ABIM MOC Lawsuits Explained, What Doctors Need to Know

Doctors frustrated with the American Board of Internal Medicine’s Maintenance of Certification program have filed multiple lawsuits over the years challenging ABIM’s practices on antitrust and civil rights grounds. The original class action — Kenney v. ABIM — was dismissed in 2021 with no settlement and no payout. A new class action filed in December 2025 by the American Osteopathic Association is now active in federal court in Illinois. Neither case has produced a settlement fund or claim form for individual doctors.

Key Dates

What Is MOC and Why Do Doctors Object to It?

Starting in 1990, ABIM issued time-limited initial certifications and required internists to take must-pass exams every 10 years or lose their board certification. Doctors who were board-certified before 1990 were not required to recertify under the same rules.

This two-track system drew decades of criticism from physicians. Complying with ABIM’s MOC costs internists an average of $23,607 in financial cost and time lost over 10 years, and costs up to $40,495 for some specialists. Doctors who declined MOC or failed MOC exams risked losing hospital privileges, insurance contracts, and employment — all without, critics argued, any proven benefit to patient outcomes.

Lawsuit #1: Kenney v. ABIM (2018–2021) — Dismissed, No Settlement

What the Doctors Alleged

In December 2018, four physicians filed a class action lawsuit against ABIM on behalf of all internists required by ABIM to purchase MOC to maintain their initial ABIM certification. This lawsuit alleged four claims based on federal law: that ABIM violated the Sherman Antitrust Act by unlawfully tying its initial certification to its MOC program; that ABIM violated the Sherman Act by engaging in anticompetitive conduct to obtain and maintain monopoly power over the MOC market; that ABIM violated the RICO Act by fraudulently misrepresenting that MOC has a beneficial impact on physicians, patients, and the public; and a claim for unjust enrichment.

The complaint alleged that ABIM controls more than 95% of the market for MOC of internists, in violation of federal antitrust laws.

The four physician-plaintiffs were not abstract names. They claimed they had lost job opportunities, employment, admitting privileges, or insurance coverage because they had either declined to participate in ABIM’s MOC program or had failed MOC exams. Each had a specific, documented story tied to those losses.

What ABIM Said

ABIM said it would vigorously defend itself, recognizing that doing so would consume resources far better dedicated to continuous improvement of its programs. The organization said it had spent the last several years working with the internal medicine community to improve its MOC program.

How the Court Ruled

The District Court found that plaintiffs’ failure to plausibly allege that ABIM’s initial certification and MOC products occupy distinct markets was fatal to the antitrust claim. The court also concluded that ABIM could not have monopoly power in the MOC market because no such separate market exists.

The court rejected the unjust enrichment charge because it found that ABIM did not force plaintiffs to purchase MOC — the physicians had purchased time-limited certifications knowing they would need to renew them.

The plaintiffs appealed. On February 25, 2021, the U.S. Court of Appeals for the Third Circuit issued its decision affirming the District Court’s dismissal of all plaintiffs’ claims. The case ended there — permanently. No settlement was reached. No money was paid to any physician.

Lawsuit #2: AOA v. ABIM (December 2025) — Active, No Settlement Yet

A Different Dispute Entirely

Law firm Eimer Stahl filed a class action lawsuit on behalf of the American Osteopathic Association (AOA), the American College of Osteopathic Internists (ACOI), and six individual physicians against ABIM on December 3, 2025, in the U.S. District Court for the Northern District of Illinois.

This case is not about MOC fees or exam requirements for individual doctors. The issue is different and more targeted.

At issue is an ABIM rule that blocks qualified residents and fellows from taking its board certification exams — not because of their competence, but because their program directors are certified by the American Osteopathic Board of Internal Medicine (AOBIM) rather than ABIM.

Why Now?

In 2015, AOA and ACGME entered into negotiations to streamline graduate medical education, creating a unified system. At the time, all ABMS member boards agreed to allow AOA board-certified physicians to function as program directors and attest to residents’ completion. This happened without problems for approximately seven years. Then ABIM on its own decided that program directors in ABIM programs and sub-specialties had to be ABIM-certified.

The effect on real physicians was immediate. Nancy Law, DO, MPH, transitioned from director to associate director, then co-director, of the infectious diseases fellowship program at the University of California San Diego School of Medicine because ABIM would not let her attest to her fellows’ successful completion of their fellowship. Maria “Lily” Asprilla, DO, took a demotion from director to assistant program director for the hospice and palliative medicine fellowship at John Peter Smith Hospital in Fort Worth, Texas.

