NAMSS

BNA: CMS's Hospital Compare Website Adds Central Line Bloodstream Infection Data

2012-02-02T11:44:00.004-05:00

The Centers for Medicare & Medicaid Services Jan. 26 posted data on central line-associated bloodstream infections (CLABSI) occurring in hospital intensive care units to its Hospital Compare website.

The data were based on three months of hospital reporting (January 2011 through March 2011), and they will be updated quarterly. The website allows users to compare an individual hospital's performance in a variety of categories against a national benchmark rate.

Roughly 248,000 bloodstream infections occur in U.S. hospitals annually. Many result from use of a central vascular catheter, also known as a central line, according to the Centers for Disease Control and Prevention.

“This is a milestone for patient safety that begins to make hospitals accountable for the two million patients who are infected each year,” Lisa McGiffert, director of Consumers Union's Safe Patient Project, said in a Feb. 1 statement. “Finally, Americans in all 50 states will be able to find out how well their hospital prevents these particular infections.”
Consumers Union, the nonprofit advocacy arm of Consumer Reports, said it has called for the release of hospital CLABSI data since 2004, and it has worked with other advocacy groups to mandate hospital infection reporting in 30 states.

The Medicare hospital Fiscal Year 2011 inpatient prospective payment system final rule required all hospitals to begin reporting CLABSI data to the CDC's National Healthcare Safety Network by Jan. 1, 2011. The data were then shared with the Hospital Compare website.

Hospitals currently report bloodstream infections occurring in a surgical setting to the CDC, and those data are expected to be posted to the Hospital Compare website in 2013.

The Hospital Compare website is at http://www.hospitalcompare.hhs.gov/. The FY 2011 Final Rule is at http://www.gpo.gov/fdsys/pkg/FR-2011-08-18/pdf/2011-19719.pdf

BYOD: Physicians' Use of Mobile Devices Seen As Improving Care, but Bringing New Risks

2012-01-30T15:44:00.004-05:00

Attorneys Mike Overly and Chanley T. Howell of Foley & Lardner LLP discuss the ways in which personal mobile devices will influence healthcare delivery

Physicians' use of personal mobile devices to treat patients could improve efficiency and reduce cost to providers, but also could pose liability and security risks, attorneys with Foley & Lardner LLP said Jan. 23 during a webinar hosted by the law firm.

Speaking at Foley's webinar on “Emerging Issues in Health Information Technology,” attorneys Mike Overly and Chanley T. Howell, partners at Foley & Lardner, identified how new mobile device trends could both benefit and hurt health care organizations.

On the benefit side of the trend, use of personal devices, such as smart phones, iPads, and other mobile devices, allows physicians to be in communication 24/7 with patients and other physicians, and enables “tremendous” cost savings, Howell, with the firm's Jacksonville, Fla., office, said.

For some hospitals or physician practices, allowing the use of personal mobile devices also can give the organization a competitive business advantage, Howell added.

According to Howell, this growing “bring your own device” (BYOD) trend should be addressed by health care organizations immediately by drafting policies that are easy for employees to understand and anticipating issues that could arise in the future.

Liability Risks
Despite the benefits, liability risks associated with employee use of personal mobile devices are increasingly becoming an issue that needs to be addressed by new health care organization policies, Overly, with the firm's Los Angeles office, said.

According to Overly, the BYOD trend could create liability risks due to:
• personal devices mixing business and personal data;
• risks to information security in personal devices;
• software licensing issues;
• risks associated with shared use of a device with nonemployees; and
• potential risks of an employee disposing of the device inappropriately.

Additionally, mobile device applications used in health care settings that are created by international companies also could pose risks to physicians and consumers, because international data use agreements are different than domestic data use agreements, Overly said.

January 30, 2012

amednews: AMA offers online CME to help with health IT

2012-01-30T10:18:00.006-05:00

The Web-based tutorials will educate physicians about analyzing workflow in their offices before they buy any systems.

Pamela Lewis Dolan, Jan. 30, 2012.

The American Medical Association has released three online tutorials aimed at helping physicians implement health information technology into their practices.

The tutorials include videos, downloadable tools and best practices for health IT in a physician practice. They are being offered when many doctors are looking at technology for the first time because of federal incentive programs aimed at increasing physician adoption and use of health IT tools.

Each seven- to 10-minute tutorial is focused on understanding workflow and what changes to expect with new technologies.

The three tutorials offered are:

E-prescribing. This series will explain the benefits of electronic prescribing and the quality, safety and efficacy compared with paper prescribing. The series identifies opportunities to improve medication management and efficiencies through e-prescribing.

Pre-visit planning. This tutorial will help physicians implement technology that provides full patient information before a visit. Benefits, including reduced waiting times and improved efficiencies, will be explained.

Point-of-care documentation. This will guide doctors in making decisions about the hardware used during an office exam. It also will explain the information that should be collected during an exam, as well as the format used to document it.

The AMA said the tutorials will explain the best ways to implement new technology.

"Physician practices may need to redesign and reorganize their office routines so that they can successfully and efficiently adopt health IT," said AMA President Peter W. Carmel, MD.

The CME-accredited tutorials are free. They are an addition to the AMA's library of CME-accredited tutorials, including those launched in May 2011 aimed at helping physicians earn incentives for e-prescribing and meaningful use of EMRs.

