Board of Medicine approves NBPAS as a recognizing agency
Mary Thomas, Esq.
Special to the FMA

The Florida Board of Medicine took a significant step toward expanding recognized board certification options for Florida physicians at its Aug. 7 meeting. 

The Board voted to grant a petition for waiver filed by the National Board of Physicians and Surgeons (NBPAS)  from a provision of Rule 64B8-11.001, Florida Administrative Code, Florida’s physician advertising rule. Once the Board’s final order is issued, NBPAS will qualify as a recognizing agency under the rule, allowing physicians certified by NBPAS to represent themselves as “board certified” in Florida. 

The decision marks a significant development in a long debate over maintenance of certification (MOC) requirements. The American Board of Medical Specialties (ABMS) and its member boards have long served as the predominant pathway for physician board certification recognized under Florida’s advertising rule. However, for years, physicians have raised concerns that ABMS’ MOC requirements are costly, burdensome and unnecessarily onerous. 

NBPAS was established as an alternative certification pathway and has sought recognition in Florida for several years. In 2021, NBPAS petitioned the Board to become a recognizing agency. The Board denied that application because the rule requires a recognizing agency to administer a comprehensive examination, and NBPAS does not itself administer such an examination.  

This time, NBPAS took a different approach. Rather than asking the Board to reconsider whether it satisfied the actual requirements of the rule, NBPAS filed a petition seeking a waiver from the examination requirement. 

Under Florida law, a variance or waiver may be granted when the purpose of the underlying statute has been or will be achieved by other means and strict application of the rule would create a substantial hardship or violate principles of fairness. NBPAS argued that both standards were met in this case.  

In its petition, NBPAS argued that the purpose of the examination requirement is to ensure that a physician claiming board certification has demonstrated competency through a comprehensive specialty examination. NBPAS maintained that its physicians have already met that standard because NBPAS certification is available only to physicians who previously completed initial specialty board certification through the ABMS, which includes a required examination.  

NBPAS also argued that strict application of the requirement created a substantial hardship for physicians who had already demonstrated their competency but chose not to maintain certification through an ABMS member board. According to the petition, lack of recognition in Florida could affect physicians’ employment, hospital privileges, credentialing and their ability to advertise themselves as board certified.  

ABMS also appeared at the meeting to voice opposition to NBPAS’ petition. While ABMS and its member boards have made significant changes in recent years aimed at reducing some of the burdens associated with MOC, those efforts were not enough to prevent the Board from voting to grant the waiver in favor of NBPAS. 

Once the final order is issued, physicians who hold qualifying NBPAS certification will be permitted to identify and advertise themselves as board certified in Florida. 

Physicians should keep in mind, however, that recognition by the Board of Medicine for purposes of Florida’s advertising rule does not necessarily mean that every hospital, health system, insurer or other credentialing organization will accept NBPAS certification for its own purposes. Although NBPAS reports growing acceptance among hospitals and health systems, individual organizations may maintain their own credentialing and privileging standards. Physicians considering a change in certification should therefore verify the requirements applicable to their employment, medical staff privileges, payer participation and other credentials before allowing an existing certification to lapse. 

NBPAS is scheduled to appear before the Board of Osteopathic Medicine at its Aug. 21 meeting to seek a similar waiver under Rule 64B15-14.001, F.A.C., the Board of Osteopathic Medicine’s advertising rule. 

The FMA will continue to monitor implementation of the Board’s decision and the issuance of the final order. 

Mary Thomas, Esq., is Executive Director of the Council of Florida Medical School Deans. Previously, she served for over a decade as the Assistant General Counsel for the FMA. Ms. Thomas continues to represent the FMA in matters before the state's regulatory boards.