Legislative and Legal Updates: Reforming the Regulatory Landscape

The momentum to decouple Maintenance of Certification (MOC) from a physician’s right to practice is no longer just a professional debate—it is a legal and legislative reality. Across the United States, lawmakers and legal experts are recognizing that mandatory MOC often functions as an anti-competitive barrier that does not necessarily improve patient care.

This page tracks the state-level legislative victories and federal legal challenges aimed at restoring autonomy to the medical profession.

State Legislative Successes

Several states have already passed landmark legislation to protect physicians from being forced to participate in MOC as a condition of state licensure, hospital privileges, or insurance reimbursement.

• Oklahoma (SB 1148): In a historic 2016 victory, Oklahoma became the first state to pass a law prohibiting the state medical board from requiring MOC for licensure. This set the national precedent for protecting a physician’s “Right to Practice.”
• Georgia (SB 40): This legislation prevents hospitals and health systems from using MOC as the sole requirement for granting or renewing staff privileges. It ensures that clinical experience and CME are given appropriate weight.
• Tennessee (Public Chapter 967): Tennessee lawmakers passed protections that restrict health insurance companies from denying reimbursement to a physician based solely on their MOC status, preventing financial “strangulation” of non-compliant practices.
• Kentucky and Ohio: Similar bills have been introduced or passed to ensure that MOC remains a voluntary educational tool rather than a mandatory professional hurdle.

National Legal Challenges: Antitrust Litigation

Beyond the state house, the MOC system is facing scrutiny in federal courts. The primary legal argument focuses on Antitrust Law, specifically whether the ABIM and other boards have created an illegal “tie-in” arrangement.

Kenny v. ABIM (Class Action Lawsuit)

This federal lawsuit alleges that the ABIM has used its monopoly power in the initial certification market to force physicians to purchase its MOC products. The litigation argues that:

1. Initial Certification and MOC are two separate products.
2. Market Coercion: By threatening to strip a physician of their “Certified” status, the board effectively forces the purchase of MOC modules to maintain hospital and insurance credentials.
3. Anticompetitive Harm: This practice prevents competition from alternative certifying bodies and increases costs for physicians and, ultimately, patients.

Model Legislation: The Right to Practice Act

The PCC supports the adoption of “Model Legislation” in every state. This framework is designed to ensure that a physician’s hard-earned medical license is not held hostage by a private, non-governmental corporation. Key components of this model legislation include:

• Licensure Protection: Explicitly stating that the state medical board shall not require any form of MOC for the issuance or renewal of a medical license.
• Hospital Autonomy: Empowering local hospital medical staffs to determine their own credentialing standards without interference from national boards.
• Insurance Non-Discrimination: Mandating that insurers recognize all physicians who hold a valid state license and meet reasonable clinical standards, regardless of MOC participation.

The Road Ahead

Legal and legislative reform is the most direct path to ending the MOC mandate. By advocating for these changes at the state level, we are dismantling the “all-or-nothing” structure of the current system. We encourage all members to stay informed on their local state medical society’s legislative agenda and to support legal funds dedicated to these antitrust challenges.

Progress is being made, but continued advocacy is required to ensure that a physician’s primary duty remains to their patients, not to a testing administrative complex.