Washington State House of Representatives Office of Program Research | BILL ANALYSIS |
Health Care & Wellness Committee |
HB 2313
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent. |
Brief Description: Prohibiting maintenance of certification as a condition for a physician to participate in a health carrier's provider network.
Sponsors: Representatives Doglio and Appleton.
Brief Summary of Bill |
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Hearing Date: 1/15/20
Staff: Emily Williams (786-7291) and Kim Weidenaar (786-7120).
Background:
Participating Provider Contracts.
Health carriers must maintain provider networks that provide enrollees with reasonable access to covered services. To do this, health carriers contract with health care providers to join the network as a participating provider. In the contracts the parties agree to the specific reimbursement rates for the provider's services and other terms specific to the contract.
Maintenance of Certification.
Maintenance of certification (MOC) programs are formal recertification programs that physicians who already hold board certifications from the American Board of Medical Specialties (ABMS), American Osteopathic Association (AOA) Bureau of Osteopathic Specialists, or other accrediting organizations must successfully complete in order to continue to be board certified. Board certifications are not required for allopathic and osteopathic physicians to receive a license to practice medicine in Washington. Board certification is a voluntary certification process that allows physicians to demonstrate a medical specialty.
The ABMS offers board certifications for allopathic and osteopathic physicians through 24 member specialty boards. The ABMS administers its Program for Maintenance of Certification to allow physicians to maintain their certification. Requirements vary among the 24 specialties, but all require an examination.
The AOA Bureau of Osteopathic Specialists offers board certification to osteopathic physicians through 18 specialty certifying boards. The AOA board certifications last six to 10 years depending on the specialty. The AOA offers Osteopathic Continuous Certification with various testing and continuous education requirements for osteopathic physicians to maintain their certification.
The Washington Medical Commission (Medical Commission), which licenses allopathic physicians, and Board of Osteopathic Medicine and Surgery (Osteopathic Board), which licenses osteopathic physicians, generally may not require allopathic or osteopathic physicians to complete a MOC program in order to obtain or maintain their license. There are some instances in which the Medical Commission and the Osteopathic Board may require MOC.
Summary of Bill:
Health carriers may not require physicians and osteopathic physicians to complete a maintenance of certification (MOC) program as a condition for the physician to be a participating provider in the health carrier's network.
A MOC program is defined as a formal board recertification process offered by the American Board of Medical Specialties, the American Osteopathic Association Bureau of Osteopathic Specialists, or another certifying board recognized by the Washington Medical Commission or the Board of Osteopathic Medicine and Surgery. The prohibition applies to new and renewed contracts that begin on or after the effective date of this act.
Appropriation: None.
Fiscal Note: Available.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.