Advocating for You

Chicago docs shape national policymaking at House of Delegates

Your Chicago Medical Society spoke up for physicians back home at the 2014 American Medical Association’s House of Delegates meeting June 7-11. Each year, serving on the Illinois Delegation, CMS members individually and collectively shape the state and national dialogue. Here are advocacy highlights:

CMS: Rein in Recertification

In 2013, CMS authored a strong measure to AMA: oppose the use of costly, burdensome certification exams by hospitals and insurance companies to restrict physicians from medical staff privileges or plan participation. Without independent studies proving the efficacy of Maintenance of Certification (MOC) and Maintenance of Licensure (MOL) on patient care and outcomes, the AMA should support or introduce legislation to prohibit hospitals, insurers, and ACOs from placing these onerous requirements on physicians. (MOC is a process developed by physician specialty boards to evaluate skills and abilities. MOL requires physicians to provide evidence they are participating in continuous professional development as a condition of licensure.)

To CMS’ alarm, new transparency policies make public which doctors are meeting certification requirements, and which ones are not. The message to patients could not more clear: good doctors pass their boards, and bad doctors fail. MOC rules have the potential to drive smaller practices out of business.

This year, CMS’ measure was reinforced by additional delegate proposals, including calls for a moratorium on MOC. And while the AMA did pass new policy surrounding MOC, OCC, and MOL it was not the decisive action many physicians hoped for. New AMA policy calls for:

• Exploring the feasibility of a study to evaluate the impact of MOC requirements and principles on workforce, practice costs, patient outcomes, patient safety and access.
• Working with the American Board of Medical Specialties (ABMS) and its member boards to collect data on why physicians choose to maintain or discontinue their board certification.
• Working with the ABMS and the Federation of State Medical Boards to study whether MOC and the principles of MOL are important factors to physicians when deciding whether to retire and whether they have a direct impact on the workforce.
• Opposing mandatory MOC as a condition of licensure.

The AMA also voted to more thoroughly interpret and report evidence showing that MOC does in fact improve patient care and outcomes.

Yet many CMS physicians remain disappointed, saying the AMA should forcefully oppose MOC and MOL practices. As a result, CMS will continue to relay physicians’ concerns about burdensome requirements that detract from the care of patients.

Compromising Lifetime Certification Retroactively
By Jerrold B. Leikin, MD

CMS made the case that retroactive restrictions on lifetime credentials granted by the American Board of Medical Specialties constitute a breach of the original guidelines. AMA’s new policy is consistent with CMS’ position that all physicians should be given the opportunity to maintain their competency through high-quality educational activities.

Increasing Physician Efficiency
By B.H. Gerald Rogers, MD

This CMS proposal says that dictation systems could be part of electronic medical record (EMR) systems. Integrating dictation would help some physicians, although others believe that dictation systems are not always the most effective or efficient way of maximizing EMR value. AMA will study this idea, including the potential that making dictation systems a standard feature would raise the cost of EMRs.