ADDITIONAL INFORMATION:

CME-accredited tutorials on health information technology from the American Medical Association (www.ama-cmeonline.com/health_it_workflow)

Let NAMSS Help you Reach your Goal To Become Your Own Advocate in 2012

2012-01-10T09:55:00.002-05:00

MSPs perform an integral role in keeping health care organizations running smoothly and ensuring the highest-quality patient care. All too often, however, MSPs do not have access to the types of development courses that will help them progress in their careers. Designed for MSPs at every stage of their career, NAMSS’ newest classroom course, Becoming Your Own Advocate, is a comprehensive interactive program designed to help you increase your professional credibility and achieve your goals within your organization. Visit our website for more information on this live offering on January 27 and 28 2012 in Las Vegas, Nevada at the Aria Resort and Casino.

For more information visit our website: http://www.namss.org/Education/CEOpportunities/InPersonCourses/BecomingYourOwnAdvocate/tabid/361/Default.aspx

Credentialing for Multiple Accrediting Bodies: Help is Here!!!

2012-01-09T17:23:00.006-05:00

Do you perform credentialing for entities with more than one accrediting body and need help in keeping all the various accreditation standards straight? We hope that this upcoming webinar series with NAMSS and Stanford University Medical Center’s Debra Green will help you. Visit our website for more information:

http://www.namss.org/MemberCenter/NAMSSStore/tabid/70/pid/315/Comparative-Differences-of-Regulatory-Standards-Webinar-Bundle-w-NAMSS-Membership-Glossary.aspx

To further complement this webinar series, NAMSS also offers “The NAMSS Comparison of Accreditation Standards” which provides you with “plain-language” interpretations of the credentialing standards in a side by side format for easy comparison of The Joint Commission, NCQA, Healthcare Facilities Accreditation Program, DNV, URAC, the Accreditation Association for Ambulatory Health Care, as well as the Medicare Conditions of Participation. Visit our website for more information on this handy reference:

http://www.namss.org/MemberCenter/NAMSSStore/tabid/70/pid/300/2012-NAMSS-Comparison-of-Accreditation-Standards.aspx

Update on The Joint Commission's Sentinel Event Alert on Health Care Worker Fatigue

2012-01-09T11:39:00.008-05:00

The Joint Commission has issued a sentinel-event alert saying drowsy health professionals are likelier to be involved in adverse events than their well-rested counterparts. The commission advised the more than 6,500 hospitals and other health care organizations it accredits to take steps to mitigate the risks of such fatigue

Nine ways to give rest to the weary health care worker

In a December 2011 sentinel-event alert, the Joint Commission offered advice to help health care organizations prevent fatigue-related adverse events:

Review policies to ensure that they address extended work shifts and hours.

Assess hand-off procedures to ensure that they protect patients adequately.

Invite staff to take part in designing work schedules to minimize potential
for fatigue.

Offer tips to fight fatigue, such as doing things that involve physical action, talking with other people, taking short naps and drinking coffee only when tired.

Educate staff about sleep hygiene and the effects of fatigue on patient safety.

Offer opportunities for staff to express concerns about fatigue.

Use a system of independent second checks for critical tasks and complex patients.

Consider fatigue as a potential contributing factor when reviewing all adverse events.

Ensure that the nap room is cool, dark, quiet and comfortable; provide eye masks and ear plugs; and let workers turn off pagers between shifts.

Source: "Sentinel Event Alert Issue 48: Health care worker fatigue and patient safety," The Joint Commission, Dec. 14, 2011 http://www.jointcommission.org/sea_issue_48/

NAMSS' Comments on CMS' CoPs Proposal

2012-01-03T11:40:00.006-05:00

December 22, 2011

Centers for Medicare & Medicaid Services Department of Health and Human Services
Attention: CMS-3244-PRIN 0938-AQ89

Medicare and Medicaid Programs; Reform of Hospital and Critical Access Hospital Conditions of Participation

To Whom It May Concern:

The National Association Medical Staff Services (NAMSS) represents medical services
professionals who, together with the organized medical staffs, manage credentialing and privileging of licensed independent health care providers in hospitals and health care plans across the country. NAMSS supports policies and practices that promote safe credentialing and privileging, and are also efficient and cost-effective. CMS-3244-P proposal is in line with the way in which the majority of medical staffs currently operate, especially with regard to the authority that medical staffs have in evaluating and recommending clinical privileges for non-medical staff members.

NAMSS appreciates many components of the proposed rule, particularly its efforts to
defer to state scope of practice statutes and provide individual hospitals with more
flexibility for purposes of credentialing and staff structure. As with current practice for many institutions, this update distinguishes between the authority of a hospital’s medical staff and its human resources department. CMS further clarifies this categorization by recognizing instances in which practitioners do not fit the traditional categories.

NAMSS response to Medical Staff (482.22)

1) NAMSS commends the progress that CMS continues to make in providing
hospitals the opportunity to grant privileges to non-medical staff practitioners – in
accordance with specific state scope of practice laws. This proposal would
benefit hospitals in rural, poor, and underserved areas. It would also facilitate
hospitals’ use of telehealth services.

