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Three California doctors have filed a proposed class action lawsuit in which they allege the American Board of Medical Specialties (ABMS), the American Board of Anesthesiology (ABA), and the American Board of Emergency Medicine (ABEM) have for years abused their positions within the American medical community by illegally obtaining revenue through anticompetitive means. According to the 31-page lawsuit, the defendants’ and their directors’ conduct has “sharply curtailed, if not eliminated” fair competition in the arena for medical specialty certification maintenance for doctors nationwide.

The American Board of Medical Specialties encompasses its two co-defendants and 22 other certifying medical specialty boards, the lawsuit explains, which range from the Board of Obstetrics and the Board of Allergy and Immunology to the Board of Family Medicine and the Board of Medical Genetics and Genomics. The boards under the ABMS’s umbrella, the suit goes on, issue the more industry-specific, specialized certifications, called Initial Board Certifications (IBC), physicians need in addition to a general license to practice medicine in a particular state in order to operate. According to the case, roughly 90 percent of the more than 880,000 licensed physicians in the United States are board-certified in at least one specialty under the ABMS.

As the lawsuit tells it, ABMS’ dominance in selling initial board certifications is indicative of its alleged monopoly over the IBC market. Whereas an initial board certification used to be a voluntary step taken by some doctors to demonstrate a distinguishing proficiency in a particular medical skill, such certifications have, according to the plaintiffs, “evolved to become an essential component of a physician’s commercial practice.” In essence, the suit argues, an IBC is today a de facto requirement for a physician’s meaningful participation in the commercial medical space.

“Fully licensed doctors authorized to practice medicine cannot expect to maintain a commercial practice, including the core requirements that they be able to maintain hospital admitting privileges and, perhaps more importantly, treat a majority of the commercially insured patients in the United States, without being board certified,” the plaintiffs argue, further alleging that a physician’s failure to maintain board certification “is likely to have devastating effects on their livelihood.”

Also for sale by the ABMS, the suit goes on, is “maintenance of certification” (MOC) for board-certified physicians. According to the lawsuit, the failure of a physician to buy maintenance of certification can lead to a loss of certification regardless of skill level in a given specialty. The case says the defendants’ sale of MOCs is a no-choice situation for physicians, who risk the loss of their initial board certifications without the purchase of maintenance of certification.

From the suit:

“Through their MOC monopoly, defendants abuse their position to extract inflated supracompetitive payments for MOC from certificated physicians and engage in other predatory and anticompetitive activities. Plaintiffs, fair competition and American medical community participants – from physicians to competitor certification providers to consumers – have been injured.”

The lawsuit can be read below.