States attempt to limit importance of MOC
Maintenance of certification (MOC) is an increasingly time consuming, expensive, and unnerving exercise.
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According to the Urology Times 2015 State of the Specialty survey, 85% of respondents' ABU certificate is time limited and 77% say certification is required to practice in their hospital. When more than half declare that they will not take the recertification exam at age 60, the impact of MOC on the urologist work force will be far reaching.
While at the federal level, definitions of quality and payment increasingly depend on board certification, state legislators, urged on by grassroots physician activists, are taking the opposite approach, rejecting recertification as a factor in reimbursement and staffing.
Dating back several years, Medicare encouraged participation in MOC programs. Physician Quality Reporting System requirements for 2013 assert that eligible professionals who met Maintenance of Certification Program Incentive requirements "could receive an additional 0.5% incentive payment." The 2015 law that replaced the sustainable growth rate formula likewise rewards MOC.
While the Medicare Access and CHIP Reauthorization Act does not mandate re-certification, providers will receive bonus payments for clinical practice improvement activities that may include MOC. Since incentives under the Merit-Based Incentive Payment System must be offset by penalties, some physicians' decisions to forgo MOC will negatively impact Medicare reimbursement.