2) NAMSS appreciates CMS’ move to defer to hospitals in credentialing and
managing advanced practice registered nurses (APRNs) by allowing hospitals to
categorize APRNs as either medical staff or general hospital staff. NAMSS also
supports the provision enabling hospitals to privilege practitioners without
making them members of the organized medical staff and to establish categories
that define staff and non-staff practitioners. This would help hospitals address
workplace shortages, provide more flexibility to critical access hospitals, small
hospitals, and hospitals in poor urban areas. It would also enable states to better
address primary care provider shortages.

3) Although one single governing body in a multi-hospital system does provide for
economies of scale, and is a reality in some systems, it is important to reaffirm the
ability of the local sub-boards to enact policies and handle issues that directly
contribute to sound patient care decision making, thus avoiding potential harmful
delays due to distance and corporate bureaucracy.

4) NAMSS appreciates that CMS addresses the potential patient care concern of
medical staffs by proposing that physicians and non-physicians will all be
required to comply with standing medical staff regulations. As many hospitals
currently operate, the proposal complies with current hospital and medical staff
regulations. These clarifications, in addition to the Joint Commission’s language
on conflict resolution, reaffirm CMS’ commitment to the important roles that
physicians and the organized medical staff have in staffing responsibilities, which
ensure safe patient care.

Simplifying the credentialing process would greatly assist medical staff professionals in improving practitioner quality and transparency while alleviating unnecessary steps. NAMSS commends CMS for taking steps to eliminate redundancies in current credentialing practice and looks forward to working together to improve health care delivery.

Sincerely,

Kate Conklin, BS, CPMSM, CPCS, CPHQ
President

http://www.namss.org/Portals/0/Advocacy/CMS%20Comments%20Letter.pdf

NPDB-HIPDB News: Enhancements Simplify Multiple Data Bank Processes

2011-12-22T08:49:00.006-05:00

Enhancements Simplify Multiple Data Bank Processes
On January 23, 2012, the Data Bank will introduce a number of enhancements aimed at streamlining processes for many Data Bank reporters and queriers, including State Licensing and Certification Agencies and Data Bank Administrators who are responsible for registering their organizations. The changes, summarized below, have the potential to benefit a large segment of the Data Bank community.

Report Forwarding to State Boards
One of the main new features coming to the Data Bank in January will eliminate the need for reporters to mail a copy of Data Bank reports to their relevant State Licensing Board. Reporters of Medical Malpractice Payments, Clinical Privilege, and Professional Society actions must print and mail a copy of the report to the appropriate State agency. Now, the Data Bank will make it easier for reporting organizations to comply with this requirement by enabling them to transmit reports electronically to State Licensing Boards that opt to participate in the new feature.

The automatic report forwarding option requires dual authorization-first by State Boards that must elect to participate, and subsequently by reporters at the time they submit each report. Electronic forwarding will not occur unless both sides agree to the exchange. To take advantage of this feature, each State Board that opts for report forwarding will verify the health care practitioner types they license or certify and agree to receive the reports electronically. Refer to the new State Board Profile page in Figure 1. Reporting organizations will choose to electronically forward their reports to the relevant agency on a report-by-report basis. Electronic report forwarding facilitates compliance with the law, and reporters who take advantage of it no longer need to remember to print and mail paper reports to State Boards.

In cases where a State Board declines to participate, or if a reporting organization prefers not to use the new feature for submitting a report, reporters remain responsible for sending a copy of the Report Verification Document to the appropriate State Board. The new service will be available initially through the Integrated Querying and Reporting System (IQRS). All State Boards will have a new State Board Profile button on the Administrator Options page, where they may enroll in the service, withdraw their agreement to participate, or modify their profile at any time.

Figure 1 State Boards must select the practitioner categories they license or certify when they first set up their profiles. This measure is designed to prevent inadvertent disclosures to the wrong licensing agency.
Please refer to the link below to access Figure 1

After a report is forwarded electronically, both the reporter and the Board will receive a Notice of Action via email and Data Bank correspondence, notifying them that a report was filed. Another email will notify the reporter when the report is viewed, or if a State Board fails to view a report within 7 days. Figure 2 depicts in more detail how the report forwarding process works. Several mechanisms will help track activity among electronically forwarded reports: The Historical Report Selection page may be used to find reports that have been electronically transmitted to State Boards; and the monthly Data Bank summary email for both reporters and State Boards will include information about the number of reports forwarded electronically and whether the reports were viewed. Use of this convenient report forwarding feature will require less manual work and enable the sending and receiving of required reports more quickly.

Figure 2. State Boards and reporting organizations may elect to use the new report forwarding feature. The process is outlined above.
Please refer to the link below to access Figure 2

Registration Enhancements
Another important enhancement taking place in January is a more intuitive entity registration process. This enhancement will simplify an entity's determination of its statutory authority by having the entity answer a few straightforward questions about its organization. As organizations re-register, they also will be able to select additional primary functions to more accurately describe their organizations.

Professional School Report Fields
The professional school report field will be expanded to include schools for chiropractors as well as the existing physician occupations.

