Friday, November 15, 2019

Timeline for Justice: ABIM v Salas Rushford

A young resident physician, Jaime Salas Rushford MD, came to New Jersey from Puerto Rico to study for his initial American Board of Internal Medicine (ABIM) board certification examination with an ACGME-approved Arora "Unusual Board Review" course. He later took his examination and passed, making him officially board certified on 8/20/2009.

Over three years later, he received a letter from Ms. Lynn O. Langdon, Chief Operating Office of the ABIM at the time, that his board certification was suddenly, indefinitely revoked because of claims he "collected and compiled hundred of ABIM examination questions from multiple sources" and that he "sent hundreds of ABIM examination questions" from his email to Arora Board Review. The letter implied he did "not maintain moral, ethical, or professional behavior satisfactory to the Board," engaged in "misconduct adversely affecting " his integrity, and engaged in "behavior that subverts the examination process."

Because the ABIM felt he violated their "Pledge of Honesty," the Board elected to "indefinitely revoke" his certification and "notify the Medical Board in every jurisdiction" that he was licensed.

He had 10 days to appeal that decision through a never-disclosed ABIM "three-stage appeal process" that lasted two years. Following this, he later discovered the ABIM had filed a copyright infringement lawsuit against him.

He describes the ordeal in detail here. In that description, he notes the additional reprimanding of some "2700 physicians," the use of a "spy" sent to the board review course he attended, the secret funneling of millions of dollars of ABIM Diplomate testing fees to create the ABIM Foundation, the raid using federal Marshals of Dr. Arora's home to copy computer files and secure physician's email addresses, and the undisclosed conflicts of interest of Christine Cassel, MD, former President and CEO of the ABIM, none of which were known to Diplomates of the ABIM at the time.

Instead, the ABIM issued a press release that was picked up by the Wall Street Journal and shocked the medical community on June 9, 2010, detailing the sanctioning of 139 physicians for claims of "cheating:"
"Any high-school kid knows that cheating is unfair," said Dr. Christine Cassel, president and chief executive of the ABIM, who called the sanctions "a message and a deterrent."

The ABIM's move springs from a case involving test-prep firm Arora Board Review, which it sued last year. The ABIM's suit alleged that Arora instructors told class members the review questions were from the actual exam and solicited them to supply the company with additional questions they remembered after taking certification exams.

The ABIM and an attorney for Livingston, N.J.-based Arora both said they are in settlement talks. Arora's website says it has "put [its] business on hold until a settlement is reached in the near future."

Materials seized from Arora in December as part of the case included 2,000 emails and audio and other communications from physicians disclosing exam questions, according to the ABIM.

Based on these materials, the ABIM sued Monica Mukherjee of Washington, D.C.; Anastassia Todor of Aurora, Colo.; Pedram Salehi of Los Angeles; Sarah Von Muller of Tulsa, Okla.; and Frederick Oni of Warner Robins, Ga.

Dr. Mukherjee couldn't be reached for comment. Dr. Todor and Dr. Salehi had no comment. Dr. Oni said he didn't know the questions he purchased were from previous tests.

Dr. Von Muller said courses like Arora's are necessary for busy physicians attempting to get their optional board certification.

Dr. Cassel said she doesn't believe sharing or selling actual questions is common. "We have a great deal of confidence that most people don't cheat on this exam," she said, adding that there are "legitimate board-review programs that continue to function." (The ABIM doesn't offer its own review courses.)

The "hundreds" of allegedly infringing questions used by the course were removed from the pool of questions used on the computerized tests starting in 2009. Doctors who took the Arora course but weren't sanctioned or sued will get letters of reprimand, the ABIM said.
The ABIM subsequently lost the copyright infringement lawsuit against Salas Rushford, but his counterclaim lawsuit filed against the ABIM goes on after being recently moved to Puerto Rico Federal District Court.

On 7 Nov 2019, the case management order for this lawsuit was published by the federal judge Francisco A. Besosa with the following timeline:

  • 29 Nov 2019 - Objections to Case Management Deadlines and all outstanding pleadings due.

  • 3 Dec 2019 - Motions to amend the pleadings or add parties to be filed.

