Thursday, August 01, 2019

AntiMOC Lawsuit Update

As the summer winds on, I have been approached by more and more people who would like an update on where the litigation filed against the many member boards of the American Board of Medical Specialties stand since the lawsuits were filed. I will do my best to briefly summarize the status of those lawsuits as I understand them. (For background on why these lawsuits have been filed against so many of the American Board of Medical Specialties specialty boards, please review this video).

The antitrust suit against the American Board of Internal Medicine (ABIM) was originally filed 6 Dec 2018 and amended 23 Jan 2019 to include RICO charges, the antitrust lawsuit against the American Board of Radiology was filed 26 Feb 2019, and the antitrust lawsuit against the American Board of Psychiatry and Neurology (ABPN) was filed 6 MAR 2019. These cases were filed by a law firm based in Chicago. A fourth lawsuit was filed by a separate law firm in Southern District Court of California on 19 Feb 2019 against the American Board of Medical Specialties (ABMS), the American Board of Emergency Medicine (ABEM), and the American Board of Anesthesiology (ABA).

Each of the member boards are represented by different law firms.

Three of the specialty boards (ABIM, ABR, and ABPN) have appeared and, as expected, filed motions to dismiss with mostly overlapping arguments. The motion in the ABIM case was fully briefed a couple of months ago (Motion to Dismiss here, Opposition for Motion Dismiss here), the ABPN motion was fully briefed last month (Brief in Support of Motion to Dismiss here, Opposition to Motion to Dismiss here), and the briefing in the ABR case should be finished mid-August.

In the interim, a motion to consolidate the above cases (brought by the law firm representing the plaintiffs in the ABMS/ABEM/ABA case) which the plaintiffs in the ABIM, ABR, and ABPN cases opposed out of the concern that it might delay the cases and add to their cost, was denied. So these three cases (ABR, ABPN, and ABIM) will each continue on their own in the federal courts in Philadelphia (ABIM) and Chicago (ABR and ABPN).

It would not be unusual for the courts to take several months to decide the motions to dismiss, especially given their complexity and importance. Discovery for these cases will begin once the motions to dismiss are decided, which is hoped will be no later than the end of the year. As I am sure many of my readers have already observed, the litigation seems to be having a modest impact, as many specialty boards and specialty societies claim to be re-thinking their Maintenance of Certification (MOC) requirements, at least around the edges.

It is important that physicians continue to help fund the GoFundMe page sponsored by Practicing Physicians of America. (Remember, short of processing fees, every penny of those contributions will to toward these continuing legal efforts.)

In summary, I believe the legal cases are progressing as well as can be expected and I remain convinced that, together, working physicians CAN end Maintenance of Certification's stranglehold on US physicians nationwide.



  1. It is so good to see that the various legal nooses are now tightening around the scrawny ABMS neck. Reading the complaints makes it abundantly clear just what a total scam MOC is and the degree to which all US physicians have been harmed by it.

  2. "Veritasiness" is the group-think word describing OPERATION MOC and ABMS' ongoing plans to invade physician/patient rights.

  3. MOC = the corporatization and monetization of professional medical education

    From prostituting for big tobacco to pimping for big data the ABIM/ABMS sold out to the highest bidder (decades ago) marking the end of the era of "self-regulation".

    ABMS/ABIM claims of "voluntary certification/re-certification" are patent lies. The word "voluntary" died with a trademarked lie. MOC®. Words matter. Truth matters.

    What does this mean for physicians and patients? It means corruption rules at the ABMS. None of these greedy politicized trade associations (ABMS and 24 medical boards) are "of the profession" or "for the public". They are for themselves and the elites they serve.

    Patients' rights (lives) matter. Physicians' rights (lives) matter. Better pass around the hat to help end this corruption with class action/individual lawsuits in federal court.

    Thomas Brem ABMS/ABIM prostituting for big tobacco (under oath in Congress paid by slush corporate slush funds)

    Christine Cassel ABIM/ABMS/NQF/Kaiser Permanente/Premiere, Inc. pimping for big data/payers/"industry"/Wall Street, etc. (under corporate contract and under oath of office in the White House PCAST)

  4. I loved my 20 year career outside of my field of Internal Medicine but my career in Occupational Medicine was taken from me recently because administrators required Recertification in the field that was not relevant to the medical field in which I was employed. I had passed the ABIM Recertification 10 years after leaving a practice of Internal Medicine but after 20 years, at age 72, I was not going to invest the time and expense to prepare again by memorizing irrelevant medical knowledge. Before MOC requirements, physicians would continue their careers into old age, beloved by their patients.