Eliminate Mailing of Paper Reports
The Data Bank will begin transitioning toward more reliance on online report change notices instead of sending paper copies by mail. Since 2008, organizations have received report change notices via paper as well as electronically. Most organizations view these notices electronically but have not explicitly opted out of the paper copy, so the January enhancement will complete the transition to on-line report viewing. Organizations that have never reviewed a report change notice online will be given instructions on how to do so and over time they, too, will transition to electronic viewing. Report subjects who currently receive a paper Subject Notification Document will receive instructions on how to view the report online through the Report Response Service. This will not only help protect personally identifiable information by reducing the amount of sensitive information that is sent by mail service, but it also will reduce the amount of paper we print by about 50 percent. Be sure to take advantage of these new features as they become available on January 23rd.

Health Care Reform Law Will Streamline Data Bank Operations
Last year's health care reform law, the Patient Protection and Affordable Care Act of 2010, included a provision to streamline Data Bank operations. Section 6403 of the Affordable Care Act was designed to eliminate duplicative data reporting and access requirements between the National Practitioner Data Bank (NPDB) and the Healthcare Integrity and Protection Data Bank (HIPDB). The statute requires the Secretary of the U.S. Department of Health and Human Services (HHS) to establish a transition period to transfer all data in the HIPDB to the NPDB and, once completed, to cease HIPDB operations. Information previously collected and disclosed through the HIPDB will then be collected and disclosed through the NPDB. The statute's intent is to transition HIPDB operations to the NPDB while maintaining reporting and querying requirements. HHS is drafting a Notice of Proposed Rulemaking to implement Section 6403 and anticipates its publication in the Federal Register in the near future.

Security in Review: Exercising Vigilance
Security is a continuous, high-priority activity at the Data Bank, and in recent years we have implemented an exceptional number and variety of improvements. Some security enhancements were highly visible to Data Bank users, while others may not have been generally obvious. Recent initiatives have included encrypting personally identifiable information, masking data, strengthening password protocols, requiring challenge questions, introducing secure messaging, and changing the way entities and users register with the Data Bank by implementing e-authentication.

There are numerous categories of security threats that all information systems must address to safeguard their information assets. In today's technological environment, the Data Bank is susceptible to a variety of threats, including:

- Identity threats leading to fraudulent access.
- Risk of data corruption.
- Improper data disclosure.
- Physical storage safety.

As technology evolves, the risks to information systems become more sophisticated and more numerous. Data Bank security initiatives reflect an ongoing commitment to confront these challenges promptly and thoroughly by following security standards and guidelines prescribed by the National Institute of Standards and Technology (NIST). For the Federal Government especially, adherence to NIST standards is compulsory and provides the foundation for an effective security policy.

NIST may issue any number of recommendations in a given year. As each new standard is published, the Data Bank must determine how best to incorporate these requirements into the framework of its system architecture, while taking into account its own requirements for meeting the needs of Data Bank users. The ongoing reassessment of security is a process that entails a great deal of planning and preparation, and often the renegotiation of priorities. In essence, security is a constant balancing act between risk and usability, with the ultimate goal of ensuring the safety of Data Bank information.

As we begin a new year, the Data Bank urges its users to review their work areas where threats may exist, from safeguarding physical assets at workplaces to restricting access where and when it is needed. As technology advances, the need for security will remain a challenge that requires continuing vigilance. Safe practices result in secure data, and the entire Data Bank community plays an important role in bringing that about.

Reporting Responsibilities for Health Plans
Health plans exercise an enormous influence on the delivery of health care in the United States. By reporting to the Data Bank, health plans help to protect patients from incompetent practitioners and to stop fraudulent health care practices. The Healthcare Integrity and Protection Data Bank (HIPDB) defines a "health plan" as a plan, program, or organization that provides health benefits, whether directly through insurance, through reimbursement, or otherwise. Examples of health plans include health maintenance organizations, third party administrators, and health insurance companies.

Health plans are required to report to the HIPDB and, in some cases, the National Practitioner Data Bank (NPDB). This article provides a brief overview of the dual eligibility requirements for health plans and their associated reporting responsibilities.

HIPDB Reporting Requirements
HIPDB regulations specify two types of final adverse actions that health plans must report: health care-related civil judgments and "other adjudicated actions or decisions." These actions must be reported to the Data Bank within 30 days of the action being taken. Table 1 describes each HIPDB reporting requirement, identifies the type of Data Bank report that a health plan would use to submit information about an action, and provides examples of reportable actions.

NPDB Reporting Requirements
The NPDB definition of a "health care entity" includes organizations that provide health care services and have a formal peer review process to further quality health care. The phrase "provides health care services" means the delivery of health care services through any of a broad array of coverage arrangements or other relationships with practitioners, either by employing them directly or through contractual or other arrangements. The definition, therefore, may include a range of managed care organizations or other types of health plans.
Health care entities are required to report adverse clinical privileges and panel membership actions to the NPDB within 30 days of the action being taken. Table 2 lists the specific NPDB reporting requirements for health plans that are "Health Care Entities." In addition, any entity, including a health plan that makes medical malpractice payments for the benefit of a health care practitioner, must report those payments to the NPDB.

