Friday, October 20, 2017

What is MOC®? Why Is This Important?

What is Maintenance of Certification® (MOC®)?

Is it an educational program for physicians? If you think so, you are wrong.

MOC® has almost nothing to do with physician education, but according to the contract we must sign, involves "certain health care service operations, including practice assessment and evaluations." Most importantly, it allows physicians' personal and practice data to be shared with an unlimited number of third parties through a HIPAA Business Agreement.

Let me be clear. MOC® is not really about physician education. Instead, MOC® allows a physician's personal data to be shared with data registries and large corporations who profit from those data. For instance,  our MOC® and survey data are shared with (sold to?) Premier, Inc. (PINC, the $4.3 billion owners of CECity, Inc.), the largest healthcare performance improvement company that serves 3,900 hospitals and health systems and approximately 150,000 other providers and organizations." (Remember, Christine Cassel, MD, former President and CEO of the American Board of Internal Medicine, served on the board of Premier, Inc at one time and earned plenty of money and stocks in that capacity while at the ABIM.)

It also allows physician data to be sold to ABMS Solutions, LLC, a for-profit wholly-owned subsidiary of the American Board of Medical Specialties that is based in Atlanta, Georgia, who then sells your MOC® status, updated every 24-hours, to others, and a company never mentioned in disclosures published in our major medical journals. They will also plan to share these data with the Disciplinary Action Notification System database owned by the privately-held non-profit Federation of State Medical Boards that solicits "Affiliate Members, Official Observers, and Courtesy Members."

Again, MOC® is not about physician education. It is about collusion with multi-billion dollar companies, including Wolters Kluwer, and Pearson, LLC, and even our own politically-powerful American College of Cardiology that who owns the NCDR procedural registries and sells access to them to hospitals with MOC® as its demographics supplier (a full explanation of how this works is available here).

Why is the understanding of this "definition" of MOC® so important?

Multiple states are enacting legislation to prevent MOC® as a cudgel to limit a physician's ability to hold hospital credentials, be on insurance panels, or obtain state licensure. Our physician data are that important to these companies they will stop at nothing to be sure we sign that MOC® agreement.

What if the ABMS re-brands MOC® to some other "product" at their December 4th meeting with all of those state medical societies frustrated with what MOC® has become? Might the American Board of Medical Specialties and their collaborators skirt existing "anti-MOC®" legislation? Current anti-MOC® legislation must anticipate this and not include "MOC®" but "MOC® or any other health care serve operation that may include practice assessment or evaluations that requires a physician to sign a HIPAA Business Agreement to which they are not parties" in their language.

Physicians enacting anti-MOC® legislation need to understand the legal definition of MOC®. That way they can write legislation that is lasting, meaningful and enforceable, irrespective of how MOC® is ultimately re-branded.

MOC® is broken and must end. Not because it's a failed physician education experiment. It's broken because of its threats to physician civil liberties and threatens the doctor-patient relationship at it's most intimate level, thanks to the age old business motivators, money, power, and greed.

-Wes

13 comments:

  1. Amen to that - it is time to put a bullet hole in the head of MOC and kill it off for good!

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  2. You just hit the ball out of the park with the bases loaded.

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  3. i hope IRS and DOJ can work against this evil.
    why can we not request president trump on this one.. he can clean a lot of swamp just by ordering via a memo to investigate these crony institutions?

    hope this nightmare can end in my lifetime so that our children dont have to suffer.

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  4. What is the ABIM Foundation? A Hedge Fund start-up paid for with windfall profits from gouging over-priced physician fees? In fact it was a kind of hedge fund courtesy of 1838 Investment Advisors, formerly Drexel, who pocketed $209,198 that year for mostly in and out short term trades. In 1997 the ABIM Foundation made from equity trades alone (not including mutual fund appreciation 22%) over $10 million dollars in pure profit. But the good times would not last as 1838 Investment Advisors had too much risk and exposure to market volatility when the 90's bull turned into a bear of a nightmare. All those beautiful profits turned into staggering ugly losses.

    So what kind of business (I mean charity) is the ABIM Foundation really when its primary source of income is coming from equities parked in the US, Ireland and the Cayman Islands?

    Btw, in 1997 the ABIM Foundation went from the cash method of accounting to the accrual method, like any good Wall Street Investment Bank. They were also getting ready for the wave of MOC fees, which would kick in and allow huge compensation packages for the ABIM's primary business, which Dr. Fisher seems to have nailed better than any Pulitzer prize winner. MOC is anything but education. They know it and now we know it.

