Late last year, Rep. Edward Canfield (R-Sebewaing) and Sen. Peter MacGregor (R-Rockford) proposed legislation that would amend: (1) the Public Health Code to prohibit the Department of Licensing and Regulatory Affairs or a professional board from requiring a physician to maintain a national or regional certification and prohibits hospitals from denying admitting privileges on that basis (see HB 5090 & SB 609); and (2) the Insurance Code to prohibit insurers from conditioning the payment of a claim on a physician’s national or regional certification not otherwise required under the Public Health Code (HB 5091 & SB 608).

Currently, national physician boards oversee subspecialty boards that provide voluntary board certification for physicians in multiple specialties (collectively, “Certifying Boards”). These Certifying Boards instituted requirements for physicians to maintain their initial certification through a process commonly referred to as “recertification,” “maintenance of certification” or “continuous certification” (“MOC”). Under most MOC programs, physicians are required to participate in certain continuous learning and education activities, which may include self-assessments, audits of patient charts and periodic examinations, in order to maintain their board certification. All of these requirements are in addition to what is required under the Michigan Public Health Code. If a board certified physician does not participate in a MOC program, the physician may lose their medical license, insurance participation or hospital privileges.

The physician community is in favor of the proposed legislation, arguing that the MOC program has become too burdensome, both financially and in terms of time commitment, varies significantly based on specialty and is redundant to the licensure requirements in Michigan, which require physicians to participate in 150 hours of continuing medical education (“CME”) during a three-year period. While components of MOC are eligible for CME credit, proponents assert that the additional time spent on completing the MOC program takes away from patient care or limits the physician from choosing CME that directly relates to a physician’s patient population. Proponents also claim that MOC has a negative impact on continuity of care since some physicians elect to retire rather than participate in a MOC program or physicians are unable to become credentialed/privileged by hospitals and insurers for failure to participate in MOC, thereby forcing their patients to seek other care.

In contrast, insurers oppose the proposed legislation, contending that it would eliminate the ability of health plans to create reasonable credentialing standards for clinical competence for physician network participation and that the Certifying Boards should have the opportunity to alter or replace the current MOC process prior to the legislature removing an insurer’s ability to use it as a credentialing component. Hospitals also oppose the legislation, arguing that the decision to require MOC should remain with each individual hospital since hospital credentials are a privilege granted by the hospital and are intended to ensure that potential practitioners meet the quality of care standards of the privileging hospital that are developed in conjunction with the hospital’s governing body and its medical staff.

Full testimony of opponents and proponents of the legislation can be found here.

All legislation concerning MOC requirements has been referred to the Health Policy Committee in both the House and Senate. Neither Health Policy Committee has held a hearing on the proposed legislation. Hall Render will continue to provide timely updates regarding this matter.