Table 1. HIPDB Reporting Requirements for Health Plans
Please refer to the link below to access Table 1.

http://www.npdb-hipdb.hrsa.gov/news/newsletters/jan2012Newsletter.jsp#User

The Joint Commission issues Sentinel Event Alert on Health Care Worker Fatigue

2011-12-15T10:21:00.009-05:00

December 14, 2011

Today, The Joint Commission issued a new Sentinel Event Alert: Health care worker fatigue and patient safety. The Alert urges greater attention to preventing fatigue among health care workers and suggests specific actions for health care organizations to mitigate the risks. An article in the November 2007 issue of The Joint Commission Journal on Quality and Patient Safety reported that nurses who work more than 12-hour shifts and residents working recurrent 24-hour shifts were involved in three times more fatigue-related preventable adverse events. In addition, health care professionals who work long hours are at greater risk of injuring themselves on the job.

The Alert addresses the effects and risks of an extended work day and of cumulative days of extended work hours. The Joint Commission Alert recommends that health care organizations:

• Assess fatigue-related risks such as off-shift hours, consecutive shift work and staffing levels.
• Examine processes when patients are handed off or transitioned from one caregiver to another, a time of risk that is compounded by fatigue.
• Seek staff input on how to design work schedules that minimize the potential for fatigue and provide opportunities for staff to express concerns about fatigue.
• Create and implement a fatigue management plan that includes scientific strategies for fighting fatigue such as engaging in conversation, physical activity, strategic caffeine consumption and short naps.
• Educate staff about good sleep habits and the effects of fatigue on patient safety.

The Joint Commission also suggests that health care organizations encourage teamwork as a strategy to support staff who work extended work shifts or hours. For example, use a system of independent second checks for critical tasks or complex patients. Also, organizations should consider fatigue as a potentially contributing factor when reviewing all adverse events, and educate employees on the importance of good sleep habits, including ensuring their rest environment.

http://www.jointcommission.org/assets/1/18/SEA_48.pdf

The Joint Commission Posts Final Telemedicine Requirements

2011-12-15T10:19:00.000-05:00

December 14, 2011

Final revisions to requirements related to the credentialing and privileging of telemedicine practitioners in hospitals and critical access hospitals.
Standards LD.04.03.09, MS.13.01.01, and MS.01.01.01

Prepublication Standards – effective immediately:
http://www.jointcommission.org/assets/1/6/PrePub_20111209_Telemedicine_HAP.pdf

URAC's revised standards to five accreditation programs

2011-12-09T14:55:00.004-05:00

“URAC's Health Network standards have been revised to elaborate on the provider relations program, and to provide clarification on the credentialing phase-in process for Health Networks. Additionally, these standards as well as the Provider Credentialing standards now allow for delegation oversight of the credentialing process to occur remotely. Further revisions to the Provider Credentialing program increased patient protection by requiring procedures that prevent a provider from being listed in a provider directory prior to being credentialed. Requirements for primary source verification of licensure were also clarified.”

More details can be found at the following link:

https://www.urac.org/press/cmsDocument.aspx?id=772

The Joint Commission: Standard IC.02.04.01 Influenza Vaccination for Licensed Independent Practitioners and Staff

2011-12-05T10:39:00.004-05:00

December 2, 2011

This voice recorded slide presentation below focuses on revised Standard IC.02.04.01 Influenza Vaccination for Licensed Independent Practitioners and Staff, for Critical Access Hospitals, Hospitals and Long Term Care accreditation programs. This revised standard will go into effect on July 1, 2012. During the presentation each of the nine elements of performance will be reviewed.

http://influenza.s3.amazonaws.com/start.html

Additional Resources:

http://www.jointcommission.org/influenza_vaccination_prepublication/

http://www.jointcommission.org/assets/1/6/JC_influenza_myths.pdf

NCQA Announces New ACO Accreditation

2011-11-21T15:11:00.003-05:00

NCQA is announcing its new Accountable Care Organization (ACO) Accreditation. This first-of-its-kind program builds on patient-centered medical homes and provides an independent evaluation of organizations' ability to coordinate the high-quality, efficient, patient-centered care expected of ACOs. It helps providers make the challenging-though much-needed-transition to ACOs, which will be expected to have a "comprehensive and cohesive" approach to primary care.

The program evaluates organizations in seven categories:

1. ACO Structure and Operations
2. Access to Needed Providers
3. Patient-Centered Primary Care
4. Care Management
5. Care Coordination and Transitions
6. Patient Rights and Responsibilities
7. Performance Reporting and Quality Improvement

NCQA ACO Accreditation includes three levels, representing varying degrees of capability for coordinating care and reporting and improving quality.

Organizations that wish to apply for NCQA ACO Accreditation must complete an application. Information provided in the application will be used to determine eligibility. Find ACO publications that include the survey and information on how to apply and the data submission process here <http://r20.rs6.net/tn.jsp?llr=hwcha7cab&et=1108718706510&s=58973&e=001g2oSgZFU93v1ai9HlLaO2mIgMS5hkJT0rona2CRTraw80uXv3FJfo-jnFwSusjzolX_zRQI_VK65KAWjXgBCx4myHPCIwUYRpBd0YgxNo5AVYgntZ6eVsaNZFP5ptcBBADtA-Z3yP-uTATrMx0a6rw>

An Educational Assessment is available for organizations in the early stage of ACO development or that are not currently pursuing accreditation. It provides the organization a chance to dialogue with NCQA about its performance against the standards and to receive an in depth review of areas to improve.

