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Landmark Opinion from the Justice Department about MOC

Dear Colleagues,

This week, the U.S. Department of Justice Antitrust Division issued a landmark opinion about MOC, vindicating NBPAS’s long-held position that alternative organizations are needed to promote competition in physician certification. In an opinion letter, the DOJ validated the NPBAS four year struggle to make continuous physician certification more meaningful and less burdensome. This public position by the DOJ should be emphasized by physicians and other stakeholders as they ask hospital boards and insurance companies to accept alternative certification organizations when setting criteria for hospital privileges and payer contracts.

The DOJ opinion letter came in response to a pending Maryland bill promoting competition in physician certification that was introduced by NBPAS board member and Maryland legislator Dr. Dan Morhaim. The DOJ explained that the ABMS Program on MOC may have the effect of “harming competition and increasing the cost of healthcare services to customers.” ABMS may do so “by imposing overly burdensome conditions on physicians who wish to maintain their certification.” The DOJ added, with respect to ABMS, “[the] vast majority of [its] board members are medical doctors”—i.e., “active market participants”—who may have incentives to limit competition through “industry self-regulation.” As a result, the DOJ warned, “there would be competition concerns, if dominant certifying bodies [like ABMS] set de facto participation requirements that did not sufficiently correspond to health, safety, or other procompetitive justifications.”

As physicians familiar with MOC know, current ABMS MOC programs have not been shown to correlate with quality of practice or patient outcomes, and yet the burden they impose on doctors is severe. NBPAS provides a more meaningful form of continuous certification. The DOJ urges such competition. It encourages legislatures to promote competition by recognizing “additional, legitimate certifying bodies” such as NBPAS, whose recognition the DOJ believes “could allow for a competitive alternative to ABMS in certifying medical specialists.” Such competition may provide a host of benefits, including physicians’ passing on “extra time and lower costs in the form of savings or extra care for consumers”, physicians’ “seek[ing] additional subspecialty certification or [staying] in practice longer”, and “further encourage[ing] the incumbent certifying body to continue refining their processes to be competitive.”

The DOJ was strongly supportive of competition in MOC stating “If other new bodies, unaffiliated with ABMS or NBPAS, can offer a more (or similarly) efficient and accurate way to certify medical specialists, the interests of competition may be better served if they have an opportunity to compete on the merits of their approach with physicians, hospitals, payers, and consumers, without needing new, ad hoc legislation to support their entry.”

NBPAS applauds the DOJ for addressing the important issues surrounding MOC. The DOJ’s legislative comment is a watershed moment. It lends powerful support for the positions NBPAS continues to press with all stakeholders in the industry.

Landmark Opinion from the Justice Department about MOC National Board of Physicians and Surgeons

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Friday, January 25, 2019
amended to include claims under the RICO Act and state law unjust enrichment claims. From the 50-page amended Complaint:
Finally, this case is about ABIM’s violation of Section 1962(c) of the RICO (Racketeer Influenced and Corrupt Organizations) Act. As detailed below, ABIM has successfully waged a campaign in violation of RICO to deceive the public, including but not limited to hospitals and related entities, insurance companies, medical corporations and other employers, and the media, that MOC, among other things, benefits physicians, patients and the public and constitutes self-regulation by internists. Believing ABIM’s misrepresentations to be true, hospitals and related entities, insurance companies, medical corporations and other employers require internists to participate in MOC in order to obtain hospital consulting and admitting privileges, reimbursement by insurance companies, employment by medical corporations and other employers, malpractice coverage, and other requirements of the practice of medicine.In addition, the suit claims violations of unjust enrichment laws:
Plaintiffs and members of the Class conferred a benefit on ABIM in the form of the money and property ABIM wrongfully obtained as a result of Plaintiffs and other internists being de facto forced to pay MOC-related fees, as described in detail above. ABIM has retained these benefits that it acquired from charging Plaintiff and members of the Class inappropriate, unreasonable, and unlawful MOC-related fees. ABIM is aware of and appreciates these benefits. ABIM’s conduct has caused it to be unjustly enriched at the expense of Plaintiffs and the other Class members. As such, it would be unjust to permit retention of these monies by ABIM under the circumstances of this case without the payment of restitution to Plaintiffs and Class members. ABIM should consequently be required to disgorge this unjust enrichment.All physicians can follow the progress of the lawsuit at Physicians wishing to assist the plaintiffs in their effort to end Maintenance of Certification (MOC) are encouraged to donate to the GoFundMe page organized by Practicing Physicians of America.

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This is a very effective group that really cares about issues that matter to doctors. Everyone should ask their local hospital credentialing committee to accept NBPAS on same level as ABMS.
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So if you don't answer enough questions right, you have to take part 1 exam again?
And then you still have to do the CertLink questions until you die or retire?

And I'm sure these questions will be totally relevant to what we do, right?

This is just not what I think we need.
My current is til 2028. Do I have to participate in this nonsense?
I'm not sure even lifetime certificate holders are exempt. It looks to me like a 5 year onramp.

What happens if you don't pay the 200/yr? You are no longer "participating"? In the same way, they could add these new requirements.

When I called them a few months ago, there was a lot of uncertainty in the specifics of how people were affected.

They did say no additional charges until they figure out the "cost of implementation".