    I am so happy to see progress against the ABIM MOC requirement!!! I graduated from Med School in 1991, just as MOC went into effect. As an older student, receiving my MD at the age of 47 and passing my Internal Medicine Boards at age 52, I felt we, physicians, are life-long learners and paid a stiff price in time and money for our careers. Why should our employability hinge on administrators whims of Board Recertification and MOC. We had proved ourselves by our initial training. I had feared it would take until my younger classmates were nearing my age to discover the burden of Recertification and MOC, and indeed, this is the case. I have joined the National Board of Physicians and Surgeons but recruiters tell me employment requires ABIM Recertification.

  5. I totally agree. I have not taken ABFM boards in a long time due to the cost if certification etc. Now that I closed my private practice two years ago, I am having to recertify this fall because even locum tenems positions require that piece of paper instead of my thirty plus years of experience. I have no intention of going back to OB at age 62 but I have to review and study that module. With instant access to medical information why do we need to regurgitate information irreleva t to our current scope if practice.
    Do not get me started on the MOC requirements that I face.

    Thank you for th8s fight.

    Dr. T

  6. I don't know why this comes as a surprise. Looks at the money involved...

    I remember when looking for my first jobs
    out of residency, someone told me that "Never lose sight of the fact that sharks eat their young".

    In this case, the sharks aren't just eating their young, but instead are well on everyone except themselves....

  7. Agree with the previous commenters that to find the motivation...just follow the money. I would point out that the AMA is in the same boat. They have so wed themselves to the insurance industry through the CPT/E&M coding system that this system is their primary source of income and therefore representing MDs is secondary in importance whether they admit it or not. As our esteemed congressperson said..."its all about the benjamins".

  8. An irony is that the boards are likely using the money raised from the fees doctors are forced to pay to fund their lawyers to fight these lawsuits against the very doctors who are trying to stop this MOC!!

  9. it did start with chris cassell md who is now MOC disavowed in her latest job in California. She is still smiling. Where is Dr Mcauley

  10. Full disclosure....I am 60 years old and grandfathered by the ABPN and don't have to recertify. I am however appalled by the business motive that has fueled the recertification process. Let's just understand.... The ABPN is using my nearly $1000 annual dues to fuel the legal resistance to what I can only assume is the will of the majority of its members? - absurd.... let justice play itself out - the madness needs to stop.

  11. In 1938 the ABMS appointed themselves and over the next decades began demanding money from their diplomat members. Who put them in charge -- why they did. Who gave them the power to demand money -- why they did. Who let them? We did, and we all deserve a solid flogging for letting this go on for so long. Richard Baron is the current CEO of the ABIM. Since its founding in 1938 he is the first and only practicing physician to hold the post. That speaks loudly.

    When Baron took the job he shared a story of a physician who inspired him -- an Army Doc in WWII assigned to take a TB patient by train to a sanitarium I believe in NY state. The Doc skipped his duty to sit for the Internal Medicine Boards. Baron praised him for being dedicated to 'His Board'. He was so dedicated that he deserted his post in time of war, exposed the public to a contagious incurable disease, and endangered his patient who was deemed too infirm to travel alone. He probably scored very well on 'His Boards', but I wouldn't trust him to care for anyone who mattered.

    Someone needs some counter-indoctrination. I am board certified by two ABMS boards, I do not use them for any credentialing. No organization has ever turned me down. If any do, I simple will not work with them.

  12. Private practice 5 days/week, long hours, coming home, turning the team viewer and finishing notes till midnight.
    1-2 short weekend days fly by. No time for myself or family, needless to say about PIP, MOC, “life long learning path “ or other crap they invented to make my life miserable. Becoming BC (Inactive) - new slang, may put me out of some insurance participation’s, ending my private practice.
    Need to drop all APBN/ ABMS requirements and let patients decide who they want to see .
    Hope the law suit will bankrupt them all, like it did to APS (American pain society) , so they will leave docs to practice in peace.

  13. Keep up the good work. The ethical standing of all boards has been undermined by the greed with which they extort the diplomates. Few in the public care about this but it’s a real problem.
    I am particularly annoyed with the board of plastic surgery which prides itself on ethics but yet participates in these scams. Every year when I pay my dues I send them a letter of protest for what they are doing.
    Regardless of outcome of these lawsuits, outing the boards on their greed is something all of us should be doing.

  14. For what do they need the additional MOC money (the fees charged) in the first place? The MOC programs really boost yearly cash flow, but for what? All of these boards ran just fine without it for decades.

  15. A very simple question to put to every Department Chairman and Residency program director:

    “Do you believe that when a resident graduates from your program they are fully qualified to deliver care in their specialty to the community regardless of board certification?”

    Put them on the stand. Depose them.

