The Texas Legislature has sent Gov. Greg Abbot (R) a bill that would classify board-certified physicians as continuously certified in their medical specialties even if those physicians forego the maintenance-of-certification (MOC) processes of the boards that certified them as specialists.
The legislation, Senate Bill 1148, would prohibit the Texas Medical Board, a government agency, from requiring physicians to do MOC as a condition of renewing their state medical licenses and prohibiting insurers from differentiating between physicians based on their MOC status.
SB 1148 would also prohibit most hospitals from using physicians’ MOC status as a differentiating criterion.
The bill, sent to Abbot on May 30, will automatically become law by mid-June unless Abbot vetoes or signs it into law before then.
Doctors spend an average of several hours of study and hundreds of dollars per year completing MOC programs run by the American Board of Medical Specialties (ABMS), the country’s largest conglomerate of specialty boards.
By contrast, the National Board of Physicians and Surgeons (NBPAS), an ABMS competitor, offers certification for $169 every two years to physicians initially certified by ABMS. NBPAS bases certification primarily on whether a physician has obtained at least 50 hours of continuing medical education (CME) in the past two years.
Texas law requires doctors to complete at least 48 hours of CME every 24 months.
Dr. Paul Teirstein, president of NBPAS and chief of cardiology at Scripps Clinic in San Diego, California, says the bill would ensure doctors could forego MOC and still practice and get paid.
“The Texas bill is excellent because it prohibits discrimination based on MOC by both hospitals and payers,” Teirstein said.
Letting health insurers discriminate against physicians who reject MOC places an undue burden on physicians, Teirstein says.
“Insurance companies that have contracts with physicians to care for non-Medicare patients are key to this controversy,” Teirstein said. “Medicare does not require MOC, but most third-party payers do require MOC.”
Dr. Deane Waldman, director of the Center for Health Care Policy at the Texas Public Policy Foundation, says SB 1148 would liberate doctors to devote more time to patients.
“Compliance with such mandates as MOC takes away time clinicians would rather spend with, or even just thinking about, the patient,” Waldman said. “As such, [SB 1148] is a wise action, one that benefits patients.”
Teirstein says a grassroots movement helped push SB 1148 through the Texas Senate.
“In the weeks prior to the Texas Senate vote, the NBPAS sent an e-blast to its 20,000 supporters, imploring them to use a state-of-the-art grassroots advocacy program we provided to send letters to their district’s legislators,” Teirstein said.
Texas is a staging ground for efforts to free doctors from MOC requirements around the country, Teirstein says.
“Over 10,000 letters from concerned physicians were sent to state representatives in every state of the country, [and] 1,029 letters were sent to Texas state representatives, which might have influenced the outcome.”
In 2016, Oklahoma became the first state to protect physicians without maintenance of certification from losing their licenses, reimbursement, employment, or hospital admitting privileges.
David Grandouiller ([email protected]) writes from Cedarville, Ohio.
Michael T. Hamilton, “Policy Diagnosis: ‘Maintenance of Certification’ Bleeds Doctors and Patients,” Health Care News, The Heartland Institute, May 2017: https://heartland.org/news-opinion/news/policy-diagnosis-maintenance-of-certification-bleeds-doctors-and-patients
Matthew Glans, “Texas Should Reject Maintenance of Certification,” Research & Commentary, The Heartland Institute, March 29, 2017: https://heartland.org/publications-resources/publications/research–commentary-texas-should-reject-maintenance-of-certification
Jenni White, “Oklahoma Frees Physicians from Forced Maintenance of Certification,” Health Care News, The Heartland Institute, June 6, 2016: https://heartland.org/news-opinion/news/oklahoma-frees-physicians-from-forced-maintenance-of-certification
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