Maintenance of Certification

Whereas, The costs associated with the recertification testing component of the MOC to an individual physician, including lost revenue, time away from practice, study materials, travel, and the examination fee itself may exceed $10,000; and

Whereas, Each specialty board has widely disparate requirements to achieve MOC, whose variations include costs associated with the examinations, locations used, time required to prepare for and complete certification, time allowed between periods of recertification, timeliness of material to be mastered, and percentage of applicants who qualify for certification; and

Whereas, Some specialties offer an Annual Board Certification (ABC) option, which focuses on learning new and current information, provides Category 1 Continuing Medical Education (CME), allows the examinee to control the preparation and testing time consistent with his or her practice, and requires a much lower fee; and

Whereas, The American Medical Association has policy supporting the use and revision of MOC (D-275.971, D275.977, and D-275.987), but not specific guidelines for how this should be done; therefore be it

RESOLVED, That the Texas Medical Association endorse the following goals and carry this resolution forward asking that the AMA exercise its full influence to protect physicians from undue burden and expense in the MOC process by endorsing the specific goals and promoting them in its deliberation with appropriate parties:

• The MOC process should become substantially more physician friendly, costing no more than $200 per year and requiring no more than one missed day of patient care per recertification cycle;
• Hours spent preparing for maintenance of certification should count as category I CME;
• Use of ongoing educational processes, such as Annual Board Certification, should be an option for practitioners in all specialties;
• There should be greater coordination between boards to ensure that the quality of continued education is similar across all specialties.

Relevant TMA Policy

235.010     Board Certification as a Requirement for Reimbursement or Licensure . The Texas Medical Association opposes the use of board certification as a requirement for reimbursement or licensure (Council on Medical Education, p 98, A-92).

Relevant AMA Policy

H-275.932 Internal Medicine Board Certification Report--Interim Report . Our AMA opposes the use of recertification or Maintenance of Certification (MOC) as a condition of employment, licensure or reimbursement. (CME Rep. 7, A-02

D-275.971 American Board of Medical Specialties - Standardization of Maintenance of Certification Requirements . Our AMA will work with the American Board of Medical Specialties to streamline Maintenance of Certification (MOC) to reduce the cost, inconvenience, and the disruption of practice due to MOC requirements for all of their member boards, including subspecialty requirements. (Sub. Res. 313, A-06)

D-275.977 Update on the American Board of Medical Specialties Program on Maintenance of Certification (MOC) . Our AMA will: (1) continue to monitor the progress of Maintenance of Certification (MOC) and its ultimate impact on the practice community; (2) encourage the Physician Consortium for Performance Improvement, the American Board of Medical Specialties, and the Council of Medical Specialty Societies to work together toward utilizing Consortium performance measures in Part IV of MOC; and (3) encourage the ABMS Maintenance of Certification Task Force to develop and adopt recommendations for re-entry into clinical practice and entry into Step IV of MOC for diplomates not involved in direct patient care. (CME Rep. 9, A-05)

D-275.987 Internal Medicine Board Certification Report - Interim Report . Our AMA shall: (1) support the ACP/ASIM in its efforts to work with the American Board of Internal Medicine (ABIM) to improve the Maintenance of Certification (MOC) program; (2) encourage specialty societies to work with their respective ABMS member board to develop, implement and evaluate the Maintenance of Certification (MOC) program; (3) continue to assist physicians in practice performance improvement; (4) continue to monitor the progress by the American Board of Internal Medicine and the other member boards of the American Board of Medical Specialties (ABMS) on implementing the Maintenance of Certification (MOC) program; (5) encourage the ABMS to include practicing physicians and physicians with time limited board certificates to assist in designing and evaluating the Maintenance of Certification (MOC) process for each of the ABMS member boards; and (6) shall study the ethical implications of the Maintenance of Certification (MOC) program including the patient assessment component vis-à-vis the doctor-patient relationship and the ethical implications of the peer review component vis-à-vis the practice environment. (CMS Rep. 7, A-02; Reaffirmed: CME Rep. 9, A-05)

TMA House of Delegates: TexMed 2007