Rhode Island Physicians for Quality Care’s goal is to keep the state’s physician community informed about our efforts to ensure that doctors have the choice of participating in meaningful activities that support their individual practices’ needs over the unproven requirements of the Maintenance of Certification (MOC) program, created by the American Board of Medical Specialties (ABMS).

We oppose the increasingly involuntary status of the ABMS MOC, which has not been proven to indicate a physician’s overall competence or protect patients. We believe the ABMS MOC can be used as a voluntary educational tool only if all board certifications are restored to lifelong certifications.

We aim to:

• Allow doctors the freedom to choose board certification agencies.
• Encourage all doctors to stand together to protect their ability to work without unnecessary bureaucratic regulation.
• Ensure that MOC is not linked to licensure in Rhode Island.
• Ensure patients have access to highly qualified care from physicians by allowing doctors to choose their own continuing medical education courses based on their practices and needs.
• Advocate for the National Board of Physicians and Surgeons (NBPAS) to be an alternate certifying agency at RI hospitals.

• 1971: American Board of Internal Medicine (ABIM) introduced the idea of voluntary recertification called Continuous Professional Development (CPD) but it was never embraced.
• 2000: ABMS mandates all board certification be limited to 10 years.
• 2010: The medical societies of Texas and Iowa pass resolutions against MOC.
• 2011: Federation of State Medical Board (FSMB) proposes a Maintenance of Licensure (MOL) program including self-assessment and performance components in addition to traditional continuing medical education (CME) activities, but it is rejected.
• 2013: Association of American Physicians & Surgeons, Inc., files a civil suit against the ABMS citing antitrust laws and misleading information about physicians’ skills based on their participation, which is still ongoing. The AMA and medical societies of California, Florida, New York, New Jersey, and Oklahoma pass resolutions against MOC.
• 2014: 2014-Jama study showing MOC programs do not improve patient outcomes.
• 2014: The American Board of Medical Specialties (ABMS) formally announces that the revised MOC standards would take effect in 2015 for its 24 member boards. The new requirements would include self-assessment and performance components in addition to traditional continuing medical education (CME) activities.
• The Interstate Medical Licensure Compact is proposed by the FSMB as a way to simplify licensing across states to facilitate telemedicine, yet it defines a physician as someone who holds ABMS specialty certification (which requires participation in MOC). Doctors object to spending time and money for a program that is not helpful to their practices and keeps them from their patients. The medical societies of Massachusetts, Pennsylvania, Virginia, and Washington pass resolutions against MOC. The National Board of Physicians and Surgeons is formed as an alternative to maintaining board certification.
• 2015: RIPQC is formed to support doctors in RI in the MOC battle.
• 2015: The Interstate Medical Licensure Compact is proposed in the RI General Assembly but tabled due to opposition. The president of ABMS sends a written apology saying “we got it wrong” yet offers delays and reprieves but does not change the final plan. The Michigan Medical Society passes a resolution against MOC.
• 2015: Newsweek Magazine exploring the MOC controversy and the finances behind the MOC® product.
• 2015: (Quote) While the Medicare Access and CHIP Reauthorization Act does not mandate re-certification, providers will receive bonus payments for clinical practice improvement activities that may include MOC. Since incentives under the Merit-Based Incentive Payment System must be offset by penalties, some physicians’ decisions to forgo MOC will negatively impact Medicare reimbursement. (Link Quote)
• 2015: (Quote) While at the federal level, definitions of quality and payment increasingly depend on board certification, state legislators, urged on by grassroots physician activists, are taking the opposite approach, rejecting recertification as a factor in reimbursement and staffing. (Link Quote)
• 2016: Philadelphia medical society issues no confidence vote in ABM’s leadership.
• 2016: AMA recommends immediate end to all mandatory re-certifications exams.
• 2016: Kentucky lawmakers approved a measure to prohibit the board of medical licensure from requiring any maintenance of certification and related continuing education requirements of licensure as a physician. (Senate Bill 17)
• 2016: Maryland Governor Larry Hogan OK’d legislation April 12 to prohibit the stat board of physicians from establishing a continue education requirement that every licensed physician complete a specific course or program as a condition of the renewal of a license (House Bill 185)
• 2016: Several bills currently being considered by legislators in Missouri seek the same goal. Two measures advancing through the legislative process were introduced by members who understand this issue first-hand. Senator Onder’s bill declares that the “state shall not require… any form of specialty medical board certification to practice medicine within the state” (Senate Bill 772).
• Reference Article on Urologytimes 
• 2016: Oklahoma Governor Mary Fallin (R) signed Senate Bill 1148. The new law forbids any requirement that a physician “secure a Maintenance of Certification (MOC) as a condition of licensure, reimbursement, employment or admitting privileges at a hospital in this state.” While nothing in the statute explicitly prohibits a hospital from mandating MOC, the law does allow a physician to challenge such a requirement, asserting that it interferes with the practice of medicine. (Link)
• 2016: Rhode Island Opposes MOC and MOL: Patient Access to Doctors Threatened by Proposed Bill By Debbi McInteer M.D. (Open Article)
• 2016: FBI Raises Questions about Interstate Licensing Compact ( Medscape Article)
• 2016: Class Action Lawsuit Filed Against the American Osteopathic Association By Westby G. Fisher, M.D.(Open Article)
• The American Board of Medical Specialties took the self promotional step of expressing “disappointment” with the measure, affirming its policy stating “neither specialty nor sub-specialty certification should be the sole determinant in granting and delineating the scope of a physician’s clinical privileges.”
• “As evidenced by the flurry of activity at the state and federal levels of government, many physicians are fighting back against increasingly burdensome re-certification requirements. Since 60% of board certified physicians participate in MOC, it is vitally important to not only stay current with the science of medicine, but the regulation of the profession, as well.”