Lessening the Grip
By Sean Price Texas Medicine August 2017

Texas Lawmakers Dramatically Scale Back MOC Requirements

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Charting the Texas Legislature: Maintenance of Certification — August 2017

Tex Med. 2017;113(7):41–42. 

By Sean Price

The Texas Legislature took a giant step toward lifting the burden of maintenance of certification (MOC) requirements on most Texas physicians by approving Senate Bill 1148.  

Authored by Sen. Dawn Buckingham, MD (R-Lakeway), and sponsored by Rep. Greg Bonnen, MD (R-Friendswood), the new law will prevent the Texas Medical Board from using MOC as a requirement for doctors to obtain or renew a medical license. In general, SB 1148 also bars hospitals and health plans from requiring physicians to obtain MOC for credentialing or contracts, though there will be some exceptions. The law takes effect Jan. 1.

The Texas Medical Association supported the measure strongly and testified on its behalf. President Carlos J. Cardenas, MD, said the bill will prevent physicians from dealing with an "unnecessary — and very costly — distraction" from working with their patients.

"TMA strongly applauds Gov. Greg Abbott for signing into law Senate Bill 1148, lessening the grip MOC requirements have had on Texas physicians," Dr. Cardenas said.

Nearly 1,400 TMA members used the TMA Grassroots Action Center to send their lawmakers more than 2,300 messages in support of SB 1148 throughout the legislative session.

The overwhelming majority of physicians become board certified. They must currently participate in MOC to maintain this status from specialty boards that are members of the American Board of Medical Specialties (ABMS) or the American Osteopathic Association Bureau of Osteopathic Specialists. Those boards say MOC is designed to demonstrate that physicians' skills have remained sharp and that they are up to date on medical advances in their specialties. Failure to maintain this status can keep doctors from practicing. 

Houston neurologist Kim Monday, MD, testified on behalf of TMA in favor of SB 1148. She told lawmakers that MOC can cost a physician up to $10,000 in fees, materials, travel, and time away from work. Many physicians find that the information studied and tested has little relevance to their medical practice.

"Many physicians feel initial board certification is necessary," she said. "However, we find the continuous maintenance of certification process to be burdensome, expensive, and filled with irrelevant curriculum."

Senator Buckingham said the frustration caused by the MOC process is making a statewide shortage of physicians much worse. 

"We're losing doctors to it," she said. "Doctors are saying, 'You know what, I've had enough of the hassle, and I'm just not going to practice anymore.'"

Under SB 1148, hospitals and health care facilities are generally barred from using MOC status for credentialing, hiring, or retaining physicians, with the following exceptions:

  • If the facility is required to use MOC by a law or rule, or because of a certification or accreditation standard;
  • If the voting physician members of an entity's organized medical staff authorize the use of MOC; and
  • If a facility is a medical school or comprehensive cancer center, as designated by the National Cancer Institute. This includes The University of Texas Southwestern Medical Center's Harold C. Simmons Comprehensive Cancer Center in Dallas, as well as Baylor College of Medicine's Dan L. Duncan Comprehensive Cancer Center and UT MD Anderson Cancer Center, both in Houston. 

SB 1148 also bars managed care insurance plans from using a physician's MOC status for selecting physicians to participate in the plan's network or for payment or preauthorization. The only exception to this is physicians who work at health care facilities that are required to use MOC because of a state law or state rule, or because of a certification or accreditation standard. For example, trauma centers are required to verify board certification status for key physician positions. 

Senator Buckingham says the new law should help most Texas physicians save time and money.

"We look forward to getting to a process that actually does improve quality and is not so burdensome to physicians," she said. 

Sean Price can be reached by phone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email.

August 2017 Texas Medicine Contents
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Last Updated On

July 20, 2017

Originally Published On

July 20, 2017

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Sean Price


(512) 370-1392

Sean Price is a reporter for Texas Medicine and Texas Medicine Today. He grew up in Fort Worth and graduated from the University of Texas at Austin. He's worked as an award-winning writer and editor for a variety of national magazine, book, and website publishers in New York and Washington. He's also helped produce Texas-based marketing campaigns designed to promote public health. Sean lives in Austin and enjoys hiking, photography, and spending time with his wife and two sons.

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