    Interestingly I remember quite well that Christine Cassel was Chair Elect of the ABIM Foundation when the good times were rolling at the ABIM in the 90's. "Dr" Casse was working for the Whitehouse in Washinton DC. trying zealously to overhaul the health system. She and her bosses were creating a network of NGO's for the next wave of push toward healthcare reform. Cassel helped found the NQF, but then that is already too much to bear of how the whole scam within scam has worked to create our "shadow government" at the ABMS that is not what it pretends to be.

    Many on the Drexel team (investment advisors) were indicted for insider trading if that help fill in any gaps in the story. And the Treasury Secretary resigned (got out at the high) just before the steep market declines.

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  5. In the business of MOC and MOCing docs 638 business professionals

    I count 638 business professionals who work/worked for the ABIM and its Foundation in zoom's online ABIM employee profile list. How many of these highly paid ABIM business professionals actually live/lived in Philadelphia? How many are under contract with the ABIM/ABIM Foundation right now.

    Another piece of the ABIM's subtle profile puzzle.

    The ABIM dropped the "Incorporated" part of its name after changing its bylaws years ago? The crossed out the "Incorporated" part of their name on the 1967 and 1982 Iowa filings. Why was that? What's that all about. It might have been in order for the ABIM to be born again, with only a slight twist in the name, as an "aggressive business with predatory practices" masquerading as a goodwill charity.

    Christine K. Cassel made a name change to the ABIM Foundation in 1999, as well, when she signed the second registration of the Foundation in PA. At first they hid the actual 1989 date from the public and the IRS.

    Or did they drop the "inc. part" to reduce their liability in case anyone ever said they (ABIM executives and staff) were not living up to the ethics and original charitable mission of the ABIM(ABMS).

    They did not drop the "voluntary" (verbal) reference to MOC and certification, however, but they dropped it in fact by colluding with insurers and hospitals courtesy of the National Committee for Quality Assurance NCQA to mandate MOC (and certification). The CEO Baron worked for the NCQA. Bagattalia the CMO worked for them. Many others throughout the ABMS business matrix worked for them and has business relations with them.

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  6. Fraud and Waste On Public Display?Sat Oct 21, 08:17:00 AM CDT

    One of the greatest heist stories ever told in the ABIM and ABIMF tax forms

    For a real mind and neck bending crime story, look online at the ABIM and ABIM Foundation tax forms. Look at the stock trades in the 2001 and 2002 tax years. They gambled so much money the ledgers ramble on for countless pages with nearly endless stock trades. You can see the high flying fiber optic companies going south fast in their portfolio. TYCO alone almost turning their winnings into dust.

    But before the heavy losses were heavy gains. Starting in 1997 the ABIM went on a spending spree with their booty and winnings from fees and trades started transforming their Walnut Street offices into a palace and fortress. With their "war chest" they spent well over 4 million and counting on "depreciating assets" to complete the remake of several floors of their office building and MAKEOVER of themselves. And their MOC "brand". All this wanton expenditure puts the additional 2.3 million purchase of a luxury-in-the-sky-condo with service personnel into context. It all went to serve the "incoming president elect" and "incoming chairman elect". It puts it into perspective, how they used docs and kept it all hidden.

    I'm curious how much do they give away/spend during the changing of the guard in executive and officer compensation? I saw after my head was about to fall off, that they spend and document much of the expenses on multiple obscure lines of the tax returns, so you can't see it.

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  7. Professionalism in Art Project? Paid for by the taxpayer and physician fees!

    The tax forms show that they spent a whopping $85,000 in one pop for an art collection. That makes many of our political figures self-dealing art projects look rather tame in comparison. But even a 10,000 dollar painting is a big deal for the GAO office of fraud, waste, abuse and mismanagement. https://www.gao.gov/fraudnet

    The costly paintings appear to have been earmarked for the ABIM/ABIMF inner sanctum's walls. I wonder, can the public see that grand collection on display sometime? We paid for the collection. As a taxpayer I am outraged to discover that they would spend on just one piece of art nearly a thousand dollars just on some of the frames. I saw the price tag was 863 dollars just to have a painting framed.

    I recently went to an art show and was surprised that one could by 4 pieces of original one of a kind art for the price of their one "frame". It is hard times for a lot of people, including artists, who are struggling while the ABIM elites waste money and time and lavish themselves with every kind of luxury. If someone inquires they have their propagandist take care of it. I mean the image-making communications officers they use to clean things up. These are the same communicators who typically never return calls of concern about all the MOC changes and money they are socking away for themselves. And they hang up if you mentions their felonious director of investigations. And now they have the nerve to raise fees rather than tighten their belt like everyone else. The gall.

    And in total discord with reality they are in the business of mandating that doctors also waste money and time. For what? The MOC fees! The irony of this story shatters the brain!

