This is a little late getting to you but I wanted to have a plan for going forward before contacting you about my meeting with the Spectrum Health Medical Staff Executive team on April 19.
I presented our arguments against requiring the endless recertification requirements now put forth by our specialty medical boards and the ABMS. All the physicians within the leadership team were in agreement that Maintenance of Certification (MOC) was an unnecessary burden that did not confer actual quality of care and probably contributed to physician stress and burnout.
Even the credentialing office was frustrated with the increasing requirements of credentialing adding to their workload in verification checks. The only concern – and the one that will prevent any change at Spectrum – is that some insurance providers require ABMS recertification for payment.
The most notable in Michigan is BCBS. The government payors do not require it. To my knowledge, Priority Health does not either. The main hurdle is BCBS. In fact, I have had a friend who was dropped out of their network simply because she refused to pay the $1500 fee to their specialty board despite completing all the components of the process.
The hospital’s position is that as long as there is a chance that someone might come into the ER and get seen by a physician who is denied payment by BCBS (therefore subjecting the patient to a full charge from the provider) then they will keep the MOC requirement in the bylaws. If, however, the insurance companies drop the requirement, the hospital would be happy to oblige and drop MOC.
There is pending legislation at the state level that will prevent insurance companies from denying payment to a physician based solely on their participation with MOC. Tomorrow (May 24) the House Health Policy Committee will convene on the legislation HB 4134 & 4135 to limit MOC use for licensure and dropping out of an insurance network respectively. MSMS will be there to fight and hopefully will carry the day. I’ve called every representative on the committee and hope others are too.
Finally, feel free to forward this website and please encourage a colleague or two to sign the petition and get on this list to help us fight MOC. This is no longer a battle for the hearts and minds of the hospital board at Spectrum Health (although their help would be much appreciated), rather it is one we need to wage at the capitol in Lansing. Together I am convinced we can win but only through acting smart and in unison.
Eric L. Larson, MD