Thursday, April 29, 2010
Making credentialing decisions more efficient is certainly a positive step. However, did lawmakers adequately consider the factors that play into the credentialing process when setting this timeframe? For example, hospitals with a delegated agreement would have a hard time meeting a 45 day timeframe. Also, the 45 day window doesn't encourage physicians to complete the application any faster, since it is imposed on the credentialing verification process.
Finally, what if additional investigation needs to be done on a physician's record and the 45 day timeframe lapses? Are hospitals comfortable with having a member on the medical staff with provisional status if they are still investigating a possible "gap" in his or her file?
NAMSS will work with members in Missouri to ensure that any concerns are communicated to lawmakers before this piece of legislation is voted upon. The bill currently has a proposed effective date of August 2010.
What are your thoughts on this issue? Do you have a credentialing timeframe in your state? If so, how long is it, and have you run into any problems because of it? Share your thoughts in the comment field below this post on the NAMSS Blog website.
To read Missouri HB 2450, click here:
Wednesday, April 28, 2010
The elements that contribute to patient safety as defined by the NQF are:
- Leadership must ensure structures are in place for organization-wide awareness and compliance with safety measures including adequate resources and direct accountability.
- Measurement, analysis, and feedback must track safety and allow for interventions.
- Team-based patient care with adequate training and performance improvement activities must be organization-wide.
- Safety risks must be identified continuously and interventions taken to reduce patient risk.
HFAP has already implemented several standards that promote the 34 Safe Practices of the NQF. The 34 Safe Practices address areas such as leadership, medication reconciliation, and wrong-site surgery.
For more information, visit HFAP's website at: http://www.hfap.org/.
Monday, April 19, 2010
Justice admitted that his scheme took place between 2004 and 2009 and that he had collected payments totalling up to $1 million.
The number of reports of practitioners bilking Medicare and Medicaid continues to grow. This is especially disconcerting in the midst of health reform, since these fraudulent payments are taking up funds that can be used to provide real coverage and care to patients. These fraud cases only highlight the need for better regulation of these programs and safeguards for catching practitioners in the act of fraudulent billing.
Thursday, April 15, 2010
Lucian Leape, MD, adjunct professor of health policy at the Harvard School of Public Health, said that too many new doctors are graduating without the leadership and communication skills that would help them to speak out when they witness an unsafe practice or event. Leape also called on hospitals to enforce a "culture of safety" in their facilities, which includes controlling disruptive patient behavior and encouraging professionalism.
A full copy of the report can be found here:
Tuesday, April 13, 2010
Shin entered the UMMSC program as an intern in 2006 and had received favorable reviews. Soon his performance declined and error rate increased. UMMSC's program director had Shin contact the Employee Assistance Program and also made arrangements to decrease Shin's patient load, to excuse him from participation in certain internship requirements, and to have him to to work under a supervised probation period. At the end of the probation period, Shin's supervising physicians reported that he should be discontinued from providing direct patient care.
UMMSC continued to accommodate Shin, who was diagnosed with ADD in 2007. Shin's doctor reported that although Shin's condition had improved in 2007, he was still unfit to perform the essential functions of his job. Shin was subsequently terminated, and then brought a lawsuit against UMMSC, claiming that he was terminated in violation of the ADA.
The court rejected Shin's claim, stating that in order to qualify for accommodations under the ADA, an individual must be able to perform the "essential functions of his job" with reasonable accommodation. The court ruled that Shin was unable to perform the essential functions of his job and that a reduced workload was not a reasonable accommodation under the ADA.
This situation highlights several issues for hospitals. How much does a hospital need to do in order to accommodate a physician? The ADA is typically dealt with by HR professionals. Medical services departments may want to reach out to their HR departments to learn more about the ADA and how physician performance reviews can play a role in the enforcement of this law.
Source: Ogletree Deakins
Monday, April 12, 2010
Chuck Mowll, executive vice president of Business Development, Government and External Relations, and Robert Wise, M.D., vice president of the Division of Standards and Survey Methods, will discuss revised medical staff bylaws standard MS.01.01.01 during a free one hour telephone conference call for Joint Commission-accredited hospitals and critical access hospitals on Thursday, April 22, at 11 a.m. P.T. / noon M.T. / 1 p.m. C.T. / 2 p.m. E.T.
MS.01.01.01, formerly known as MS.1.20, is designed to contribute to patient safety and quality of care through the support of a well-functioning, positive relationship between a hospital’s medical staff and governing body. The revisions are based on the unanimous recommendations of an 18-member expert task force.
The speakers will discuss:
· Why the standard changed
· How the standard impacts quality and safety of patient care
· What requirements are changing
· When these changes take effect
If you would like to participate in the call, click on the link below to complete the registration form.*
Upon registration you will immediately be provided the toll-free telephone number and pass code. Please print out the page or write down the telephone number and pass code. You will NOT receive an e-mail confirmation.
If you are unable to participate on the call, a transcript and a playback option will be available on The Joint Commission Connect, your secure extranet site, following the program.
To register for the April 22 call, click on the link below or copy and paste it into the address bar of your browser.
* One line per hospital, please
For the report, the FSMB monitored the actions of 70 state medical and osteopathic boards. FSMB assessed the Composite Action Index (CAI) of each state board, which is an average of the number of disciplinary actions taken by the board and the total number of licensed physicians in the state.
The New Hampshire and South Dakota medical boards were shown to have the highest increase in their CAIs between 2008 and 2009. The Florida Board of Osteopathic Medicine and the South Carolina Board of Medical Examiners had the largest decrease between 2008 and 2009.
To read the FSMB report, click here:
Sources: FSMB, Modern Healthcare
Tuesday, April 6, 2010
Bedi and his clinics were involved in a scheme to prescribe controlled substances without a legitimate medical use, and to submit Medicare claims for these illegal prescriptions. Bedi allowed nurse practitioners and physician assistants to write these prescriptions using pre-signed forms, even though writing prescriptions for the controlled substances was outside their scope of practice.
This case is a reminder of the importance of considering both inpatient and outpatient practices of physicians for membership, even if they are not granted privileges.
Friday, April 2, 2010
The AMA is calling for the elimination of a cap on the number of Medicare-paid residents at hospitals, which has kept some potential students from enrolling in medical school. Also, there continues to be the problem of increasing student debt. This forces students to seek positions in higher paying specialties, rather than in primary care, where the shortage will hit the hardest.
Furthermore, the number of new medical school enrollees is not expected to offset the number of physicians expected to retire in the coming years, contributing to the expected shortage of 125,000 doctors by 2025.
In the coming years, there will be an increased need for primary care physicians. This article suggests that the solution may not be increasing the number of medical schools, but to find economic ways to lure students to this field.