Thursday, December 12, 2019

Just In Time for Christmas: The MOC Legal Juggernaut Intensifies

With the recent back-to-back announcements that the class action antitrust and racketeering lawsuit against the American Board of Internal Medicine (ABIM) and the antitrust lawsuit against the American Board of Radiology were dismissed (e.g., the ABIM announcement and ABR announcement), doctors everywhere - both young and old - seemed resigned to the fact that they will have to be subjects to lifelong extortion of private American Board of Medical Specialties member boards and their affiliates if they wanted to practice medicine in the United States.

But fear not, dear colleagues. I bring you tidings of great joy. The first great Supplemental Opposition to the Motion to Dismiss the lawsuit against the American Board of Psychiatry and Neurology (ABPN) was filed yesterday that promises to renew the call for justice on the basis of proper legal procedural grounds:
Defendant American Board of Psychiatry and Neurology (“ABPN”) illegally ties its initial certification product, which it sells to new doctors to demonstrate completion of their medical education and assess the quality of their residency program, and its MOC product, which it requires some older doctors, but not all, to purchase throughout their careers to demonstrate lifetime learning or forfeit their initial certification. ABPN brings to the court’s attention Kenney v. American Board of Internal Medicine, No. 18-5260, 2019 U.S. Dist. LEXIS 164725 (E.D. Pa.Sept. 26, 2019) (“Kenney”), and Siva v. American Board of Radiology, No. 19 C 1407, 2019 U.S. Dist. LEXIS 200645 (N.D. Ill. Nov. 19, 2019) (“Siva”). Kenney came first, followed by Siva which “agree[d] with the reasoning in Kenney.” Id. at *11.1

Nothing in those opinions changes ABPN’s unlawful conduct. A critical reading of the opinions and application of the universally accepted rule that well-pleaded factual allegations and all reasonable inferences therefrom must be taken as true compels the conclusion that Kenney and Siva were, respectfully, wrongly decided.
1  The tying claims in Kenney were dismissed with prejudice without plaintiffs being allowed to amend, the court finding as a matter of law that separate products could never be alleged. Plaintiffs are appealing that ruling. The claims in Siva were dismissed without prejudice and plaintiff is filing an amended complaint on January 10, 2020.
The supplemental opposition to the ABPN motion to dismiss then outlines multiple legal reasons why the plaintiffs believe the decisions were wrongly decided. In essence, the attorneys are arguing that the facts in this case were not even allowed to be considered past the judges' chambers.

We can anticipate that the multitude of moneyed interests behind Maintenance of Certification will stop at nothing to assure this unlawful program continues unchecked.

Still, a bit of hope and cheer is always welcome for working physicians this time of year.

Merry Christmas!


P.S.: On a separate legal note:

Remember the Puerto Rican physician, Jaime Salas Rushford, MD, whom the ABIM revoked his board certification and dragged him through the court system since 2012 with a dismissed time-barred cheating claim while the President and CEO of the ABIM simultaneously failed to disclose her conflicts of interest with Kaiser and Premier Inc? Yesterday, the judge issued the following order to expedite the counterclaim suit filed against ABIM by Salas Rushford:
The American Board of Internal Medicine may file its motion for judgment on the pleadings no later than December 18, 2019. Dr. Salas-Rushford will respond no later than January 2, 2020. The Board may reply no later than January 9, 2020. The case schedule will be discussed at the scheduling conference to be held on January 31, 2020. Signed by Judge Francisco A. Besosa on 12/11/2019. (brc) (Entered: 12/11/2019)
It seems that case will soon be coming to a head, too.

Readers wishing to support the brave physician plaintiffs involved in these lawsuits trying to end the unlawful Maintenance of Certification program are encouraged to contribute to their GoFundMe campaign.


Anonymous said...

ABMS Medical Boards' Court History

For decades, the ABMS and its 24 medical boards have hidden their conflicted, self-serving financial and political agendas and executive largess. Over the past several years the conflicts, corruption and unaccountable behavior has become more clear. It became very clear in 2015 with mainstream media coverage in Newsweek, and with the ABIM's refusals for interview requests. Not even written Q & A. The continuous subsequent stonewalling on all substantive questions is alarming as they are a tax exempt corporation accountable to the taxpayer/public.

Plus there has been the ABIM's failure to submit to an independent financial audit.

It's shocking and telling that the courts would appear to have us believe, with such quick dismissals, that the entire ABMS are one of a special protected class of elites who are above the law.

Profiting from Aiding and Abetting the ABIM/ABMS said...

Is Longitudinal Assessment® (MOC®) an investment vehicle of third-party for-profit corporations, private equity, and highly conflicted academics and their publishers?

For those who are not in the loop, the answer is yes, all MOC, in whatever form, but especially "Longitudinal Assessment" is as conflicted and corrupt.

Such new and untried beta-research projects used by the ABMS on live subjects (physicians and patients) is not only concerning, but violates the rights of physicians (and patients) who will have even more instances of privacy violations and physicians will be subjected more often to ABMS Solutions millions of dollars of data dumps. I'm speaking about ABMS Solutions' lucrative sales to third-party certification and accreditation agencies.