    What about the Walnut Street art? The IRS implies that it should serve the public and be put on display in a gallery for the taxpayer who is paying for their profligate lifestyles and adventurism. And while mentioning waste, what about recovery money from the sale of the historic Ayer Building condo--furnishings, including the art. Did they just give it away, or did someone decide it was theirs? How much did they spend remodeling and furnishing and decorating Dicky's dacha?

    What happened to that "depreciating assets" from all their properties. They never list their art collections. At $4000 a piece, the taxpayer would like to know if it has been given away or tucked inside someone's golden parachute? How about the furnishings and art for the condo? Were the furnishings sold at auction? How come the Walnut Street art collection does not appear in their taxes.

    Self-dealing at its best for the ones of good taste? It certainly appears that way. How about a chauffeur and first class travel for me to visit the palace of the rich baron? I'd like to have a chance to enjoy "our" fine art collections, tailored suits, and nice designer leather chairs and sofa too!

    After all we paid for it.

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  8. I don't think you can do much about their investment profits except grit your teeth after realizing their investment capital were the pooled fees from everyone who ever took an ABIM test or related study aid.

    Let's look forward. The fact is just what Wes stated. This is a hugely profitable greedy "non-profit" organization who has been ripping off the Diplomates and our entire nation. ABIM does very little for society. It does not have any charitable endeavors and pretends that MOC is a panacea for all that is wrong in health care when in fact MOC is part of the disease process. ABIM and the ABIM stay afloat by abusing the tax code. They are in the same category as churches, hospitals, universities, temples, charitable foundations and other groups who try to move the needle for the greater good. The ABIM and the ABIMF need to pay taxes and lots of it. They need to pay Federal, State, City, property and transfer taxes. They need to pay long term and short term capital gains taxes. They need to stop riding on the coattails of John Q Public and every single one of us who actually see patients and take on call responsibilities.

    It is the duty of every single one of us to file a complaint with the IRS.

    https://www.irs.gov/charities-non-profits/irs-complaint-process-tax-exempt-organizations

    That URL will help you download a PDF that you can mail anonymously or not. The data have been compiled by Fisher, Cutler, Kroll, Teirstein et al. All we need is to galvanize us. Stop e-complaining and do something about it. For the cost of a lousy postage stamp you can formalize our request to the Federal Government to look into a fleecing of the American Public. The Federal Government is US. You, me, all of US. If enough complaints hit the mailbox, the IRS is compelled by Federal Code to do something about it.

    This is our Call of Duty.

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  9. We agree with "Call of Duty! It is time to act. Reporting directly to the IRS is a good strategy and actually a civil duty. It is outrageous what the ABIM, ABMS and other member boards have done in violation of tax code and rip off docs. Plus there are tax attorneys who help with this process in whistle blower suits where you receive a share of the taxpayer's lost money from violatory corporations such as the ABIM/ABMS (upon recovery of whatever money returns to the US treasury).

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  10. I am dumbfounded by the continuing saga of the ABIM. It only gets worse. We have to stop these professional medical bureaucrats at the ABMS from completely ruining the medical profession.
    I have never heard of such fiduciary irresponsibility, cunning cover-ups and outright graft in my life.
    For the ABMS to continue to push MOC is suicide. It is suicide for the member boards, societies and quality assurance organizations that get rich pimping for their corporate partners.
    Anyone who supports MOC does not know the facts, or prefers to keep the blinders on, because the money is just too tempting for them.

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  11. The man who would be ABIM COO - John K. Davis II

    More ABIM executives with conflicts of interest? Or is it something worse - Christine Cassel's IT strongman and chief information officer John Davis II - groomed beginning in 2009 to be the next Lynn Langdon, ABIM's long running COO and former boss of Ariel Benjamin Mannes - Director of the Office of Investigations. Mannes was a former cop thrown off the DC Metro police force. He ended up as a TSA agent by day and by night a bouncer in a DC night club, where a something caused him to unhinge and commit three felonies. Two felony convictions and the worse one was plead out by his attorney in court.

    We have some problems with Davis, though. Just like the misstatements on Benjamin Mannes' CV, we have the same cognitive dissonance in believing Davis' CV. There are huge gaps a mile wide between what Davis claims on his LinkedIn CV and what the ABIM tax documents show. And there is absolutely no announcements from the ABIM to verify it. He believes he was COO concurrently to Lynn Langdon's rule.

    So, who do we believe, Davis or the ABIM press releases and tax forms, or John Davis II? Given the ABIM's track record for lying and hiring people who misspeak, I say that we can believe neither of them.

    We should take a close look at Davis' work history anyway, because just like the former AbIM Chief of Staff, Suzanne Biemiller, who erroneously claimed she was the "Internal CEO" of the ABIM, both Chiefs had work connections with or actually worked for GlaxoSmithKline. That is interesting. Davis worked for SmithKline and Beecham before this iteration of big pharma was merged with Glaxo Wellcome, which changed it name to GSK. It became second largest pharma giant overnight.