  16. After spending over $3,000 for EP board review (course cost, hotel, travel), taking three days off work and spending 15 hours previous in preparation, I decided to take the 10 year in the spring of 2020. For the amount of time I had spent and the uncertainty surrounding 2 year, 1 year and now the potential 90 day option, I decided to do to 10 year to get it over with and not be burdened with stress, contending with a "do or die" exam even more frequently than 10 year. As I went to the ABIM website to register for the Spring exam, I discovered it is no longer being offered! Now, I have to wait until the fall of 2020 for the 10 year!

  17. Please check out the Association of American Physicians and Surgeons(AAPS/ They are a very strong supporter of private practice, physicians and patients rights. They appose MOC and many other onerous regulating bodies. They often file suit against medical boards and the ACA. They are totally supported by physicians. I'm sure they can help in the fight against MOC. They are the only organization that is truly looking out for us. Please consider supporting them.

  18. Several yrs ago, the president of ABP,Dr Bruder Stapleton returned to Buffalo and was asked to.ptesentnto the local pediatric society. Intrepidly, I asked during the Q&A about ABP being out of touch with young pediatricians and not caring about the arduous MIC unraveling before them. My blasphemy was greeted with silent gasps as I witnessed the old guard (All grandfathered) closing ranks. Their loyalty to a former chair of pediatrics notwithstanding, it was an embarrassingly accurate depiction of the medicine landscape and the challenges we are facung.

  19. Is there a way a law suit could force organizations like ACP to disclose how much of dues goes for their litigation costs so that we might deduct this portion from our dues payment if we disagree with this? Or else we are supporting their fights against member physicians!!! Just a thought.... I am grandmothered.
    Also, when I looked at AAPS website, the honored speaker was Ted Cruz.

  20. Thank you for the update. It’s long past time for this to end and for physicians to be released from the MOC stranglehold.I’m sure it is one of many factors that contributes to burn-out and early retirement.

  21. I am the mother of a 50 year old physician who is going through all this like you are. He/she has to take 4 boards. Keep up the good fight and you will get a life as well as boost your self-respect. The AAPS needs to be part of this.

  22. I'm an FP. BC since 1982. As time has gone on the process has gotten more expensive, less transparent, and less relevant. Now I'm shocked (SHOCKED!) at how poorly the Board is updating their website and how unresponsive they are to gross inaccuracies in the certifying materials. Yet the ABFM is not getting sued. Why the heck not?

  23. In any other field, the MOC/proprietary counting of CME credits/ and related activities by the various boards and their umbrella organization would be called racketeering and restraint of trade. We have it because we allowed it. Just say no...drop your memberships in these groups and stop sending them a nickel. When confronted with the bizarre system they concocted, and after voluntary recertification one time, I refused further “participation” in their program. I offered my boards the return of my so-called lifetime certificates. I proudly wear my badge of “non-participation in MOC”. My patients never cared about or even understood the entire concept. Neither did the payors. Now retired at 73, I read medicine both on line and in print almost daily, mostly because I like it. When doctors stop letting these organizations cheat and steal, it will end. You can make a difference, and end the oppression and graft.

  24. "MOC" sounds good on paper. It has proved essentially worthless in my plastic surgery specialty. Older physicians, some still practicing were exempt. The cycle is one of paying a yearly fee for enriching the board and playing silly games which they construct. I feel no better a physician and surgeon taking part in this charade. It should end!

  25. A thought from the author, Robert Anton Wilson --

    "The Ultimate Weapon isn't this plague out in Vegas or any new super H-bomb. The Ultimate Weapon has always existed. Every man, every woman, and every child owns it. It's the ability to say No and take the consequences."

    It's time to say No.

  26. I certified with the ABMS originally in my specialty and again in my sub-specialty. Ii subsequently re-certified ten years later. For all three of those evaluations, I was evaluated on my knowledge base and judgment on utilizing that base in clinical practice. As my next ten-year re-certification deadline approaches and I began to complete the requirements for the MOC, I found myself answering a barrage of test questions in order to reach the required number. Next, I was faced with coming up with a 'care improvement documentation project' that was sufficient to satisfy the MOC requirements but no so time consuming as to be counterproductive to my practice. We decided to perform a survey and analysis of the wait times in my clinic and ways we could improve any problems. Although I fail to see how this reflects on my ability to perform the medical sub-specialty I have been for over twenty years, I believed that ABMS certification is important.
    during this time, my metastatic melanoma returned for the third time and I had to take significant time off because of the effects of the disease and its treatment. It was all I could do to get some patient care done at work so the MOC activities were deferred for a time. After re-evaluating my future in practice and the amount of time necessary to satisfy the MOC requirements for another ten year certification, who knows how many of which I will be around for, I have decided to forego re-certification.
    fortunately, or unfortunately, my hospital system has not place a high priority on board-certification. Many older physician were 'grandfathered' into staff privileges without certification and despite an executive committee decree and numerous advertisements about all the board-certified doctors practicing at our institution, newer staff members have been given privileges without being certified in any specialty or by non-ABMS 'boards' who may be nothing more than 'pay-for-paper' document mills. One pain practitioner was listed in the hospital directory as being 'certified' by the "American Board of Pain Management". When I asked the administration whether they meant the American Academy of Pain Management or the American Board of Pain Medicine, the listing was removed from that doctor's profile. Another neurologist was listed as being 'certified' by the "South Carolina Board of Medicine", which means after over a decade of practice, he had no specialty certification in ANY specialty but had obtained his state medical license.
    I'm planning on telling my patients that I have been certified twice in my career but given my circumstances, I will not be paying to have it renewed and let them decide if that changes how they feel about the care they have received over the past twenty years form me.