For more information about NCQA's ACO Accreditation and other NCQA evaluation programs, visit www.ncqa.org <http://r20.rs6.net/tn.jsp?llr=hwcha7cab&et=1108718706510&s=58973&e=001g2oSgZFU93tvrB2YUyfxsPYKLBElWqyT8ZNKvF29iLOd-NrAlP3YT8MRGpJe-eDIC8RL4GN83j-C7acHnfFjE5dVXB75o-LYFwEbQ2kmBfI> or contact NCQA Customer Support at 888-275-7585.

Interesting Case - Federal Health Care Quality Improvement Act Doesn't Allow Doctor to Sue for NPDB Report

2011-11-16T12:51:00.001-05:00

Zoher, a medical doctor licensed to practice in Florida, applied for a staff position at Naples Community Hospital (NCH), a facility operated by defendant NCH Healthcare System Inc. (NCHS). NCH's board of trustees denied Zoher's application. It later made an adverse action report to the NPDB indicating that Zoher was denied an initial appointment and privileges.

Zoher brought suit against NCH and NCHS, seeking, in part, injunctive and declaratory relief under the HCQIA. Zoher contended that the NPDB Guidebook states that the denial of medical privileges based on a physician's failure to meet a hospital's established criteria is not a reportable event. A hospital should report a denial only if it was based on a lack of professional conduct by the physician, Zoher argued. He said NCH's denial of his privileges was based on his inability to meet the hospital's standards for appointment.

NCH moved to dismiss the lawsuit on the basis that the court lacked subject matter jurisdiction. In a decision by Judge John E. Steele, the court agreed.

The court found that it did not have jurisdiction because the only federal question at issue was Zoher's claim under the HCQIA.
The HCQIA was enacted to improve health care and reduce the number of incompetent physicians, the court said. In actions brought by physicians, the statute grants limited immunity from liability to individuals who participated in peer review activities that resulted in physician discipline, it said.

The HCQIA, however, does not grant a physician a private cause of action in connection with the peer review process, the court said. Since Zoher had no private right of action under the federal statute, there was no claim that arose under federal law in this case, and the court did not have subject matter jurisdiction, it concluded. Doctor's lawsuit against hospital that denied his application for staff appointment is dismissed because HCQIA does not provide for private right of action, federal court did not have subject matter jurisdiction over doctor's action.

A physician cannot recover damages from a hospital for allegedly mistakenly reporting a clinical action against him to the National Practitioner Data Bank (NPDB), a federal district court said Nov. 14 in dismissing the action (Zoher v. NCH Healthcare System Inc., M.D. Fla., No. 2:11-cv-86, 11/14/11).

The U.S. District Court for the Middle District of Florida noted that there is no private right of action under the Health Care Quality Improvement Act (HCQIA) and, therefore, Dr. Mina Zoher failed to state a claim within the court's federal question subject matter jurisdiction.

For full text of the court's opinion: http://op.bna.com/hl.nsf/r?Open=mapi-8nmlb9.

From The Joint Commission

2011-11-10T16:46:00.001-05:00

Record of Care, Treatment, and Services (CAMH / Hospitals)

Texting Orders
November 10, 2011

Is it acceptable for physicians and licensed independent practitioners (and other practitioners allowed to write orders) to text orders for patients to the hospital or other healthcare setting?

No it is not acceptable for physicians or licensed independent practitioners to text orders for patients to the hospital or other healthcare setting. This method provides no ability to verify the identity of the person sending the text and there is no way to keep the original message as validation of what is entered into the medical record.

http://www.jointcommission.org/standards_information/jcfaqdetails.aspx?StandardsFAQChapterId=79&StandardsFAQId=401

FierceHealthcare: Docs sue Kaiser, Sutter over peer review process

2011-11-10T14:27:00.007-05:00

By kcheung -- Nov 9 2011

Two California physicians on Monday filed suit against Sutter Central Valley Hospitals, which manages Memorial Medical Center, and Kaiser Permanente, challenging the peer review process, reported The Modesto Bee this week. The physicians' attorneys say the hospitals violated federal due process when Sutter terminated Dr. Mark Fahlen's privileges at Memorial Medical Center and when Kaiser did not allow Dr. Hamid Safari to work at its facilities, both without cause.

The article points to a long history of tensions between Fahlen and the nurses at the hospital. Fahlen from 2003 to 2008 complained to Memorial administration that the nurses were insubordinate, committed errors, and disobeyed or changed patient orders. The nurses also complained to administrators that Fahlen was confrontational with the staff. In August 2008, the hospital executive committee recommended Fahlen's privileges be terminated, but the hospital judicial review panel recommended he maintain privileges. Sutter nevertheless terminated his privileges in January.

A year earlier in 2007, the California Medical Board accused Safari of gross negligence in the deaths of two newborns. Although a state judge in 2009 found that Safari was not at fault and complied with care standards, Kaiser did not permit Safari to practice at its facilities, according to the lawsuit.

The physicians argue that the peer review process violated their civil rights, denying them due process.

