For years, many state medical boards, hospitals, and private payers have used specialty certification as a requirement for licensing, privileging, and network participation. Yet, through the years, "Community urologists in smaller group practices have found it more difficult to meet the administrative burden and afford the costs attributed to the recertification process," according to AACU President Charles McWilliams, MD.
Most urologists believe specialty certification is important. "Although imperfect, it is necessary to preserve the integrity of our profession," Dr. McWilliams said.
Grassroots sentiment concurs with this assessment, but a nearly equal number wish that maintenance of certification (MOC) be done away with, according to a number of studies, including a 2016 Urology Times survey that found 84% of urologists were dissatisfied with the current MOC process.
Lawmakers across the country began to respond to calls for an end to MOC in 2016. At the time, five states sought limits on the role of specialty certification in licensing, privileging, and reimbursement decisions. The American Board of Medical Specialties (ABMS) expressed "disappointment" with a law passed in Kentucky and affirmed its stance that "neither specialty nor subspecialty certification should be the sole determinant in granting and delineating the scope of a physician's clinical privileges."
MOC supporters' resolve was further tested in 2017 as grassroots campaigns to erode the ubiquitousness of recertification sprouted in at least 19 states. A new Georgia law passed this May prohibits MOC from influencing licensure, health insurance panel participation, eligibility for malpractice insurance, and privileges at state-owned hospitals. In Texas, a similar measure included exceptions for academic medical and certain cancer centers. Oklahoma legislators failed to close a loophole in a landmark law passed last year that was being exploited by hospitals and insurance companies—two powerful industries that generate jobs and political contributions.
Lois Margaret Nora, MD, JD, MBA, president and chief executive officer of ABMS, meanwhile, told Medical Economics: "Legislation being introduced in states across the country increases the potential for patients and families to receive substandard care by either reducing access to board certified medical specialists, or by lowering the standards for specialty medical practice."