On November 7, the Maryland Health Care Commission (MHCC) issued findings in response to a request by the House Health and Government Operations Committee Chair, Delegate Shane Pendergrass.  Del. Pendergrass requested recommendations for legislation that might be proposed in the 2019 session related to the topic of physician maintenance of certification (MOC).  The MHCC work group was unable to reach consensus on recommendations, although they did agree on facts and identified non-legislative approaches that might help.

The MHCC findings letter outlines physician objections with MOC as fairness, time burden and access, relevance and expense.  It lists a few paths to change in this area that do not require statutory changes:

• Specialty boards are reevaluating recertification requirements and processes.
• A new board certifying entity is competing with ABMS and AOA: NBPAS
• Hospitals can change their credentialing requirements via a change in medical staff bylaws. Frederick Memorial and Sibley in DC have done so.
• The Maryland Board of Physicians has the authority to recognize alternative board certification entities.

The letter goes on to review legislative approaches in other states that have attempted prohibit the requirement of board recertification by state licensing boards, hospitals, insurers, etc.  Texas and Tennessee have amended their state code related to insurance and hospitals to prevent differentiation among physicians based on their certification status, which MHCC judged as most likely enforceable.  However, the hospitals and physicians in the MHCC workgroup were unable to agree on an approach “as achieving one group’s goal requires limiting the other group.”

MHCC also points out that most insurers in Maryland are not currently requiring board recertification, except for Kaiser.  However, insurers in Maryland often delegate credentialing to hospitals for their affiliated physicians so the hospital’s requirement on MOC would carry through.

MHCC concludes, “Maryland should continue to monitor implementation in the states that have adopted legislative changes.”  Work group resources, minutes, presentations, reports, and state statutes that reference board certification are available here.  For feedback and questions, email  Megan Renfrew, MHCC Chief of Government Affairs and Special Projects or call 443-615-1338.