Thursday, February 25, 2010

NCCPA Seeks Comment on MOC Implementation

The National Commission on Certification of Physicians Assistants (NCCPA) has released a proposed plan for implementing the Maintenance of Certification (MOC) program. The MOC requirements are mandated by the American Board of Medical Specialties (ABMS) and emphasize the importance of developing patient care competencies as a part of maintaining certification.

The NCCPA proposes the addition of two competencies to the six required by ABMS -- completion of an approved self-assessment activity and participation on a clinical quality improvement project. The NCCPA also proposes extending the recertification cycle from six years to ten years.

The NCCPA is accepting comments on their proposed plan until March 31, 2010. For more information and to submit comments, click here:

Source: NCCPA

Final Revisions to 2010 AAAHC Standards Released

The Accreditation Association for Ambulatory Healthcare (AAAHC) has released the final revisions to its 2010 standards, which now include a chapter on Infection Control.

Along with the new revisions, AAAHC has released the following note:

"Organizations submitting an Application for Survey to AAAHC on or before February 26, 2010 and that are surveyed on or before June 30, 2010, will be surveyed according to 2009 standards. Organizations submitting an Application for Survey on or after March 1, 2010 and/or are surveyed after June 30, 2010, will be surveyed according to 2010 standards."

The AAAHC has been granted deemed status by CMS for Ambulatory Surgery Centers.

The 2010 standards revisions can be found here:

Source: AAAHC

Tuesday, February 23, 2010

Higher Standard of Review for Peer Review Malice Recognized by Supreme Court

The Supreme Court announced that it will not review a decision by the U.S. Court of Appeals for the Fifth Circuit, which held that "clear and convincing evidence" is required to prove malice of peer reviewers seeking immunity under the Texas Medical Practice Act (TMPA).

The Court accepted the Fifth Circuit's standard after Dr. Royal Benson had argued that a "preponderance of the evidence" standard should be met, which is a lower standard of proof. Dr. Benson claimed that St. Joseph Regional Medical Center and members of its peer review committee should not be granted immunity under TMPA because the statute bars immunity if it can be proven that decisions were made with malicious intent.

Dr. Benson was denied reappointment by the peer review committee. He also alleged that the denial of privileges was a violation of section 1 of the Sherman Act because it caused injury to competition. The Fifth Circuit dismissed this claim.

Source: BNA

Tuesday, February 16, 2010

Texas Jury Clears Nurse of Criminal Charges for Reporting Physician

A jury in Andrews, Texas acquitted nurse Anne Mitchell after she had been charged with "misuse of official information" and harassment after filing a complaint about a physician at Winkler County Hospital. Mitchell reported Dr. Rolando Arafiles to the Texas Medical Board after he had performed surgical procedures without privileges and had tried to prescribe patients an herbal supplement that he was selling.

The prosecution argued that Mitchell's report to the state medical board was motivated by personal intentions. The jury ultimately acquitted Mitchell of all charges, saying that she acted in the interests of the patients.

The verdict has been applauded by nursing groups and medical quality groups who feel that a different decision might have discouraged others from reporting improper behavior among medical professionals.

To read the full article on the decision, click here:

Source: The New York Times

Thursday, February 11, 2010

NCQA Response Regarding American Board of Pediatrics Certification Changes

NCQA was recently contacted regarding the American Board of Pediatrics' (ABP) implementation of the Maintenance of Certification (MOC) program and elimination of certification expiration dates. NCQA was asked how the change will affect scoring of pediatricians in 2010 and beyond for CR 3 Element A factor B.

NCQA provided the following response:

"We are investigating the changes in the ABMS policy to determine whether or not a change to our board certification verification requirements is appropriate. Once we have reviewed the ABMS policy, we will notify customers of any changes through the Programs section of our Web site ( Any changes will be posted as a Policy Update; to access any changes, please visit the Web site provided and click on "Policy Updates and Supporting Documents" and then on "Corrections, Clarifications and Policy Changes." The next Policy Update is scheduled for March 29, 2010."

NAMSS will continue to alert the membership as more information regarding the ABP's changes becomes available.

IL Supreme Court Overturns Landmark Medical Malpractice Reform

On February 5, the Illinois Supreme Court overturned the state's medical malpractice law, which set limits of $500,000 in non-economic damages against doctors and $1 million against hospitals.

The court ruled that the law was unconstitutional because the determination of damage awards should be left to the courts, not the legislature.

The ruling reflects the current debate in Washington, where medical malpractice caps have been considered as part of the health reform debate.

An article on the court's ruling can be found here:

The court's decision can be found here:

Sources: New York Times, Illinois Supreme Court

Monday, February 8, 2010

New CMS Regulation for Foreign-Born Physicians

The Centers for Medicare and Medicaid Services (CMS) has issued a new regulation regarding the verification of legal status of foreign-born healthcare professionals. CMS provides the following summary of the rule:

"If a newly-enrolling physician or non-physician practitioner indicates in Section 2 of his/her Medicare enrollment application (CMS-855I or Internet-based PECOS) that he/she was born in a foreign country, the contractor shall verify that the physician or non-physician practitioner is: (1) a United States citizen; (2) a legal resident of the United States, or (3) otherwise legally authorized to work in the United States. The purpose of this change request is to help ensure that all enrolling physicians and non-physician practitioners are legally authorized to perform Medicare services. "

The regulation will be implemented and ruled effective on March 29, 2010.

The full transmittal describing the new regulation can be found here:

Source: CMS

Thursday, February 4, 2010

Report Calls for Improved Oversight over Credentialing and Privileging in VA Medical Centers

The Government Accountability Office (GAO) conducted a review of six Veterans Affairs medical centers (VAMCs) to determine if VA policies on credentialing and privileging were being properly implemented. A report detailing this review was released this month.

The report shows that staff at the VAMCs studied were inconsistent in meeting credentialing standards. Some of the issues highlighted in the report include: improper verification of state licensure, failure to document physician performance information, and the failure to detect malpractice information that was not disclosed by physicians.

The VA has accepted the findings of the GAO report and has already taken steps to implement improved policies and oversight over the credentialing and privileging processes. Some of these improvements include: updating the VetPro system by September 2012, working with state medical boards to see if they will provide additional information for credentialing and privileging purposes, and amending the current VA policy so that written verification is not required for states that provide information that can be verified online or over the phone.

To read the full report, click here: