
*If each bullet point is not addressed, practice gap is non-compliant.
Clinical Bottom Line
Summary of the evidence that identifies the clinical recommendation of the intervention outlined in the learning objectives.
*If summary does not concisely explain recommendation of intervention, it is non-compliant.
Create three to four measurable learning objectives that define the knowledge and/or skills an AT is expected to acquire by completion of the CE event.
*Learning objectives that are not measurable are non-compliant.
Each learning objective must have an appropriate, corresponding strategy for learning measure in the participant assessment.
*If the participant assessment is not aligned with the learning objectives, it is non-compliant.
2. Program Directory
What is it?
The program directory provides an easy and effective method for Athletic Trainers to find CEUs they need for certification. Every Category A program available to Athletic Trainers can be found in this searchable directory. Click here to visit the program directory.
Failure to upload programs to the directory at least 10 calendar days prior to the start of the program will result in discipline. The program directory will not allow a BOC Approved Provider to upload programs with a start date that is less than 10 calendar days away. At this point, a BOC Approved Provider must contact the BOC for assistance. This instance will be documented in the BOC Approved Provider’s profile. If this occurs twice in a calendar year, the BOC Approved Provider will be placed on probation.
In the event the BOC receives a complaint from an Athletic Trainer or other person(s) or discovers information indicating that a violation of the standards or requirements may have occurred, an investigation will begin. The investigation protocol is stipulated below.
Filing A Complaint
Athletic Trainers and BOC Approved Providers that have access to the portal can file a complaint by accessing the portal and following the steps outlined there. If you are a member of the public or other person who does not have access to the portal, please contact the BOC at firstname.lastname@example.org to begin the process; paperwork will be sent to you. To prepare, BOC will collect the following: BOC Approved Provider name/number alleged to be involved, any facts concerning the alleged conduct, and any available documentation.
The BOC shall notify a BOC Approved Provider of an investigation and will require a response within 15 calendar days from the date notification is sent. The BOC may extend this period up to 15 calendar days upon request. The notification shall provide instruction on the materials needed from the BOC Approved Provider to conduct the investigation. The BOC shall notify the BOC Approved Provider of the outcome within 30 calendar days of receipt.
Issues of non-compliance are not the only reason a status may become expired. A status may become expired due to missed deadlines. See the next section “Status Changes” for more explanation.
A status may be changed to probation due to non-compliance. An expired status may be issued due to non-compliance or because of missed deadlines. It’s important to understand what this means for you as a BOC Approved Provider and what your responsibilities are to Athletic Trainers.
A BOC Approved Provider can have one of three statuses: active, active - probation and expired.
Active illustrates a BOC Approved Provider in good standing: 1) annual fee paid 2) annual report completed and 3) programs uploaded to the program directory within 10 days of start date.
Active-Probation is merely a warning status. BOC Approved Providers in this status may still offer CEUs for the year. The BOC does not require an action or response by the BOC Approved Provider at the time of decision. It is highly suggested a BOC Approved Provider reviews non-compliant items to ensure future programs are adjusted accordingly. Note: Athletic Trainers do not see your probation status. BOC Approved Providers will see this status when logging into the portal only.
A BOC Approved Provider will enter into probation immediately upon a BOC decision based on non-compliance. This status remains until a successful outcome of a subsequent annual report. For example, if a provider is found to be non-compliant on the annual report in early 2021, the probationary status will remain until the following annual report. If the annual report is accepted without any items in non-compliance, status will revert back to active in early 2022 upon BOC decision to approve the annual report.
Expired status means a provider may not offer Category A CEUs and may not upload programs to the program directory (access is revoked).
Expired (former) Providers who Offer CEU:
If as an expired provider (i.e. not BOC approved) you deliver CEUs to Athletic Trainers (ATs) the BOC will send you a cease and desist letter and require the following steps be completed:
- Contact all affected ATs providing notification of this error.
- Retract the invalid CEU certificate and reissue a new one to attendees without the BOC logo and CE statement.
- Send the BOC a copy of the message sent to ATs, along with an example of the new certificate (for an actual affected participant) to the Senior Manager of Professional Development, who will maintain records in the provider account
To ensure the ability to offer Category A CEUs going forward, we encourage you to reapply to become a BOC Approved Provider.
A number of conditions will prompt an expired provider status:
Condition 1: A BOC Approved Provider is on probation from a previous year and is found to be non-compliant on a subsequent annual report.
Condition 2: The annual fee was not paid within the November to December 31 window.
Condition 3: The annual report was not completed within the November to March 31 window.
Recourse: If you are in expired status, your courses are not eligible for Category A. Please see the category explanation to identify whether your course is eligible for a different category. As recourse, a provider may re-apply for accreditation by completing an initial application and paying the initial application fee. A provider may do this immediately as there is no waiting period.
In the event a BOC Approved Provider’s status changes to probation or expired, they may elect to appeal the BOC decision. The appeal process is completed in BOC360; it must be in writing, and we will not hold any phone conversations or email conversations regarding appeals. Everything must be documented in BOC360 under the “appeal” form, and the below procedure is all done within BOC360 (all deadlines are automatically handled by the system). There are strictly defined grounds for appeal (see below under Qualified Reasons).
Submit within 30 days: A provider will have 30 days once a decision has been made to make a formal, written, appeal. Note that this 30-day window begins on the day of decision which will be automatically sent to the primary provider contact(s). This 30-day window does not begin upon receipt of the decision.
- BOC reply within seven days: The BOC will review qualified reasons for appeal (see below) and will return a response within seven days. The decision will either be “Yes, your reason is qualified” OR “No, this does not qualify as a valid reason for appeal.” IF the decision is “NO”, then the appeal process will end. It will not advance.
- Submit evidence within seven days: If your appeal is filed under a qualified reason, you will then have seven days to submit supporting documentation and evidence to support your claim.
- BOC decision within seven days: The BOC will examine the evidence and will return a decision to either grant or deny your appeal. If granted, provider status will revert back to active. If denied:
- Submit appeal to CEO within seven days: If the appeal is denied by BOC staff and you wish to continue to appeal, you may do so through the portal, in writing, to the CEO.
- Final decision of the CEO within seven days: Once the decision is given by the CEO, the appeal process is officially closed and no further communication will be given by any member of the BOC on this specific matter.
An appeal may be made based on a qualified reason. All qualified reasons are listed below.
- BOC staff have missed something or overlooked something in an initial review such as the annual report.
- BOC staff have provided inconsistent feedback that either misleads and/or does not align with the “Standards for BOC Approved Providers.”
- A provider that receives a decision of probation or expiration may request an appeal when it feels that the evidence it presented to the BOC justifies a different decision.
If the appeal does not meet one of these conditions, it cannot be considered.
Reasons that do not qualify:
*Please note: The appeal process is not a place to contend with the “Standards for BOC Approved Providers.” If there is an area of ambiguity in the standards wherein upon you do not feel you understand what is expected of you as an BOC Approved Provider, ask questions prior to the development of your program(s) and prior to beginning an annual report.
*The appeal process is not a place to contend with the Policies & Procedures. To ensure fairness among BOC Approved Providers and to uphold the highest ethical standard, the BOC will operate in accordance with the published Policies & Procedures.
*Appeals are not a place for providers to submit additional material that was omitted previously. Only material which was considered at the time of the initial review, such as in the annual report, may be reviewed upon reconsideration.
*Note that non-accreditation decisions (when your status becomes expired) delivered as a result of administrative issues such as failure to submit fees are not eligible for the appeals process.