"California's peer review system for physicians is the only legal system in the United States where a powerful corporation is permitted to target an individual's career and then pick the judge and jury who decide the matter," the physicians' attorney, Stephen Schear, said in a press release.

http://www.fiercehealthcare.com/story/docs-sue-kaiser-sutter-over-peer-review-process/2011-11-09?utm_medium=nl&utm_source=internal

NEWS FROM THE JOINT COMMISSION

2011-11-09T16:38:00.004-05:00

The term “disruptive behavior” is changed in the standards

The term “disruptive behavior” in two elements of performance (LD.03.01.01, EPs 4 and 5) has been revised to “behavior or behaviors that undermine a culture of safety.” It has been brought to the attention of staff at The Joint Commission that the term “disruptive behavior” is not viewed favorably by some in health care, and it can be ambiguous for some audiences. For example, some physicians object that strong advocacy for improvements in patient care can be characterized as disruptive behavior.

Also, the phrase “disruptive behavior” may be used in the context of a care environment that has become temporarily unsettled by the behavior of a patient. The term was discussed with The Joint Commission’s Accreditation Committee and its Board of Commissioners. Because of the term’s potential for ambiguity, the new term better describes the problem that the standard is trying to address. The change will be made in the update to the accreditation manuals, which will publish in the spring of 2012.

Revised standard IC.02.04.01 on influenza vaccination for licensed independent practitioners and staff to be applicable to all accreditation programs

The Joint Commission has revised standard IC.02.04.01, strengthening the requirements to better reflect current scientific evidence and the national initiatives on influenza vaccination for licensed independent practitioners and staff. The revised standard is effective July 1, 2012 for the critical access hospital, hospital and long term care accreditation programs.

Happy National Medical Staff Services Awareness Week

2011-11-07T13:11:00.000-05:00

As we celebrate National Medical Staff Services Awareness Week, let’s take a moment to reflect back and honor the 22 medical staff secretaries who met in California 40 years ago with a vision that has led us to where we are today. Now 4,600 members strong, we continue to grow together, influencing the ever changing face of healthcare. Volunteerism in our organization has played an important role in our success through the years. We take this opportunity to thank everyone who has given back to our profession through their volunteerism, nationally, or on a state of local level. Have a wonderful week!

Remember the Kadlec Case?

2011-10-27T16:54:00.001-04:00

Although Lakeview Medical Center was dropped from the case, the courts found the physician who wrote the glowing reference for Dr. Berry, guilty of engaging in negligent misrepresentation with a 8.2 million dollar penalty. Read the full story below.

Our thanks to the MSSP Yahoo Group for forwarding us this story!

http://www.outpatientsurgery.net/news/2011/10/20-Anesthesiologist-Pays-8-2M-for-Praising-Error-Prone-Colleague

CMS Recognizes The Joint Commission's Critical Access Hospital Accreditation

2011-10-20T15:44:00.002-04:00

Elizabeth Eaken Zhani October 19, 2011

The Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) has again granted The Joint Commission deeming authority for the accreditation of critical access hospitals.

The CMS designation means that critical access hospitals accredited by The Joint Commission may choose to be “deemed” as meeting Medicare and Medicaid certification requirements. CMS found that The Joint Commission’s standards for critical access hospitals meet or exceed those established by the Medicare and Medicaid program. CMS’ notice of approval, which was published September 23 in the Federal Register, becomes effective November 21, 2011 and runs through November 21, 2017.

“The Joint Commission is pleased to once again receive this recognition for its accreditation of critical access hospitals, which are vital to the health of Americans, especially residents of rural areas,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission. “This public-private collaboration between CMS and The Joint Commission creates the necessary quality and safety oversight framework for these hospitals.”

Critical access hospitals have no more than 25 acute care beds and have an annual average length of stay per patient of 96 hours. These hospitals, which are typically located more than 35 miles from another hospital, receive cost-based reimbursement from Medicare.

Accreditation is voluntary and seeking deemed status through accreditation is an option, not a requirement. Organizations seeking Medicare approval may choose to be surveyed either by an accrediting body, such as The Joint Commission, or by state surveyors on behalf of CMS. All deemed status surveys are unannounced.

In addition to critical access hospitals, The Joint Commission has federal deeming authority for advanced diagnostic imaging, ambulatory surgery centers, clinical laboratories, durable medical equipment suppliers, home health, hospice, hospitals and psychiatric hospitals.

http://www.pwrnewmedia.com/2011/joint_commission/cah_deeming/

NPDB Posts New Data on Reporting Compliance Status of Government Agencies

2011-10-19T15:37:00.004-04:00

This is National Healthcare Quality Week. Please join me in wishing our Healthcare Quality Professionals a Happy Week and Thank them for all they do!

Quality and patient safety professionals are an integral part of the success of today’s modern healthcare system. They impact every aspect of the healthcare process in facilities large and small, from major metropolitan health centers to local long-term care facilities.

A quality professional addresses many issues in the healthcare workplace:

• medication reconciliation
• mortality and incident rate reduction
• risk management
• core measures
• patient safety
• quality management
• quality improvement.

Healthcare quality professionals ensure their facility meets specific requirements set forth by accrediting bodies for healthcare organizations and programs, such as The Joint Commission and Centers for Medicare & Medicaid Services.

http://www.npdb-hipdb.hrsa.gov/news/reportingCompliance.jsp.