What the AOA Is Asking For

The complaint seeks a court ruling that the ABIM policy violates the Sherman Antitrust Act and an order that ABIM must accept attestations from AOBIM-certified program directors. This lawsuit seeks a court order to change ABIM’s policy — not a cash settlement or payment to individual physicians.

ABIM’s Response

As of February 2026, ABIM has not issued a detailed public response to the December 2025 lawsuit in court filings that are publicly accessible. The case is in its early stages.

What This Means for Individual Physicians

If you paid MOC fees and hoped for a refund: The Kenney lawsuit that covered that issue was dismissed with no settlement in 2021. There is no settlement fund, no claim form, and no payment process available for MOC fee disputes.

If you are a DO physician blocked from a program director role: The AOA v. ABIM case filed in December 2025 directly addresses this issue. It seeks a court order changing ABIM’s policy — not individual cash compensation. That case is in its early stages, and no resolution has occurred.

If you are a resident or fellow whose training attestation was rejected: This is the class of individuals the new AOA lawsuit aims to protect. The lawsuit seeks to restore fairness and ensure that all qualified program directors, whether certified by AOBIM or ABIM, can guide residents and fellows toward the certification of their choice.

Possible Outcomes in the AOA v. ABIM Case

This section presents general legal possibilities for educational purposes only. No outcome can be predicted.

ABIM could file a motion to dismiss. Given the history of Kenney, ABIM may argue again that no separate market exists that can support antitrust claims. The court would then decide whether the case proceeds.

The case could settle privately. If ABIM and AOA reach an agreement, ABIM could agree to change its policy without a court ruling. Settlement terms would likely be confidential.

A court could issue an injunction. If the AOA prevails, a judge could issue a court order requiring ABIM to accept AOBIM-certified physician attestations — changing the policy entirely.

The case could be dismissed. Courts have dismissed prior ABIM antitrust lawsuits, and a dismissal in this case is a recognized possibility, regardless of the merits of the underlying dispute.

Frequently Asked Questions

Is there a settlement I can claim money from? 

No. No ABIM settlement fund exists as of February 2026. The Kenney lawsuit was dismissed in 2021 with no settlement. The 2025 AOA lawsuit seeks a policy change, not a cash fund.

Did doctors win the Kenney MOC lawsuit? 

No. The U.S. Court of Appeals for the Third Circuit affirmed the dismissal of all claims on February 25, 2021. The case is permanently closed.

Can I join the new AOA v. ABIM lawsuit? 

The December 2025 lawsuit was filed as a class action on behalf of osteopathic physicians and affected residents. It is in its early stages. Anyone who believes they have been directly harmed by this policy should consult a qualified attorney.

Does the new lawsuit cover MOC fees? 

No. The AOA v. ABIM case filed in December 2025 is about ABIM’s refusal to accept attestations from AOBIM-certified program directors. It does not address MOC fee disputes.

Why did the original Kenney lawsuit fail? 

The courts found that plaintiffs failed to plausibly allege that ABIM’s initial certification and MOC are two separate products in two distinct markets. Without a separate MOC market, the antitrust claims could not legally stand.

How much does MOC actually cost doctors? 

According to the Kenney complaint, complying with ABIM’s MOC costs internists an average of $23,607 in financial cost and time lost over 10 years, and up to $40,495 for some specialists. These figures come from the complaint and were not independently verified by the court.

What is ABIM’s stated position on MOC? 

ABIM has said its focus remains on maintaining a standard of professional achievement that the public values, signaling that ABIM diplomates are well-trained and staying current in their fields to better serve their patients.

Where is the AOA v. ABIM case being heard? 

The case was filed in the U.S. District Court for the Northern District of Illinois on December 3, 2025. It is active and no hearing date has been publicly confirmed as of February 2026.

Will ABIM ever have to change its MOC program? 

That is a question courts would need to decide if future litigation proceeds. No court has ordered ABIM to change or eliminate MOC requirements as of February 2026.

Last Updated: February 18, 2026

Disclaimer: This article is for informational purposes only and does not constitute legal or tax advice. Settlement terms, eligibility, and payment amounts are subject to court approval and may change. For official information, always refer to the settlement administrator or the official settlement website.

About the Author

Sarah Klein, JD, is a licensed attorney and legal content strategist with over 12 years of experience across civil, criminal, family, and regulatory law. At All About Lawyer, she covers a wide range of legal topics — from high-profile lawsuits and courtroom stories to state traffic laws and everyday legal questions — all with a focus on accuracy, clarity, and public understanding.
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