Who's involved? That should be a question for the DOJ, IRS, and OIG of the HHS.

Let's open up the tax records of those who have received public money for their efforts to serve the healthcare industry's bottom line, while lining their own conflicted (bulging) pockets with public and private money to do further harm to physicians and patients.

Why were ABIM's own Christine Cassel a serial coi and ABMS' own Dutch longitudinal assessment academic Cees Van der Vleuten appointed by Bob Wachter and UCSF to receive public money to be Presidential Chairs. What are the chances that these appointments are a conincidence?

Any doubts?

Anonymous said...

The American Board of Preventive Medicine recently announced that they are doing away with MOC and moving to a continuous assessment model. The new longitudinal assessment pilot is being undertaken by the clinical informatics subspecialty and will entail 12 open-book, open-resource, at-your-own-computer questions per 6 months, with the correct answer being provided after submission of a response by the physician. There will also be self-reported CME and practice improvement. Y'all are having an impact even on the specialties not in these lawsuits.

MOCraker - a note about the ABPM said...

Population health data collection and the enhancement of ABMS profits is the name of the game here. Physicians are no longer leading the organizations. Private equity is. Profit models are being pursued, that is all. The American Board of Preventive Medicine was the poorest performer of the 24 medical boards and the the ABMS executives want to bolster their investment in data collection and mining.

Not sure why the physicians who are certified with the ABPM would want longitudinal MOC.
ABPM had the easiest MOC program of them all. 250 questions, paper and pencil test administered in a resort every ten years. Test taken right after your board review course in the hotel. Not a Pearson Vue center. Longitudinal Assessment is even more onerous program for the diplomates and candidates. The data collection will be constant and the legal liability of being sued by them is enhanced 20 fold every time you sign their contract. Just so you know the executive director is a controversial and aggressive attorney who in the past has threatened many folks associated with the business he ran with lawsuits.

So the very disturbing news is that the American Board of Preventive Medicine is not even run by a physician anymore. Private equity executive, Chris Ondrula, has infiltrated the top executive position. ABMS recently appointed him as a kind of business executive to run it. Ondrula was employed with ABMS for couple of years after he sold his private equity owned Burger King franchise. So bizarre. Last known job was with the ABMS as risk management/private equity attorney. Business enhancement for private equity is his game.
Some have called him a ruthless operator. The checkered history is there to back those claims up. But everyone must verify this information for themselves. It is frightening how quickly the medical boards have changed from a public safety concern into to private equity partnership club.

Absolutely no medical experience has Ondrula, no matter what BS the ABMS puts into his bio. No expertise in preventive medicine or population health. That is scandalous imo and not just scary.

The ABMS no longer serves physicians or patients they are looking for revenue enhancement.
At the ABPM data collection is the name of the game. Cash is king. Longitudinal Assessment is their next MOC cash cow. It is still MOC and it is still intended to be a means of milking physicians out of their time, data, and money. Just more of it, more often. Anyone who is fooled by the "new assessment models" is totally naive. These are not "we are listening" projects, but something they have been intending since 1988. These clever bastards are even using anti-MOC sentiment to push it through on those unsophisicated or too busy to investigate what it means and who is involved. It is about money and even more political control over physicians and enhanced bottome lines for themselves and partners, that will never let go of the MOC gravy train.

Chris Ondrula, the new non-physician executive director at the ABPM has nevern been a very popular man. The ABMS tries to bury the fact that Ondrula had a very bad health and safety record at the large Burger King franchise he grew for a private equity group. It was last acquired by the the Blackstone group in 2008 and shopping the franchise around after a sluggish fast food market made the investment less attractive. Blackstone has acquired several healthcare companies. TeamHealth, which acquired Bob Wwachters, the Hosptialist Company is one very pertinent relationship that should be mentioned.

Poor safety record



The Longitudinal Assessment Learning Cycle© said...

MOC stakeholder news (American Academy of Family Physicians®)

The medical specialty societies are already frothing at the mouth, racing to get their share of the latest MOC money grab. Longitudinal Assessment.

The medical societies are writhing in the ABMS mud trying to lay claim to their share of the MOC gravy.

The American Academy of Family Physicians has (as of May 2019) just copyrighted their version of longitudinal assessment. Longitudinal Assessment Learning Cycle©.

It's sickening to see the feeding frenzy for profit and power among the medical specialty boards and societies and their associates.,2&Search%5FArg=longitudinal%20assessment&Search%5FCode=TALL&CNT=25&PID=bSh6a5EOFIoULjDeGBqypyauCq1&SEQ=20191213151213&SID=2

Co-Creation of WILEY CECITY and the Common Denominator $$$,$$$,$$$ said...

Seeking Profit

What's going on between Wiley Bob Wachter, Wiley Cees van der Vleuten, and not so Wiley, queen of Premier/CECITY MOC, Christine Cassel?

