Update: States limit the role of specialty certification

Responding to physicians’ data-driven arguments, including a December 2014 JAMA study showing maintenance of certification (MOC) programs do not improve patient outcomes (JAMA 2014; 312:2348-57), state legislators proposed several new laws in 2016.

Based on a partnership with Urology Times, articles from the American Association of Clinical Urologists (AACU) provide updates on legislative processes and issues affecting urologists. We welcome your comments and suggestions. Contact the AACU government affairs office at 847-517-1050 or info@aacuweb.org for more information.

Passionate physicians have organized state-based campaigns to minimize the role recertification plays in licensing, payment, and employment or admitting privileges. These advocates firmly believe that initial board certification and continuing medical education ensure that physicians stay current and competent.

Responding to physicians’ data-driven arguments, including a December 2014 JAMA study showing maintenance of certification (MOC) programs do not improve patient outcomes (JAMA 2014; 312:2348-57), state legislators proposed several new laws in 2016.

Missouri. A comprehensive proposal protecting patients and providers in Missouri was advanced by members who understand this issue first hand. Representative Keith Frederick, DO (R), and Senator Bob Onder, MD (R), secured the governor’s signature on the Medical Practice Freedom Act. In addition to a prohibition on requiring any form of specialty board certification or MOC, as of Aug. 28 of this year, licensure may not be tied to any insurance plan participation, emergency room coverage, or electronic health record “meaningful use.”

Oklahoma. Under a new law signed April 12 by Oklahoma Governor Mary Fallin (R), physicians may challenge a hospital granting privileges exclusively based on MOC, asserting that it interferes with the practice of medicine. The American Board of Medical Specialties took the unusual step of expressing “disappointment” with the measure, affirming its policy stating, “Neither specialty nor subspecialty certification should be the sole determinant in granting and delineating the scope of a physician’s clinical privileges.”

Next: Kentucky, Maryland, Michigan

Kentucky, Maryland. On April 8, Kentucky Governor Matt Bevin (R) signed a narrower ban on making MOC a condition of licensure. Maryland Governor Larry Hogan (R) likewise approved a law April 12 that prohibits “the State Board of Physicians from establishing a continuing education requirement that every licensed physician complete a specific course or program as a condition to the renewal of a license.”

Also see: Look for MOC changes in 2017, American Board of Urology says

Michigan. Two proposals in Michigan are still under consideration in the year-round legislature. One bill uses the Oklahoma template, prohibiting the denial of admitting privileges solely because the provider chooses to forego MOC. A second forbids the withholding of reimbursement by insurers based on a physician’s MOC status.

As evidenced by this activity, many physicians are fighting back against increasingly burdensome recertification requirements. Since 60% of board-certified physicians participate in MOC, it is vitally important to not only stay current with the science of medicine, but with the regulation of the profession, as well.