Monday, July 8, 2019

ABMS Names Diane Meldi as Stakeholder Council Liaison to the Information and Data Sharing Task Force

NAMSS congratulates Diane Meldi, MBA, CPCS, CPMSM on being named as Stakeholder Counsel Liaison to American Board of Medical Specialties’ Information and Data Sharing Task Force. The Information and Data Sharing Task Force is one of five Task Forces ABMS created to execute its Achieving the Vision plan to develop a continuing certification program that achieves high quality patient-care standards.

The Task Force will develop research and data-sharing strategies to guide future certification assessments, enhance diplomat education, and communicate requirements and standards to strengthen and advance specialty learning and improvement goals. Through collaborations between ABMS Member Boards and key stakeholders, ABMS seeks to learn how continuing certification affects change in diplomat practice, professional development, and patient-care delivery.

As Liaison, Diane hopes to serve NAMSS members by influencing and reporting on ABMS data update frequency and their timeliness of changes. Diane recognizes the challenges and opportunities MSPs have regarding data sharing, “MSPs need to ensure that all data sources are accepted by federal and state regulations and accreditation standards. Additionally, managed care plans need to accurately reflect a physician’s certification status for their marketing materials. Opportunities associated with data sharing are faster verification, lower costs, and the ability to share the importance of physician board certification.”

MSPs can benefit from, and influence, clinical data-sharing processes and policies by demonstrating the role timely and accurate data has in ensuring credentialing excellence and efficiency. Diane’s liaison role will also help show how data sharing can improve the payer and practitioner credentialing processes. “Health care organizations may require certification and recertification and depend on accuracy and timeliness. The number of days to complete the initial credentialing process is getting shorter and shorter. This would ensure that MSPs can get the verifications requested faster.”

The ABMS Stakeholder Liaisons will provide guidance to the Oversight Committee and providing recommendations to the five Task Forces:
  • Advancing Practice
  • Information and Data Sharing
  • Professionalism
  • Remediation
  •        Standards
The ABMS Commission Task Force Oversight Committee determines each Task Force’s deliverables and timelines. Stay tuned for more updates from Diane Meldi on the progress of the Information and Data Sharing Task Force.

Click here to read the Continuing Board Certification: Vision for the Future Commission's Final Report. Click here to read more about the ABMS Vision Initiative. Click here to read more about the five Task Forces.

Monday, April 1, 2019

NAMSS Updates Ideal Credentialing Standards for Practitioner Applicants

NAMSS has recently released an updated version of the Ideal Credentialing Standards, which outline best practices for the initial credentialing of independent practitioner applicants in medical facilities. The Ideal Credentialing Standards were initially released in 2014, having been developed with a coalition of notable industry representatives across the credentialing ecosystem. In 2019, members of the NAMSS Board convened to review and update the Standards to align with current best practices in the credentialing profession.

The Ideal Credentialing Standards have been recognized as an essential document for determining the gold standard of practitioner credentialing for the past five years. In order to ensure that the Standards remain reflective of the highest level of credentialing practice, NAMSS Board members reviewed the Standards and analyzed new developments in credentialing nationwide. The working group included updates to the standards around identity proofing, education and training, and military service, and revised the list of potential red flags. Additionally, the group detailed recommendations around Internet background checks and social media review, as applicants’ online history continues to be a thorny issue for Medical Staff Offices.

The updated edition of the Ideal Credentialing Standards can be found on the NAMSS website.

Friday, March 8, 2019

GAO Report Reveals VHA’s Need for Improvement in Credentialing and Hiring Process


            A report from the U.S. Government Accountability Office discovered that the Veterans Health Administration had overlooked or missed adverse actions that were reported to the National Practitioner Data Bank (NPDB) while hiring physicians and other healthcare providers. The GAO analyzed healthcare providers at the VHA as of September 2016 who were recorded in NPDB, and found that VHA facilities did not consistently act within VHA employment policies and hired providers with various disqualifying adverse actions.

Staff that were involved in the credentialing and hiring process in at least 5 facilities did not have knowledge of the VHA policy regarding hiring providers with revoked or surrendered licenses due to misconduct or incompetence. VHA officials have stated that they are developing improved processes to verify credentials of providers and ensure they meet all requirements. In December 2017, the VHA conducted a review of all licensed providers and removed 11 that did not meet the licensure requirements, but these reviews are infrequent.

 The GAO made seven recommendations on how the VHA can better their reviewing and hiring process. The recommendations included that the VHA should implement mandatory training periodically for facility staff that is responsible for verifying credentialing and hiring.

Click here for more information regarding the GAO report on VHA.

Friday, January 25, 2019

ABMS Vision for the Future Commission Releases Report on MOC Process


On December 11, 2018, the ABMS Vision for the Future Commission released a report regarding their review of the MOC process. The Commission was tasked with reviewing MOC within the current medical profession and confronted issues that ABMS Boards and Diplomats experience. The Commission addressed areas that are problematic for physicians and provided recommendations for overhauling the MOC system, including retiring the “maintenance of certification” terminology. It remains to be seen what specific changes the ABMS will make to the MOC process, but the commission’s report represents a concerted turn towards real change in the current status quo.