    Now GSK is one of the top four. ABIM has no monetary payments made to them from "the industry", but it is clear the industry does need to pay them when they have their representatives on the inside. Biemiller had such a close working relationship with GSK as a representative of Philadelphia where GSK has their main US headquarters, it is embarrassing to speak about it.

    Who is Davis really and what roles did he play at the ABIM? Unfortunately we only have Davis at his word and a single press release from the ABIM.

    A search for Davis or Langdon on the ABIM website draws a big blank. How did that happen? Langdon was connected with many studies at the ABIM, but somehow there search engine has made her "go missing". Did the former CIO have something to do with this - helping the data to slip between the digital cracks. Deleting histories and other important documents. That makes room for much more important and profitable server space at the ABIM - hitting on physicians' personal lives, practices, credentials and other information that they can sell. Or is it all on the cloud - with a fee paid to provider of cloud services and a bitcoin flowing back to them from their rich data-hungry partners. (Physician fees pay for intrusions of their own data and on their lives as we have seen over and over. Pretty scary stuff that has been exposed.)

    John K Davis II: A former ABIM mystery CIO (and COO for two years or so he claims) holds a masters degree in business administration with a concentration in international business - (Drexel U, Philly, MBA). Davis had no history working at not-for-profit orgs.

    Why was there another ABIM COO we did not hear about. It's intriguing. More deep conflicts of interest with the healthcare and financial industries at ABIM? it appears o and deep ones.

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  12. No lobbying? $120K to K Street says otherwise. 2010 ABIM 990s under independent contractors.
    Page 3, NO to lobbying and page 8 120K to lobbyist Jennings. Lying to the IRS?

    https://projects.propublica.org/nonprofits/organizations/390866228

    "CHRIS JENNINGS

    FOUNDER AND PRESIDENT
    Chris Jennings is an over three decades-long health policy veteran of the White House, the Congress and the private sector. In 2014, he departed from his second tour of duty in the White House where he served President Obama as Deputy Assistant to the President for Health Policy and Coordinator of Health Reform. He served in a similar capacity in the Clinton White House for nearly eight years.

    From his positions in the executive branch, Mr. Jennings has helped implement the Affordable Care Act’s access and delivery reform provisions (for President Obama) as well as played leadership roles in the development, passage and implementation of bipartisan health reforms, such as the Children’s Health Insurance Program, the Health Insurance Portability and Accountability Act (HIPAA), the Prescription Drug User Fee Act (PDUFA) of 1997 and major Medicare reforms in the Balanced Budget Act (BBA) of 1997 (for President Clinton).

    In his decade of service in the U.S. Senate, he served as the Deputy Director of the Special Committee on Aging for three Senators (Glenn, Pryor, and Melcher) and led major reform efforts in the areas of long-term care, prescription drug coverage/cost containment, and rural health care. In this capacity, he also served in a major role for the U.S. Bipartisan Commission on Comprehensive Health Care (also known as the “Pepper Commission”).

    Outside of government service, Mr. Jennings has been a senior health policy advisor to seven Presidential campaigns, the 2008 and 2016 Democratic Platform Drafting Committees, and multiple gubernatorial and Senate candidates. Recognizing his pragmatic nature and experience with key Democratic policymakers, the Bipartisan Policy Center (BPC) sought Chris to serve as a senior advisor on a number of health reform projects, including reports and recommendations on access, delivery reforms, cost containment, and long-term care.

    Jennings Policy Strategies (JPS) is a nationally respected health care consulting firm committed to assisting foundations, purchasers, health systems and other aligned stakeholders develop policies to ensure higher quality, more affordable and sustainable health care. He has consistently worked to develop administrative, legislative, and private sector policies/interventions to ensure better stewardship of and a greater return on investment on the nation’s $4 trillion investment in health care. In addition to his consulting work and his collaborations with think tanks Mr. Jennings is a frequent contributor on health reform issues to publications such as the New England Journal of Medicine, Health Affairs, and the Atlantic."

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  13. Courting conflicts of interest (influence by all means)

    Did all that 'dynamic 'transformation' and 'quiet restructuring' at the ABIM eliminate the 'corrupt COO position' and the 'felonious offices' of the 'director of investigations', as the ABIM allegedly "executed the organization’s new strategic stance, moving from an authority-based model to one that actively engages its community in program design and shifting how the ABIM communicates to its varied stakeholders."

    https://webcache.googleusercontent.com/search?q=cache:cGn3PX1bEekJ:https://www.reuters.com/article/us-gsk-romania-corruption-exclusive-idUSKCN0Q32A920150729+&cd=9&hl=en&ct=clnk&gl=us

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