  • 31 Jan 2020 - initial Case Management and Settlement Conference

  • 29 May 2020 - Motions to Dismiss must be filed

  • 30 Dec 2020 - All discovery must be completed

  • 9 Apr 2021 - Pretrial and Settlement Conference

  • 19 Apr 2021 - Trial Shall Begin (09:00AM)

The wheels of justice might turn slowly, but they are turning. The number of lawsuits currently underway against the ABIM is mounting and while it appears they will stop at nothing to maintain their monopoly, the activities that took place in the case of these physicians need investigation and explanation.

Perhaps now light will shine on the inner dealings of the so-called "voluntary" US Physician Board Certification process that has harmed practicing physicians without accountability or means of due process for years.



Jude said...

The ABIM has created 200k perfect storms of pain with its greed, arrogance and lust for power.

Dr Kartenhaus said...

Illegal abuse is their specialty.

ABIM's Dirty Money/Dirty Secrets said...

One thing you cannot do with the ABIM is trust them.

They stole physicians' hard earned money by upbilling/overcharging them for tests and adding MOC as a surcharge. From 1989 through 2007, right after they created MOC, hrough a series of illicit/unethical money transfers the ABIM's executives and BoD ran it through their secret money laundry (ABIM Foundation formed 1989/1999).

The history is very clear. They created a political/corporate war chest with the money. One of the bad things they did was to hire a double-felon as a spy and "hitman" to do harm to physicians with that dirty money. They ABIM set up their clandestine "bureau of investigations" with that money and in 2009 after Christine Cassel (ABIM CEO) was appointed to advise the POTUS on "science" (PCAST) implemented their horrific plans.

It was not long after the ABIM secured power that they abused that power. Cassel, Baron, Holmboe, Langdon, Mandes, Mannes, Wachter et al implemented their evil plans by persecuting thousands, while at the same time intimidated 900,000 diplomates/candidates in order to build a political and financial empire for themselves, their associates and partners.

It is clear that Dr. Salas Rushford's kangaroo court and subsequent bogus time-barred lawsuit were part of a political hit job to further their dark agendas. The persecution and public debacle is further evidence of the ABIM's corporate policy of monopoly. Intimidation/abuse is a their clear corporate message and political statement that their empire/monopolyis/ was not to be messed with. The facts need to come out in discovery on this continuing dark story about the ABMS/ACBME and their flagship medical speialty board. The ACP and AMA as cofounders of the ABIM have dirty hands as well in this ongoing illicit MOC/power/money-related debacle.

The hidden relationships that exist between the ABMS/ACGME and other corporate bodies with much larger wealth/influence, such as insurers, hospitals, private equity groups is a criminal matter that should be referred to the DoJ, IRS, and OIG of the HHS. The ABMS/ACGME and associates are involved in one of the most widespread schemes to defraud the American public in false claim of public safety. MOC is a central character to be investigated in the corporate shenanigans, malfeasance, and criminal activities. Unless all this is brought to the attention of the American people factually, the public will continue to be defrauded and their health and healthcare will continue to be placed in serious jeopardy.

Wolters Kluwer - CCH Cloud Data Breach said...

How safe and how private are your data? The ABIM has proven that it is not trustworthy or reliable. Both of its partners have problematic histories as well.

ABIM and their testing partners PearsonVue/Wolters Kluwer have had serious technical issues and literal shutdowns/technical service breaches in. As result the ABIM has not been able to reliably offer/conduct its online proctored 2-year Knowledge Check In. Physicians and their patients have been harmed by the MOC mandate and the meltdown of their technology that they rely upon.
The new version of Apple operating system was announced to be not compatible with KCI.

Was anyone's personal information compromised or hacked during these reported outages of service and work with unknown third parties? Wolters Kluwer owns UpToDate which is offered as a tool during the high stakes Knowlege Check In.

ABIM downplays the seriousness of the harm they have caused physicians. The ABMS/ABIM is keeping physicians on hold and in the dark about real issuses and concerns. Sometimes the only way to get satisfaction and relief is to sue. I am glad to see that Dr. Salas Rushford is standing up for his rights and ours as well by seeking compensation for the personal and professional harm that the ABIM obviously caused him.

