No more MOC: One state bans the controversial credential requirement—and others may follow

Michigan and Missouri are eyeing similar legislation

Oklahoma just removed maintenance of certification (MOC) as a requirement for physicians to be hired, get paid, obtain a medical license, or secure hospital admitting privileges, Robert Lowes reports for Medscape.

MOC programs—as defined by the law signed by Gov. Mary Fallin (R) earlier this month—are continuing education initiatives approved by nationally recognized accrediting organizations that measure core physician competencies.

For instance, the American Board of Medical Specialties (ABMS) has MOC certification programs for its 24 specialty boards. The programs require doctors to maintain a valid, unrestricted medical license, regularly participate in continuing education activities, pass a written examination, and periodically complete a practice performance assessment.

Critics say MOC programs are expensive and don't improve patient care, while advocates argue that the programs encourage providers to stay up-to-date with current medical advancements.

Doctors v. boards: The debate over new certification rules

State laws

Oklahoma's new law does not explicitly stop hospitals from requiring MOC as a condition of admitting privileges, but it's uncertain whether the measure will have that effect in practice. A physician could challenge a MOC requirement "as interfering with the practice of medicine" says Wes Glinsmann, director of legislative and state political affairs for the Oklahoma State Medical Association.

ABMS president and CEO Lois Margaret Nora says that her organization believes MOC shouldn't be required for medical licensure, but that it would be a mistake to bar hospitals from requiring MOCs as part of their credentialing process.

Hospitals, she says, adopted MOC requirements for credentials "because they recognized board certification as a quality indicator," adding, "Wouldn't it be a shame if you couldn't have your neurosurgical procedure done at a facility that wanted to say board certification is part of the credentialing process?"

Action by other states

Meanwhile, several other states have taken action on the controversial MOC requirements:

  • Earlier this year, Kentucky Gov. Matt Bevin (R) signed a measure that bans making MOC a condition of licensure;
  • Michigan is considering a bill that would ban hospitals from denying admitting privileges based on MOC, ban insurers from making MOC a prerequisite for reimbursement, and prohibit medical and osteopathic boards from making MOC a condition of licensure; and
  • The Missouri General Assembly is debating a measure that would prevent the state's oversight board for allopathic and osteopathic physicians from requiring MOC for licensure and also would prevent the state from requiring board certification or MOC to practice medicine (ABMS MOC report, accessed 4/25; Lowes, Medscape, 4/22).

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