MOC Policies

MOC POLICIES and PROCEDURES

The following policies are specific to MOC :

 Appeals
Canadian MOC Program Relationship to ABR-MOC

Late Fee
Licensure Outside U.S. and Canada

Professional Standing
Random Audits

Appeals Policy

The American Board of Radiology has established the Appeals Policy to resolve concerns with decisions made by the Board relative to the following five areas:

• Training requirements
• Admissibility to examinations
• Examination process
• Requests for examination accommodations under the Americans with Disabilities Act (ADA) (see ADA policy)
• Nonrenewal of MOC certificates

The policy provides for three avenues of resolution for concerns:

1. Inquiries and requests as to status or requirements
2. Requests for reconsideration by the Board
3. Appeals hearings (informal and formal)

All appeals MUST be made in writing, submitted via email or certified letter, and received at the ABR office no more than 45 days from the date of the initial written notification of the Board decision. Appeals must be addressed to the Executive Director, and appropriate documentation should accompany written concerns.

Categories of Concerns

• TRAINING REQUIREMENTS
  Concerns regarding denial of approval of training
• ADMISSIBILITY TO EXAMINATION
  Concerns regarding the denial of admissibility to an examination for any other reason
• EXAMINATION PROCESS
  -Concerns regarding the process (including form or administration, e.g., computer malfunction) of the Maintenance of Certification examinations
  -Examination results may not be appealed.*
  -Hand scoring of Maintenance of Certification computer-based exams is available in these areas:

Diagnostic radiology
Radiation oncology
Medical physics
Neuroradiology
Nuclear radiology
Pediatric radiology
Vascular and interventional radiology

Appropriate documentation should accompany written concerns.

• REQUESTS UNDER THE AMERICANS WITH DISABILITIES ACT (ADA):
  Concerns regarding the denial of a request for examination accommodations under the ADA
• NON-RENEWAL OF MOC CERTIFICATES
  Concerns regarding notice of nonrenewal of an ABR time-limited certificate, or a continuous certificate issued in 2012 and thereafter (based on failure to meet MOC requirements)

*All examination results are subject to extensive quality assurance procedures before release.

This policy is subject to amendment. Candidates and diplomates are advised to check the ABR website periodically for the most current version.

Canadian MOC Program Relationship to ABR-MOC
 

Policy:
ABR diplomates who are participating in the Canadian Continuous Professional Development Program (see description below under Canadian MOC Program to ABR Program equivalence section) may fulfill the four MOC parts in the following ways:

1. Professional Standing: continuous possession of a current and unrestricted medical license in a Canadian province(s) (or U.S. state).
2. Lifelong Learning: documentation of satisfactory participation in the Canadian Continuing Professional Development program.
3. Cognitive Expertise: successful examination through the ABR MOC exam every 10 years
4. Evaluation of Performance in Practice: documentation of satisfactory participation in the Canadian Continuing Professional Development program.

Fees:

Diplomates maintaining an ABR certificate expiring in 2019 or later and maintaining Canadian certification through the processes listed in this policy will be offered a reduced ABR MOC participation fee. Fees will include the following:

1. MOC exam fee of the year charged at the time of exam registration
2. Administrative fee of $200 due at the time of exam registration

Canadian MOC Program to ABR Program equivalence

1. Canadian Program title: Continuing Professional Development (CPD)
2. Canadian Program Sponsor: Royal College of Physicians and Surgeons of Canada
3. Canadian Program activity categories:
   