Anonymous said...

Classic "Casselian doublespeak" when cheaters like Chris and Rich point fingers at their victims.

Milking Da Data Cows said...

ABIM is on the front lines of the health equity markets fighting for you.

Their stellar investment teams are focused on helping physicians stay stress free and keeping the public safe by being good stewards of the ABIM's lucrative portfolio of MOC, Big Data and Stock. Giddy from watching their offshore hedge funds grow. (In theory,

Golden parachutes for the promised few.

Investing / merger of their MOC money with private investment (on the sly) is why ABIM in 2015 hired a CMO who previously worked for PwC. (Not a physicians at all and not even living in Pennsylvania.

Rich was hired to "merge" ABIM's illicit MOC proceeds with other promising new enterprises.

Hats off in honor of ABIM's supreme magnanimity shown toward physician wellness and sacrificing their lives in the occasional dedication to testing. the full-time charitable contributions toward the reduced health of physicians and their patients.

Who was that corporate spy they hired in 2008 again. Mandes"? Milking his data rich cows.

Questioning ABIM's Honesty said...

How honest is the American Board of Internal Medicine (ABIM) in presenting their executives and conflicts of interests - perceived or actual?

The answer to that question is unequivocally no! Richard Baron is not very truthful or trustworthy in this regard and neither is his number two in command Richard Battaglia, formerly with PwC, a "big four accounting corporation" with their headquarters in London.

The ABIM and their communications executive/public relations director Pamela Browner White obliterated and marginalized their Chief Medical Officer's employment history with PwC. (PriceWaterhouseCooper). Anybody who can't see the sham here needs to take a step back with the ABMS and examine their integrity to serve in the interest of public safety and not the interests of WAll STREET.

This withholding of pertinent facts is reprehensible as it shows very clearly how the ABIM (ABMS/ACGME), NCQA and many others work together in a pathway of patent collusion to control physicians. This financial and professional abuse needs to be exposed and stopped.

They control their "labor force" in order to promote business and not safety. MOC is one of their biggest levers - a huge one. And the ABMS/ACGME/NCQA/Payers/Global Fortune 5000 hide these important facts hoping no investigative journalist or federal, state and local purchasers of healthcare will dig deeper into these not-for-profit "trade associations" and why they really exist.

Their primary reason for existence has (if you can believe their mission at all) morphed from testing/certification companies/accreditation bodies, serving the public safety interests, transformed into full blown "Wall Street/Silicon Valley" partners and the "payers". Specifically, I'm speaking of their close ties and work with "Wall Street", the big five (now four) "accounting firms", private equity markets, insurers, large global fortune corporations. Plus there is clear evidence that they have choked out competition with leverageing their improper relations with federal, state and city payers to promote business models and large healthcare plans to improve their bottom lines and not public safety as is falaciously presented by them.

MOC is one of the biggest fallacies promoted, which does actual harm to the public and profession. ABIM claims to be "of the profession and for the public". Nothing could be further from the truth. Facts reveal that they are a corrupted institution in bed with other corrupted trade associations to promote profits and not public safety.

They need to be investigated by the DoJ, IRS, and OIG of the HHS. This includes the executives who wittingly conduct business as usual on a daily basis and hide these current facts and the total misrepresentation of their broader histories.

Penetrating ABIM's Corrupt Wall of Silence said...

Here's a truer picture of the work history of Richard G Battaglia, the ABIM's unelected "Chief Medical Officer". PwC appears prominently in the CMO's linkedin profile. (CMO, in this case means obviously, Chief Money Officer and not a liason between physicians and the illegal/harmful MOC program. You can clearly see the relationship with the NCQA, which Richard Baron has a "revolving door" with as well.

By the way, corporate and special interests are promoting the "longitudinal assessment" pathway and not physicians or the public.)

Here's how the ABIM obfuscates facts and deserves a tarnished lead star for transparency. Compare the actual recent work history of the ABIM's CMO and what they wright. The examples are numberous and this is not an isolated incident of misrepresentation of the ABIM or its executives, many of them who do not live and work in Philadelphia.

