The Deductible Guide: A New Legal Threat For Maintenance of Certification


Could the hated maintenance of certification system be on the verge of going away? A new lawsuit filed against the American Board of Medical Specialties, the American Board of Emergency Medicine and the American Board of Anesthesiology last week in the Southern District of California argues that the current system violates federal antitrust law. The lawsuit, which names the Chicago-based non-profit’s 24 member specialty boards as co-conspirators asks for an end to maintenance of certification and economic damages.

A lawsuit filed in December of last year against the American Board of Internal Medicine goes even further, seeking to apply the Racketeer Influenced and Corrupt Organization Act (R.I.C.O.) The RICO statutes have been used by in the past by prosecutors to target various shadowy defendants including the Gambino and Lucchese crime families, a corrupt unit in the Los Angeles Police Department and famously, Lt. Colonel Oliver North and his co-conspirators in the Iran-Contra affair in the 1980s.

The suit argues that the Philadelphia-based ABIM meets the definition of a criminal organization engaged in racketeering, pointing at the tangled web of ties linking the national medical boards, insurers, hospitals and the executives who run the certification programs.

The early success of the ABIM suit appears to be inspiring other doctors around the country to take similar action. Insiders the Deductible talked to believe a wave of lawsuits is likely to drop in the weeks to come. Potential targets could include the American Board of Radiology, the American Board of Family Medicine and the American Board of Obstetrics and Gynecology.

Is it extreme to use a law originally intended to allow prosecutors to target people like Tony Soprano and John Gotti to take on a venerable medical board ? Critics of maintenance of certification don’t think so. They argue that while the original intent was good, the current dysfunctional system has evolved into a monopoly that has funneled millions into the pockets of corrupt board executives by creating a Ponzi-like industry based on regular recertification tests and annual fees.

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