Help Stop the MOC Trojan Horse, the Interstate Medical Licensure Compact


Are you involved in your county or state medical society? We have TWO important resolutions for you to introduce. The first one calls for opposition to the Interstate Medical Licensure Compact. The second asks your state medical board to withdraw from the FSMB (the author of the compact). Click here for a short video explaining these resolutions and click here for a longer video exposé about the Compact and FSMB.

Eleven states (AL, IA, ID, IL, MN, MT, NV, SD, UT, WV, WY) have passed legislation implementing the Compact and AAPS is writing physicians in these states warning them to avoid participating in it.  Our letter is copied below.

DANGER: Do Not Get Licensed under Interstate Compact


Dear Colleague:
As you are likely aware, your state has enacted legislation that allows your state medical board to cede control of medical licensure to a new entity known as the Interstate Medical Licensure Compact. This is supposed to facilitate telemedicine and to streamline application for licensure in multiple states.

Beware! If you want more than one state license, you are better off to apply the old‐fashioned way.

The Compact has been heavily promoted by the Federation of State Medical Boards (FSMB)—which exists to promote itself, not to help doctors.

If the FSMB really wanted to facilitate the practice of telemedicine, as it claims, it would support the TELE‐MED Act of 2015, introduced in both the U.S. House of Representatives and the U.S. Senate.

This provides for physicians licensed in one state to remotely care for Medicare patients in another state. Both FSMB and the AMA oppose this bill!

The Compact, in contrast, does not reduce the number of required licenses. It just makes them more costly. Furthermore, it completely alters mechanisms for license renewal. And, the Compact changes the very definition of the word “physician.” The FSMB, finding a way around physician resistance to its Maintenance of Licensure proposals, now defines a physician as one who is board certified via one of the ABMS approved specialty medical or osteopathic boards. Thus, most physicians seeking a medical license under the Compact will not be able to unless participating in costly, time‐consuming, and counterproductive Maintenance of Certification® (MOC)!

By the FSMB’s definition, the instant you stop participating in proprietary, costly MOC, or fail an exam, you are no longer a physician!

MOC means that you are no longer a professional, but a subordinate of self‐ appointed higher authorities. You will be constantly on probation, subject to a never‐ ending round of examinations that may be completely unrelated to what you do every day.  AAPS, unlike most medical associations, has been fighting this monster.

But even if you do participate in MOC, you should avoid Compact licensure.

Please consider the following, and warn your colleagues:

  • States that refused to implement the Compact (Missouri and Ohio) note that it adds another layer of bureaucracy, and another fee to the process. The costs are significant and unknown. It might actually delay, rather than speed licensure. Read the reports of the medical boards of Missouri and Ohio at
  • Additional fees might include the mandated use of the Federation Credentialing Verification Service (FCVS), which currently costs at least $350. IMLC might also mandate the use of FSMB Uniform Application, which currently costs $50. In addition to these “licensing fees,” states will continue their own current fee systems!
  • If there is a complaint against you in one Compact state, all states will get this information. While they might not do their own investigation, you will have to defend yourself in every state. Moreover, states may not have the discretion to make their own determination. Some state boards are thrilled that they’ll be able to discipline more doctors more easily.

Many legislators have not yet considered that physicians will simply refuse to use Compact licensure because of the serious disadvantages. If this happens, they might repeal the legislation—which impairs state self‐determination, imposes costs, and may even subject the state to legal action brought by other component states. Physicians need to expose the real agenda of FSMB and keep it from expanding its power. As most recently reported, this “non‐profit” private corporation enjoys yearly revenues of $47 million, and its executives enjoy lavish compensation. Along with other non‐profits, it recently formed a for‐profit entity known as Data Commons, which will traffic in physician data.

The freedom and integrity of our profession is under continued assault. The Association of American Physicians and Surgeons (AAPS) is the national medical organization that has been fighting this since 1943.

Please help us turn back this latest threat. What you can do:

  • Do not, under any circumstances, obtain a medical license via the Interstate Compact.
  • Ask your state legislators to reverse this legislation, or at least, to refrain from funding it.
  • Ask your legislators and state medical board to withdraw from FSMB. The dues money saved can provide for decreased medical licensure costs in your state.
  • Request your state medical board to NOT require use of Data Commons or FSMB data, which is extremely costly.
  • Ask your state medical association to protect patients, physicians, and taxpayers from the costly and unnecessary provisions of the Compact, as by introducing Resolutions. (This may be difficult, as the AMA is for some reason trying to protect the FSMB and its Compact, and often the AMA is well‐represented in state medical societies.) AAPS members have led the way in bringing anti‐MOC Resolutions—see samples at

Sincerely yours,
Jane M. Orient, M.D., Executive Director
P.S. If you want private medicine to continue, AAPS is your organization.

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