Appendix 9 — Summary of Activities Related to State Anti-MOC Laws

As a result of advocacy by physician groups, states have begun to consider and pass laws that limit or restrict MOC requirements for all physicians as a condition of 1) state licensure, 2) hospital employment and privileges and 3) insurance reimbursement and participation in preferred provider networks [1,2]. Of those 15 states, six states (Arkansas, Georgia, Oklahoma, South Carolina, Tennessee and Texas) prohibit state licensing boards, insurance providers, and hospitals from requiring physicians to maintain a specialty certification through participation in an MOC program.

Most of the other states have relatively weak laws that include exceptions. In the case of medical licensing boards, they may still be able to use initial certification and MOC as factors in licensing decisions. Hospitals and insurance companies may also be allowed to continue to use initial certification and MOC for employment, hospital privileges and participation in PPO networks. A complete tabulation of the state laws is available [1].

The first such anti-MOC state law was passed in 2016, so relatively little time has passed to judge their effectiveness in limiting use of MOC for such purposes. Physicians may be reluctant to forgo complying with board-mandated MOC requirements because of uncertainty as to whether the anti-MOC laws will be enforced at every level relevant to them. Furthermore, many physicians are licensed in multiple states and, given the small number of states with such laws, they would feel obligated to comply with MOC if they are also licensed in any state without an anti-MOC law.

Federal Anti-MOC Suits

At least four of these suits are class-action suits, with one being an antitrust suit, brought by the American Association of Physicians and Surgeons (AAPS) against the ABMS. Defendants named in the other suits include ABMS, the American Board of Internal Medicine (ABIM), the American Board of Psychiatry and Neurology (ABPN), the American Board of Emergency Medicine (ABEM) and the American Board of Anesthesiology (ABA).

There are two suits directly relevant to the ABR, one filed by a radiologist against the ABR and the other naming the ABR as a co-conspirator in a suit that claims the ABMS, ABEM and ABA violated federal antitrust laws. The suit against the ABR was filed in February 2019, was subsequently dismissed, and then amended and refiled in January 2020. Another suit with an amended complaint that was filed against the ABIM was dismissed, with an appellant brief filed on May 4, 2020 [3].


  1. Schaeffer-Helmecki J. “Anti-maintenance of certification” laws. Published October 23, 2019. Accessed July 10, 2020.
  2. Association of American Physicians and Surgeons (AAPS). MOC Legislation Tracking. Published October 1, 2018. Accessed July 17, 2020.
  3. Kenney, Joshua, Manalo, Murray-Leisure v American Board of Internal Medicine, 2:18-cv-5260-WB. (3rd Cir 2020).