"Richard G. Battaglia, MD, FACP, Chief Medical OfficerExpand/Collapse Content
Dr. Battaglia, a board certified internist, is Chief Medical Officer (CMO) of the American Board of Internal Medicine (ABIM). There, he leads ABIM's effort to incorporate feedback from practicing physicians and key stakeholders into clinical aspects of all of ABIM activities, including Certification and Maintenance of Certification (MOC).

Previously, Dr. Battaglia served as a primary care internist with Health Care Plan/Univera, a multi-specialty, staff model practice in Western New York before transitioning into leadership roles, including Medical Director of the Medical Centers Division and Senior Vice President, Medical Affairs/Corporate Medical Director. He also served as Medical Director/Chief Medical Officer of large multispecialty medical groups in Western New York. He has participated in national quality initiatives focused on physician group practice and health maintenance organizations. For more than 10 years, he devoted time to The National Committee for Quality Assurance, including a term as Chairman of the committee charged with accreditation decision-making. Most recently, he was a consultant for national and international organizations, including academic medical centers, health systems, community hospitals, medical groups, payers and national physician certification organizations.

Dr. Battaglia received a biochemistry degree from Canisius College, a Jesuit institution in Buffalo, NY. He obtained his medical degree from the University of Rochester School of Medicine and Dentistry. Dr. Battaglia completed his residency through the University of Rochester Primary Care Program in Internal Medicine and also served as Chief Resident."

Whys was PwC left out? The answer is obvious. Collusion with moneyed interests.

Non-disclosure of 14 years with PwC said...

ABIM's Chief Medical Officer and the PwC NCQA continuum

How does the ABIM executive staff and Dr. Baron explain the withholding of work history of their CMO?

Is it because of egregious conflicts of intetrest in how the ABIM opeartes? They operate under the radar promoting specific healthcare models. Their unfair business practices have harmed healthcare markets in the US. ABIM's actions supporting selective hospitals and plans needs investigation.

The ABIM CEO, Baron, worked for CMS while he was on their board had financial and political relationships that need to be examined. Working with the NCQA the ABIM/ABMS has been facilitating boons for health care systems and plans that fit their vision of how healthcare should be delivered.

This has given unfair business adavantage and poses a problem for consumers. When a monopoly certification company and monopoly accreditation association promote their ideal models over others physicians and patients lose autonomy and choice.

But more to the point the NCQA holds the key concerning the orgigins of how the untested MOC program was created. Then how MOC was mandated, illegally tied to payment and employment.

That should be the subject of a federal investigation in conjunction with state attorney generals and the CMS' boss, the citizens of the United States, who should be informed of back room deals concerning their right to affordable and the models and physicians (or nurse practitioner) that they choose, not the one that insusres mandate.

ABIM CMO, Rich Battaglia


Chief Medical Officer
American Board of Internal Medicine
Oct 2015 – Present
Duration 4 yrs 2 mos

Lead ABIM’s effort to incorporate feedback from practicing physicians and key stakeholders into clinical aspects of all of ABIM activities, including Certification and Maintenance of Certification (MOC). Build and lead ABIM’s Clinical Affairs efforts to support the organization’s work in defining and assessing physician competencies. Integrate physician voices into the design and operation of ABIM activities to ensure that all products and services, including Certification and MOC, contribute to the highest quality practice of medicine and better outcomes for patients.

14 yrs 3 mos

Jul 2012 – Jun 2015
Duration 3 yrs

Areas of focus include strategy, physician alignment, clinical quality improvement, efficient healthcare resource utilization, performance improvement and accreditation. With over 25 years of healthcare experience, clients have included both provider and managed care payer organizations. Working with hospital management teams and medical staff leadership, efforts often assist in bridging the gap between the business and care aspects of healthcare, with emphasis on reducing cost and waste while simultaneously increasing quality of care.

Apr 2001 – Jun 2012
Duration 11 yrs 3 mos


Duration 10 yrs
Title Member, Review Oversight Committee
1995 – 2001
Employment Duration6 yrs

Member of NCQA's accreditation decision-making body, analyzing survey findings and assigning accreditation status based on compliance with NCQA standards, as well as HEDIS performance.