Non of them actually do MOC. But all made a bundle$ co-creating with the health industry to profit from MOC. Now they're working on the next version of "professionalism" and "ethics" in the new age for others to follow, but not them.

Wachter, the father of the hospitalist movement and Chairman of Safety for IPC, The Hospitalist Company, has still not taken the ABIM's hospitalist boards. Last test he took was when he was on the ABIM payroll.
It's safe to say Bob's never set foot in a Pearson Vue testing Center and it's probable he too was one of Dr. Lynn's in-house benefactors. Famous line from Bob speaking of the ABIM luxury condo. "It was not a scandal, just politically dumb." Still have not got a log of who stayed there at that dumb political house where all the ABIM lobbyists birdnested.

Van der Vleuten is not a physician.
Closest Cees ever got to an Pearson Vue testing center was in recommending Wolters Kluwer as an open-book source partner for the ABMS testing. Kluwers Academics and Wolters Kluwer has published van der Vleuten. So does Wiley. Both Van der Vleuten and Wolters Kluwer - Uptodate - are incorporated in the Netherlands.)

Cassel stopped participating in MOC after she left the ABIM CEO position. Waste of time for the "co-creator" of CECITY, which was bought out by Premier, Inc, in 2015.
How much money did she personally get from Premier, Inc. on the CECITY deal and as director on the board of the PBM Premier?

All three are Wiley with hidden conflicts of interest and money stashed away in their investment accounts co-creating MOC and acting as planning deans for the latest ABMS MOC alternative - longitudinal assessment. Don't be fooled by their BS. Longitudinal assessment is MOC and contrary to what the medical boards say, physicians don't want it. Docs didn't ask for longitudinal harassment every month out of the year, forever. Absolutely not.

Collusion between medical boards, corporations and government revolvers and business partners like Wachter, Baron and Cassel.

Wiley Health Powered by Premeier; before that powered by CECITY.

At -0:38 in this Wiley Health demo, on the lower right it reads "Powered by CECITY" (copyright 2000-2014).,AAAAkPubcZk~,_5wRjVEP-2Sma1whESEDFKmqjWi9oghp&bctid=3420307328001

Better get a screen capture of it before Wiley scrubs it clean. MOC has been a long term project to control physicians and have them pay for it as well. What irony. The CECITY logo on the Wiley Health site indicates clearly that Wachter, Cassel a/nd others at the ABIM/ABMS colluded with Wiley, CECITY and Premier Inc. That may be partly why Wiley took down Wachter's World. Plus Bob Wachter is a political hot potato. We don't know what relationship Wachter has with Wiley other than publishing, but it clearly shows that MOC is a scam. And the longitudinal assessment is the latest version of their scam that they are co-creating on the taxpayers' dollars.

Anonymous said...

I wish only that judges dismissing rank and file practicing physicians and academic physicians concerned about the integrity of MOC from ABMS and its umbrella subspecialty boards might ask THEIR personal physicians how they feel about MOC? Because these dismissing judges --- who have no MOC requirements for their Bar examinations --- have most wrongfully curbed public access to physicians (but not midlevels). These court dismissals deprived PHYSICIAN SCHOLARS and their patients from an American trial by jury while allowing MOC to kill initially- boarded physician diplomates from their rights to work. MOC is a major contribution to physician burnout and loss of physician access -- do the dismissing judges care? Dismissing the MOC lawsuits lets MOC continue to operate high-revenue, burdensome mandates against the better health of our patients and the public. Midlevels benefit, however, and will increasingly replace the physicians retired early due to MOC. Lord have mercy, Kyrie eleison, on U S healthcare as reformers try to clean up upside-down healthcare and remove dark holes and niches like MOC. Follow the money.

Anonymous said...

CECITY, Premier, Wiley, ABIM continued

Bottom line

Wiley Health was paying Wachter at the same time that CECITY was being funded and co-created by the ABIM. Cassel was on the board of Premier, Inc. They coaxed the sale of CECITY to Premier and profited from it. This is why we hear over and over that the ABIM is unaccountable acting with egregious conflicts, with executives profiting through public service positions.

Bob Wachter and his business partner Chris Cassel acted way outside their job descriptions, while on the ABIM's payroll.

Cassel, Baron and Wachter were all three influencing government policies and healthcare reform through PCAST (CASSEL), AHRQ (Wachter), and Baron (CMS).

It's astonishing such corruption is tolerated. It's obvious the healthcare industry has their insiders in key positions at the ABMS. Look at what CECITY was developing along with the ABMS and the conflicted money. Wiley was also a co-creator of CECITY and as seller/publsiher of CME/MOC products has benefited financially.

How many millions did the ABIM fund/invest in CECITY? How much of a return on their investment did they make. How much did Wachter, Cassel, and others make? How much does the industry rake in from MOC as a result of ABMS insiders?

It is much clearer now why Bob Wachter was called in to help Christine Cassel make the Chuck Denham/Cardinal Health/CareFusion kickback scandal go away and what was at stake. We understand why Wachters's World had so many narratives to guide the public's views away from the truth.