The War Over MOC Heats Up

Neil Chesanow

Disclosures

June 21, 2017

In This Article

Georgia: A True Anti-MOC Bill Becomes Law

Georgia's anti-MOC legislation, proposed by the Medical Association of Georgia (MAG) in January, states that MOC "shall not be required as a condition of licensure to practice medicine, employment in certain facilities, reimbursement, or malpractice insurance."[16]

The state House of Representatives passed the bill on March 1 (the vote was 171-2).[17] The state Senate passed the bill on March 28 (the vote was 52-1). Governor Nathan Deal signed the bill into law on May 8, making Georgia the only state that currently lifts MOC requirements for staff privileges at "certain" hospital facilities and for insurance network membership, as well as for medical licensure.[18]

"That was pretty stunning," Dr Edison remarks.[6] "That one went completely under the radar. No drama. That was a pretty big win."

"Georgia was a biggie," Dr Fisher agrees. "That's got all the conflicts. They can't use MOC for hospital credentialing. They can't use it for licensure. Or for insurance reimbursement of physicians. So it fills the entire bill."

What accounts for this political victory? Dr Fisher credits the leadership of Rep Betty Price, MD, who cosponsored the bill. Dr Price, an anesthesiologist, is married to Health and Human Services Secretary Tom Price. "She made a very compelling argument for why this is bad for patients," Dr Fisher maintains.

But compelling arguments for removing MOC requirements have been made in other states, without success. Why no drama in Georgia? Georgia has over 23,000 practicing physicians.[14] Oklahoma, with only 8854 physicians, had plenty of drama.[14] Why didn't ABMS, and Georgia's hospitals and insurers, mount an effective lobbying campaign to defeat or at least water down the bill, as they have done in other states?

As it turns out, ABMS did make an effort to block the Georgia bill. "ABMS contacted several lobbying firms to see whether they could have that battle fought down here, and I think many of them declined," says Derek Norton, MAG's Director of Government Relations. "With the strength of our legislative team and our position in the capital, I don't think they thought they could win that battle."

However, the law prevents MOC from being mandated at certain facilities, Norton emphasizes. The key word is "certain." The removal of MOC requirements only applies to state hospitals. The bill does not apply to general hospitals in Georgia that require MOC for credentialing. "That's why the Georgia Hospital Association didn't mount a big fight," Norton explains. "It really wasn't a huge deal to them."

The initial draft of the legislation was directed at all the hospitals in the state. "Once we took that out, the hospital association was okay with it," Norton says, "and so we just went forward from there."

Georgia has six state hospitals, which are covered by the new law. But the state has nearly 150 acute care hospitals, 17 long-term and rehabilitation hospitals, and 20 psychiatric and chemical dependency facilities that are still free to require MOC.[19]

The law represents progress for the anti-MOC movement, but it's not as dramatic a win as some observers believe. In Norton's words, "It was more of a preemptive strike."

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