   1. Section 1: Accredited group learning activities - national and international group CME activities (examples: workshops, meetings, courses, conferences and distance-education conferences approved by an RCPSC-accredited provider; grand/M&M rounds, journal clubs, tumor boards self-accredited by chair of planning committee) -- approximates Category 1 CME
   2. Section 2: Other learning activities - learning activities that are not affiliated with or approved by an accredited provider (examples: nonaccredited meetings, journal clubs, tumor boards, Internet CME, audio and videotapes, reading journals and texts, MEDLINE-type searches) -- approximates Category 2 CME
   3. Section 3: Self-assessment programs - programs designed to assist the specialist in identifying his or her educational needs (examples: self-assessment programs developed or sponsored by national specialty societies, universities, and medical colleges; training simulators approved by an RCPSC-accredited provider) -- approximates SAMs
   4. Section 4: Structured learning projects - personal learning projects (PLPs), courses, or traineeships that are planned, and the outcome is recorded and evaluated (examples: keeping a learning portfolio, activity generated out of participating in another CPD activity, master’s and PhD studies) -- approximates Category 2 CME
   5. Section 5: Practice review and appraisal - activities that help specialists review their personal practice for assessing and identifying areas of potential improvement in delivered care or practice delivery (examples: practice and institutional audits, utilization studies, patient surveys, incident reports) -- approximates Practice Performance
   6. Section 6: Teaching, research, standard setting -- activities that involve setting standards for practice and that expand specialists' expertise or enhance their ability to practice (definition: publications, preparing presentations or teaching sessions, developing examination questions, research, setting standards) -- approximates Category 2 CME

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Late Fee Policy, approved February 2008

Policy history:
Approved by the MOC Coordinating and Budget and Finance Committees at the February 2008 meeting of the Board of Trustees. Revised by MOC Coordinating and Budget and Finance Committees at the October 2009 meeting of the Board of Trustees.

Policy:

• Diplomates will be subject to late fees if the following occur:
  • Untimely agreement into the MOC process. Agreement must occur before February 28th of the year following initial certification or entrance into subsequent MOC cycles.
  • Invoice issued for annual fee not paid by due date
• Lifetime certificate holders will not be subject to a late fee for voluntary participation in MOC.

Staff procedures

• Finance will be responsible for communicating, handling and collecting late fees. All inquiries will be handled by the AR Specialist and collection procedures will be consistently performed.
• Authority to waive a late fee can be given by the executive director, associate executive director, or MOC division chair. To waive a late fee, the diplomate must have demonstrated a consistent annual pay history (to be considered consistent, previous fees must have been paid in the year billed or by the specified due date) and no prior late payments (first time offense).
• No late fees will be refunded.

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Policy on Professional Standing (Licensure) Requirements for Diplomates Practicing Outside the United States. and Canada
 

A. Policy overview

The ABR recognizes that some of its diplomates may practice outside the United States and Canada but wish to maintain ABR certification. For those diplomates practicing outside the U.S. and Canada, Part 1 of MOC (professional standing) will be recognized if the diplomate holds and submits documentation of unrestricted licensure in the country in which he or she is practicing.

B. Policy details

• Documentation of unrestricted licensure must be submitted annually.
• As with U.S. and Canadian practitioners, diplomates practicing outside the U.S. and Canada are required to report any license restrictions to the ABR within 60 days of their imposition.
• This policy applies to all physician diplomates, and to medical physicist diplomates practicing in any country that licenses medical physicists.

C. Requirements for international diplomates who also hold licensure in the U.S. and/or Canada

• The ABR will continually monitor licensure actions reported through DANS (Disciplinary Action Notification Service), based on the Federation of State Medical Boards' database.
• If U.S. or Canadian licensure is revoked or suspended (or surrendered in lieu of investigation/action), the ABR will pursue withdrawal of the certificate according to its due process policy (even if there is continued unrestricted licensure in the diplomate's country of practice).
• The Board may also pursue withdrawal of the certificate if the diplomate's license has been placed on probation (unexpired) or put under special conditions/requirements, and if, upon review according to Board policy, the Board deems the restriction is of such nature and extent as to preclude continued certification during the time of the restrictions.
• Reinstatement will be considered when the license is returned to current and unrestricted status.

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Professional Standing Policy for Diplomates

A. Required Licensure

At the time of certification by the ABR and throughout the certification and Maintenance of Certification processes, the physician must hold a current, full and unrestricted license to practice medicine in at least one jurisdiction in the United States, its territories or Canada, including the state(s) in which he or she currently practices, or if practicing abroad, in the country of practice (see Policy for International Licensure). Restrictions placed on a medical license must be reported to the ABR by the physician within 60 days of their imposition.

B. Potential Certificate Sanctions

The Board may at its discretion revoke or suspend a certificate for due cause as provided in the ABR Bylaws:

"Any license of the person to practice is not, or ceases to be, a valid and unrestricted license to practice within the meaning set forth in the Rules and Regulations of the American Board of Radiology. In the event that a Diplomate's license to practice is suspended, revoked or restricted in any state in which the Diplomate practices, holds a license or has held a license, the Diplomate's board certification may be revoked or suspended."

