SGR Relief: Bait for MOC® and More Government Control


This week’s health policy news roundup curated by Jane Orient, M.D.

The Texas Medical Association says any connection between Maintenance of Certification® (MOC®) and the “doc fix” (HR2) was created by “internet trolls.” This is one of the “top 10 myths about HR 2.”

But there’s a smoking gun: In a letter to Energy and Commerce Committee Chairman Fred Upton and ranking member Henry Waxman, the American Board of Medical Specialties (ABMS) proposes a public-private partnership with its member boards and their MOC® programs to develop the performance and quality measurement gaps:

Use of ABMS MOC® as a value metric will avoid placing additional administrative burdens on physicians already participating in professional development activities, help to assure that there are practice-relevant options for all specialties and tie quality measurement to a disciplined improvement process. Alignment of federal quality programs with ABMS MOC® has been advocated by the Centers for Medicare and Medicaid Services (CMS), the Measures Application Partnership (MAP), and the National Quality Forum (NQF).

The corruption in the MOC®-related “monopoly for money,” the heavy burdens on physicians, and the lack of evidence of any benefit to patients attracted national attention in a Newsweek article.

The American Board of Internal Medicine (ABIM) responded on MedScape, saying that the Newsweek story about the “civil war” in medicine was inaccurate.

Another article on ABIM malfeasance followed, in which Newsweek asks: Does ABIM consider doctors its enemy?

Opposition from physicians is so intense that ABIM issued an apology to its diplomates, promising some modifications and delays. The American Board of Pediatrics and the American Board of Family Medicine are unrepentant.

ABMS continues to maintain that MOC® is voluntary. Its collusion with the federal government to impose it on physicians shows that its intention is to make MOC® voluntary only in the sense that you don’t have to practice medicine, or get paid for your work.

Why is AMA lobbying so heavily for HR 2? Could it be because of ties to special interests including ABMS and its member boards? Or the whole panoply of special interests that benefit ObamaCare, which HR 2 advances?

Beyond its CPT coding monopoly, does the AMA contemplate other profit centers in setting the metrics for the replacement SGR—sustained global rationing?

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