Friday, September 14, 2018

When the Walls Start Crumbling Down

From the Department of Justice via the NBPAS website:
'The DOJ explained that the ABMS Program on MOC may have the effect of “harming competition and increasing the cost of healthcare services to customers.” ABMS may do so “by imposing overly burdensome conditions on physicians who wish to maintain their certification.” The DOJ added, with respect to ABMS, “[the] vast majority of [its] board members are medical doctors”—i.e., “active market participants”—who may have incentives to limit competition through “industry self-regulation.” As a result, the DOJ warned, “there would be competition concerns, if dominant certifying bodies [like ABMS] set de facto participation requirements that did not sufficiently correspond to health, safety, or other procompetitive justifications.”'
While this letter is very helpful to the National Board of Physicians and Surgeons (NBPAS) and detrimental to the efforts of the American Board of Medical Specialties and their subsidiary boards to monopolize the physician continuous credentialing system in states' legislation accross the country, it might not be entirely advantageous to employed physicians because of this paragraph on page 14:
"At the same time, the Division discourages the legislature from interfering with unilateral business decisions—such as an individual hospital’s decision about what criteria to use for granting hospital privileges or an individual insurance carrier’s decision about what criteria to use for allowing participation in the insurer’s network, as restricted in the Workgroup’s Bill—unless a restriction is determined to be necessary and narrowly tailored to redress well- founded consumer harms or risks. ... The Division encourages the Maryland legislature to consider whether other tools, such as facilitating entry by competitive certifying bodies, can address concerns with certification without imposing restrictions on the unilateral business decisions of hospitals and carriers."
Still, this letter represents a significant blow to ABMS in their efforts to prevent NBPAS's entry into the physician maintenance of certification (or "continuous certification") market as 30 states have some form of anti-MOC legislation either pending or passed.



Anonymous said...

Is the DOJ looking into them as a Ponzi scheme? Have they looked at Mr. Kroll's investigation accounting into the ABIM? What is the AMA's response to the DOJ's letter? How does the ABIM respond to this and to all the diplomates?

Anonymous said...

I'm surprised even with this opinion that all the states medical boards have not condemned MOC as there are standards of professionalism and issues of doing no harm. I wonder if those docs who manage the boards are being influenced in some ways as the regular doc can see this sham.

Anonymous said...

This is the ABMS response from their website:

"For that reason, we believe that claims of Board certification should be based on transparent standards that will genuinely advance the interests of patients and avoid deception. We are confident that, when compared to any other specialty certification programs, ABMS Boards can clearly demonstrate the superiority of their certification programs in giving useful information to hospitals, payers, and patients. It is for this reason that hospitals, health plans, consumers, and even providers themselves, overwhelmingly select ABMS certification as the gold standard of specialty care."

They said transparent standards and they said they can clearly demonstrate their superiority of their certification programs. This sounds like they should have to prove this to the DOJ that there is even any benefit at all. Time for them to eat their words and prove it to the state medical boards and DOJ. Remember, their words when they have to prove to their members, and patients that MOC and the specialty boards are actually harming patients and physicians.