                The Commission also recommended that ABMS boards conduct research to analyze the success of continued certification in helping clinicians provide quality and safe care for their patients. In addition, ABMS should research potential activities that help clinicians maintain their skills. The commission did not directly address fees, yet the survey measured that 58% of doctors said MOC costs were their top concern, 52% said MOC was a burden, and 48% said MOC was not a true reflection of their abilities as clinicians. The Commission report suggested shifting from single point-in-time assessments leveraged years apart to more regular, longitudinal, multi-source assessments to provide more useful appraisals of physicians’ ongoing competence. The report also encouraged medical staff offices and other credentialing professionals not to make credentialing and privileging decisions solely on the basis of certification status, but to utilize certification as an additional data point when evaluating practitioner applicants.

Commission Co-Chairs Christopher Colenda, MD and William Scanlon, PhD told Medscape that while fee structures and pricing were not addressed in the Commission report, they noted that boards should implement reasonable fees. They believe that the changes recommended will enhance the value of the MOC process for all stakeholders. Former NAMSS Presidents, Linda Waldorf and Diane Meldi contributed to the Commission’s work.

Click here to read the Commission’s draft report and here for more information regarding the ABMS commission report on MOC. NAMSS will continue to monitor any further actions of the Commission and changes to the MOC process.

Tuesday, December 11, 2018

2018 Updates to the NPDB Guidebook


           The Health Resources and Services Administration (HRSA) recently updated its online National Practitioner Data Bank (NPDB) Guidebook on October 26, 2018. This is the first time the Guidebook has been updated since April 2015. The October 2018 Guidebook added a new section titled “Length of Restriction” under Chapter E: Reporting Adverse Clinical Privileges Actions and alters language regarding the reportability of proctoring. The Guidebook also adds seven new questions and answers to the end of Chapter E. Additionally, the Guidebook clarifies that indirect action taken by a physician during an investigation maybe reportable.

            The new section titled “Length of Restriction” states that if a restriction has an adverse effect on a practitioner’s privileges for more than 30 days, then it is reportable on the 31st day, regardless if the length of the restriction is in writing. The seven new questions that address reporting requirements address the following topics:
  1. Agreements not to exercise privileges while under an investigation (Q. 22)
  2. Leave of absence while under investigation that restricts privileges (Q.23)
  3. Reappointment application review (Q.24)
  4. Resignation while subject to a “quality improvement plan” (Q. 25)
  5. Restrictions versus generally-applicable guidelines regarding first assistants and practitioner specific requirements (Q.31)
  6. A practitioners lapse of privileges at the end of a scheduled term (Q.46)
  7. Guidelines on updating NPDB reports modified by Court order (Q.49)
Click here for more information regarding the NPDB Guidebook.  

Tuesday, September 4, 2018

Foreign Medical Graduate Commission Updates Identity Certification Process


The Educational Commission for Foreign Medical Graduates (ECFMG) recently announced an enhancement to their process for certifying the identities of applicants, beginning in mid-September 2018. The current Certification of Identification form (Form 186) will now be required to be completed online, using NotaryCom.com. NotaryCam is an online service that provides 24 hour access to professional notaries, allowing applicants to bypass the sometimes complicated and burdensome process of using a notary in person.

Additionally, the online Form 186 will now be a requirement for applicants as part of the Application for ECFMG Certification. This is required before submission of an application to take the United States Medical Licensing Examination (USMLE). All new Certification of Identity forms will require the online process, as well as expiring or invalidated forms. Currently, the Certification of Identity form lasts for five years from the accepted date. Find more details about the new process here.

The ECFMG is the standard for international medical graduates (IMGs) to be evaluated on their qualifications before entering the US graduate medical education (GME) process, or to take the USMLE and obtain a license to practice medicine in the US. ECFMG also provides application, visa, and verification assistance for IMGs. Learn more about the ECFMG at https://www.ecfmg.org/

Wednesday, August 29, 2018

NAMSS Releases Position Statement on MOC


Maintenance of Certification (MOC), the program through which ongoing physician competence is demonstrated through American Board of Medical Specialties (ABMS) and American Osteopathic Association (AOA) boards, has been controversial since its launch. As NAMSS members have heard, the ABMS has recently launched an initiative to reexamine MOC and provide recommendations for the future state of physician certification. NAMSS has engaged with this Vision Commission, with several NAMSS leaders participating in past meetings, and with other organizations to contribute the MSP perspective on this issue. As the issue has continued to affect MSPs directly and indirectly, NAMSS has released the following organizational statement on Maintenance of Certification.

The National Association Medical Staff Services (NAMSS) supports efforts by the American Board of Medical Specialties (ABMS) and stakeholders across the health care industry to re-envision the process of continuing board certification and the Maintenance of Certification programs. Demonstrating ongoing physician competence is an essential piece of maintaining patient safety, and is an important part of evaluating practitioners for credentialing and privileging decisions. Concerns around the existing continuing certification programs have led some states to propose or enact laws restricting their use in making these decisions, which infringes on the ability of Medical Services Professionals and Organized Medical Staffs to fulfill their duty in evaluating providers. However, physician burnout is an increasingly difficult issue as additional burdens are being placed on providers across the continuum of care.

Increased standardization, clarity of requirements, and reduced physician burden will all be integral parts of a modern, effective board certification program. NAMSS looks forward to the outcomes of the ABMS’ Vision for the Future Commission and to aiding in the evolution of board certification to best support our ultimate goal of patient safety.

NAMSS will continue to monitor the work of the ABMS Commission and other progress in the area of continuing physician education, and work to inform our MSPs about important developments. Find our position statement and others at the NAMSS website, and be on the lookout for further communications on this issue.