In an August publication, we outlined proposed legislation by Rep. Edward Canfield (R-Sebewaing) and Sen. Peter MacGregor (R-Rockford) that would have revised: (1) the Public Health Code to prohibit the Department of Licensing and Regulatory Affairs or a professional board from requiring a physician to maintain a national or regional certification and prohibit hospitals from denying admitting privileges on that basis; and (2) the Insurance Code to prohibit insurers from conditioning the payment of a claim on a physician’s national or regional certification not otherwise required under the Public Health Code. These two prior initiatives aimed to prohibit hospitals, the state boards of medicine and insurance companies from requiring physicians to participate in maintenance of certification programs (“MOC”), a requirement emanating from physician national certification boards.
On January 31, 2017, Rep. Canfield and Rep. Hank Vaupel (R-Handy Township) introduced new legislation on the topic of MOC that would revise: (1) the Public Health Code to prohibit the Department of Licensing and Regulatory Affairs or a professional board from requiring a physician to maintain a national or regional certification (HB 4134); and (2) the Insurance Code to prohibit insurers from conditioning the payment of a claim on a physician’s national or regional certification not otherwise required under the Public Health Code (HB 4135).
The newly proposed legislation now only targets the Department of Licensing and Regulatory Affairs and insurers for this prohibition and drops any discussion of imposing such a prohibition on hospitals as the previous legislation requested. Insurers, especially private payers, are likely to continue to oppose the proposed legislation by contending such a prohibition interferences with the ability of a health plan to create reasonable credentialing standards for clinical competence.
This updated legislation has been referred to the House Health Policy Committee for further review. Hall Render will continue to provide timely updates regarding this matter. If you have any questions regarding the proposed legislation, please contact:
- Susanne E. Crysler at (248) 457-7843 or scrysler@hallrender.com;
- GinaMarie F. Geheb at (248)-457-7823 or ggeheb@hallrender.com; or
- Your regular Hall Render attorney.