Definitions of Sanctions:

1. Revocation: Diplomate ceases to be certified. Re-entry is under provisions of re-entry policy, with a new continuous certificate (without a “valid-through” date) requiring participation in MOC for its maintenance.
2. Suspension: Diplomate is not certified for at least the specified period of time (possibly concurrent with the licensure action). Conditions may be stipulated by the board; when met, the suspended certificate is reinstated (as a lifetime certificate, if it was originally lifetime).
3. An alternative to certificate sanctions is "probation" in which the diplomate continues to be certified; monitoring is done, there may be restrictions on practice, and periodic contacts and other requirements may be stipulated.

C. Regaining or Reinstatement of Certification

1. Once a valid, unrestricted license is held in the state of current practice, a physician may contact the Board to initiate a request to regain board certification or have his or her original certificate reinstated.
2. After suspension: When the Board reinstates a physician's board certification after it has been subject to suspension by the Board, he or she is entitled to resume use of his or her original board certification with the appropriate expiration date of that certificate. If the original board certification was not time-limited or continuous (without “valid-through” dates), after reinstatement the physician will continue to have a non-time-limited (lifetime) certificate. The Board may, however, in its sole discretion, set other conditions and terms for reinstatement that it deems appropriate, considering, among other things, the underlying facts that led to the restriction and the period of time in which the physician has not been able to engage in the unrestricted practice of medicine and in his or her specialty.
3. After revocation: When the Board has revoked a physician's board certification, the physician is not eligible to have the original certificate reinstated. In addition to other terms and conditions, the Board may require that a physician first pass the examination(s) required for ABR certification or Maintenance of Certification in the specialty or subspecialty. Upon satisfactory completion of all steps required by the Board, the physician whose certificate previously was revoked shall be issued a new continuous certificate (without a “valid-through” date), and the physician shall be required to participate in MOC for its maintenance.

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Random Audits Procedure

The ABR will randomly select a number of diplomates annually for audit of their MOC progress. An audit is the process of requesting from the diplomate, and reviewing, documentation of records of CME, SA-CME, and PQI activity not conveyed to the ABR electronically from the awarding societies/organizations. The ABR will examine the documentation and will make a determination regarding to the validity of the activities with respect to each MOC part. The ABR review will result in the following:

1. A declaration of which claimed activities accurately reflect the data
2. An evaluation of the extent to which the diplomate is compliant in making continuous progress toward fulfillment of all MOC requirements.

The results will be communicated only to the diplomate. If a diplomate is chosen for a random audit, he or she must achieve a compliant status before his or her certificate can be renewed.

PROCESS: A letter will notify a diplomate of selection for random audit and will ask him or her to provide the following documentation within sixty (60) days:

PART ONE: PROFESSIONAL STANDING
Evidence of active, current, valid, and unrestricted licenses relevant to all locations of practice.

PART TWO: LIFELONG LEARNING
Copies of certificates from all ACCME-approved Category 1 CME and SA-CME for which the credit was not conveyed directly to ABR from a society or Gateway (Note that in many circumstances, additional CME credits will be those provided by one or more institutions through which ACCME-approved credits have been obtained. Click the links below for the list of available Self-Assessment Modules (SAMs):
Diagnostic Radiology SAMs
Radiation Oncology SAMs
Medical Physics SAMs

PART FOUR: PRACTICE QUALITY IMPROVEMENT (PQI)

Copies of supporting documentation for each essential element completed up to the point of the audit, e.g., project title, baseline measurements, analysis, action plan, etc. If applicable, a copy of a PQI certificate of satisfactory completion from a society should be provided.

Download diagnostic radiology (DR) audit checklist
Download radiation oncology (RO) audit checklist
Download medical physics (MP) audit checklist

Please note that a compliant audit status does not necessarily indicate that you are current in your progress toward completing your MOC requirements within the prescribed timeline. We suggest that you compare your MOC activity to the MOC Participation Guidelines for your specialty.

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These policies are subject to amendment. Candidates and diplomates are advised to check the ABR web site periodically for the most current version.