1991 – 2001
Duration 10 yrs

Led and participated in multiple managed care organization surveys. Often called upon to lead survey teams for large group model and staff model HMOs.

Title Chairman, Review Oversight Committee
1998 – 2000
Duration 2 yrs

Chairman of NCQA's accreditation decision-making body. The Review Oversight Committee is responsible for analyzing survey findings and assigning accreditation status based on compliance with NCQA standards, as well as HEDIS performance. As Chairman, also served as the Review Oversight Committee liaison to the NCQA Standards Committee."

ProPublica's Incomplete Investigations said...

Two or three damning examples of ABIM corruption

Christine Cassel and the ABIM withheld her deeply conflicted board of directors positions with Kaisers Permanente Hospitals and Health Plans and Premier, Inc. Cassel not only personally profitted from these lucrative positions, but was instrumental in creating unfair advantages to Kaiser and Premier abusing her positions at the ABIM, NQF, and in the White House as "science" advisor.

The ABIM also "groomed" CeCity for sale to Premier, Inc. who bought the company after the ABIM funneled millions of dollars into the company and developed a dashboard for collecting huge amounts of data on physicians and their patients under the sales mantra of "quality improvement".

A federal and state investigation into the entire ABMS/ACGME/NCQA trokia and quality continuum (both their dometic and global operations) is not only warranted, but overdue.
The NCQA has had one Czar in charge since its founding and intitial funding by special interests, RJW Foundation and fortune 500 companies in the late 1980's.

One person in charge of a non-profit public safety "forum" for over 30 years should set off red flags. Especially when you look the countless millions of dollars the CEO has siphoned from accreditation and certification fees for her personal accounts. The CEO's take far exceeds what one would expect from a non-profit "public benefit" trade association. Another unnacountable organization with huge executive overhead. Peggy O'Kane the CEO has hired/appointed a cadre of industry and government insiders, who themselves have benefitted personally from ABIM's shenanigans, such as the former CEO of Kaiser Permanente.

NCQA BoD said...

Who's Who of conflicts of interest

We read the words NCQA "oversight committee" on Battaglia's CV. Most of the general population of the United States has never heard of the NCQA or ABIM? The people of the United States of America need oversight of the NCQA and ABIM/ABMS/ACGME who are marginalizing the rights of physicians to practice and the right of a patient to have the access to care.

The hypocrisy and self-dealing of the players in the quality assurance cartel needs to be investigated.

The CEO for the NCQA has been on the boards of the ABMS and NQF. The BoD of the NCQA reads like a who's who of potential conflicts of interest.

Dutch Big Four Accounting Co. KPMG and NCQA said...

"Who controls the past controls the future; who controls the present controls the past."

Foreign interference/influence in our healthcare choices and maintenance of certification

Is there foreign interference in our healthcare system? Political influence? It would appear so. Millions of dollars have poured in from Pearson and Wolters Kluwer and partners spent on lobbying in behalf of the continued status quo with MOC and the promotion of longitudinal assessment.

This study/survey commissioned by the NCQA (and sponsors/members) conducted by the global financial powerhouse KPMG shows how the NCQA has colluded with the PcWs of the world in order to influence employers, thus furthering their own personal financial and political agendas and not public safety or public need. ABIM's CMO was working for the NCQA at the time of publication.

PcW is based in the UK, while KPMG is based in the Nederlands. The ABIM's partnerships with Pearson, Plc, a UK-based testing/educational conglomerate and Wolters Kluwer (UpToDate parent company) needs investigating by our regulators at the SEC, IRS, and Deptartment of State.
Does the ABIM meet the determination requirements of a non-profit when it engages in lucrative multi-year partnerships with foreign corporations. Is our healthcare system under attack by foreign interests with fiancial and political influence blowing in the wind as a prime concern these days of our legislators.

I see the Commonwealth Fund has an interest in the study and promotion of HMOs and so on. Does Dr. Baron's association with the Commonwealth Fund need scrutiny? Any conflicts of interest? The organization is highly political and partisan with offices in New York and Washington DC.