  27. The ABA changed it's way of reporting who was "certified" just a few years back. You are certified for 10 years, but on their site they report either "participation or non participation" in MOCA as a means of separating those going along with the program.

    They did allow just 2 years ago those of us fellowship trained pain guys boarded in both to participate in a combined program and save a little! So nice. I was in the first year given this need to recertify. If those "grandfathered" in by all this all this coercion ever signed up, they lost their ability to ever change back to their original status.

    I would need to do the recertification deal only about one more time, and that would have lasted until retirement. But, as of now, I must pay monthly in order to maintain a "status" that is reported to any healthcare agency.

    This is long overdue. Will join the fight.

  28. I recently tried to change my license from active-retired to active-active. Since I had been
    retired for 5 years, after 30 years of practice in psychiatry, the board informed me that I needed an evaluation for fitness. Well ok, no objection. If deficient in any areas I would need to take remediation in a nationally recognized program. Well ok, no objection, actually could be exciting. However, I then found out the cost could be 8,000-16,000 or more! I inquired about grant money but of course the programs were not aware of any.
    I guess my impression that the nation needed psychiatrists and encouraged physicians who retired early to come back into practice was just more, what is the expression "talk-speak"
    or something like that. After reading the above, even if I go through all the hoops, will my
    grandfathered BC in psychiatry-neurology be accepted? Will the LT clients say they will not accept me because I need to MOC it up!
    I am very interested in what the readers on this blog think.

  29. To date I've only heard of a few 'grandfathered' certifications being not recognized. Mostly ER docs. There was a good number of IM and FP docs who grandfathered into ER certification. The ER docs who are residency trained have done a good job shutting them out in several communities I know of. I think psychiatry is safe, there are so few available I can't see them turning anyone away.

  30. There is only one way to deal with this: If all doctors refuse to participate this MOC examination it will fall apart. Mahatma Gandhi would have recommended this.

  31. 2020 would be my first round of re-certification in IM with ABIM. I am an Osteopath and I have AOA CME requirements for the state I practice in. I am have spent several hours trying to talk to an administrator at ABIM and AOA to see if there are CME's that would cover both MOC/AOA. At this point I have to juggle fulfilling both requirements which means time away from patients/clinic and the financial burden of $2000. Let alone the time and effort of finding CME's close enough to home and trying to stay within budget.

  32. Wake are poor and abused!
    The redo on boards more salt on our chronic wound!

    Try that with the IRS will be in jail!


  33. The reason is money, just like it always is.
    Several years ago, my legislature passed, literally in the night, a bill that states when an insurer refuses to pay for a procedure or service that is specifically covered in the policy, that is not considered practicing medicine, essentially giving the insurers carte blanche to do or not do anything they want without regulation or repercussion.
    About this time, it was reported in the news that a VP for an unnamed insurance company (two colors, religious symbol and an ancient item used for defense in combat) bought a half-acre of totally undeveloped island beachfront for three million dollars so we know where a lot, if not most, of all this money they are 'saving' their policy holders is going.

  34. I find the material in ABIM exam extremely broad and heavily including the fields of subspecialties. In no way is it close to my day-to-day practice. MOC recertification does not seem to care that aging physicians in their 50s – 60s face difficulties to memorize and retrieve multiple facts. Combining the demanding job of a physician and preparing for MOC re-certification practically leaves normal living out of the equation. And if we don’t pass the exam, we are out of work. All these hours of study and countless sacrifices … Sadly, we reached the state when no-one cares about well being of those providing care.

  35. The greatest failure of Internal Medicine Education is that everything we do is taught by and judged by specialists. In my time there was not a single internist to look up to as a role model. At its worst general internists were to send patients to and mop up the scut work of so the specialists could focus on doing expensive procedures.

    That was before MOC. MOC adds insult to injury and robs us of our money, our time and our dignity. I know a doc who took his recert at 8 years so it would not be such a crisis if he didn't pass at 10 year -- he flunked AND THE ABIM CANCELED THE LAST TWO YEARS OF HIS CERTIFICATION. It was a full year before he could try again.


Note: Only a member of this blog may post a comment.