CMS releases proposed Hospital CoPs

2011-10-19T15:33:00.004-04:00

Below are the proposed rules published by the Centers for Medicare and Medicaid Services’ (CMS’) in line with their commitment to the general principles of the President’s Executive Order 13563, released January 18, 2011, entitled “Improving Regulation and Regulatory Review.” In these proposed rule CMS seeks to reduce the regulatory burden placed on hospitals by identifying a number of existing hospital CoPs that they believe could be reformed, simplified, or eliminated in order to reduce unnecessary burden and costs placed on hospitals and critical access hospitals (CAHs) under existing regulations. These revisions are open for comment. Please see the first few pages of the document which lists authorized means to submit comment and the deadline to do so.

Some points of interest are:

Governing Body
Revise and clarify the governing body requirement to reflect current hospital organizational structure whereby multi-hospital systems have integrated their governing body functions to oversee care in a more efficient and effective manner. Specifically, CMS proposes to revise §482.12 to state that “There must be an effective governing body that is legally responsible for the conduct of the hospital.”

Medical Staff Organization
Proposing changes to the more direct responsibilities for the organization and accountability of the medical staff. Presently, the hospital may assign these management tasks to either an individual doctor of medicine or osteopathy or, when permitted by State law of the State in which the hospital is located, a doctor of dental surgery or dental medicine. CMS proposes to expand the list to include doctors of podiatric medicine (DPMs). This change would permit a podiatric physician to serve as the president, or its equivalent, of a
hospital’s medical staff in a significant number of states.

CMS is seeking comments on whether their language is clear on the single organized medical staff as it currently allows for a multihospital system to have the option of a single organized medical staff responsible for the quality of medical care provided to patients by all of the hospitals in the system, however does not state it in those words. However, CMS is not sure if this is clear to stakeholders and welcomes comment.

Allied Health Professionals:
Propose to revise language to clarify that a hospital may grant privileges to both physicians and non-physicians to practice within their State scope of practice, regardless of whether they are also appointed to the hospital’s medical staff. That is, technical membership in a hospital’s medical staff would not be a prerequisite for a hospital’s governing body to grant practice privileges to practitioners.

Changes and clarifications regarding medical staff and privileging would allow hospitals to substitute and rearrange actual delivery of care. In particular, use of Advanced Practice Nurse Practitioners (APRNs) and Physician Assistants (PAs) in lieu of higher-paid physicians could provide immediate savings to hospitals. CMS welcomes comments on their saving assumptions which are outlined in the full text.

http://www.ofr.gov/OFRUpload/OFRData/2011-27175_PI.pdf

ABMS Now Publicly Reports Physicians' Status of Meeting Maintenance of Certification Program Requirements

2011-10-13T10:55:00.001-04:00

Lori Boukas, October 11, 2011

The American Board of Medical Specialties (ABMS) announced today that it has begun reporting publicly whether physicians who are Board Certified by one or more of the 24 ABMS Member Boards are meeting the ABMS Maintenance of Certification® (ABMS MOC®) program requirements established by their certifying Board(s). The public reporting initiative is being rolled out during the next year beginning with seven Member Boards, including the American Board of Dermatology, American Board of Family Medicine, American Board of Nuclear Medicine, American Board of Otolaryngology, American Board of Physical Medicine and Rehabilitation, American Board of Plastic Surgery and American Board of Surgery. The remaining 17 Member Boards will make the MOC status of their Board Certified physicians available in August 2012 or sooner.

Some Member Boards have already been reporting the MOC status of their Board Certified physicians in alternate formats. For the first time, however, ABMS will serve as the central repository for the MOC status of physicians from all 24 ABMS Member Boards, which will be reported publicly in the same format. The MOC status of physicians Board Certified by an ABMS Member Board(s) will also be displayed by ABMS licensees, official display agents and on www.CertificationMatters.org.

“We’re honoring our pledge of increased transparency to the public by providing easy access to important information about individual physicians,” said Kevin B. Weiss, MD, ABMS President and CEO. “This is a significant milestone in ABMS history. The public can be confident that physicians who are meeting the requirements of the ABMS MOC program are committed to lifelong learning and ongoing self-evaluation.”

Board Certification is a voluntary process that assesses a physician’s competence in his or her specialty. To maintain their certification, physicians may participate in an ABMS MOC program, a rigorous process that continually assesses and enhances their medical knowledge, judgment, professionalism, clinical techniques and communications skills. For some ABMS Member Boards, physicians who were Board Certified before those Member Boards established their MOC programs are not required to participate in the ABMS MOC program created by their Member Board(s).

To obtain information regarding whether a specific physician is required to participate in the MOC program of his or her certifying Board(s), please contact that ABMS Member Board(s) directly.

“The ABMS MOC program is being incorporated into the credentialing process and is recognized as an important quality marker by insurers, hospitals, quality and credentialing organizations, the federal government and the public,” said Dr. Weiss. “We’re pleased to serve as the clearinghouse with the launch of the initial data from seven Member Boards, and look forward to full Member Board participation by this time next year.”

For those seven Member Boards participating in the initial rollout, the results of researching a physician’s status will show the name of the physician, the name of the ABMS Member Board(s) that certifies the physician and include a “yes” or “no” response to the question of whether the physician is meeting the MOC requirements of that Member Board(s). It will also include a link to the website of the physician’s certifying Board(s).

The types of tools and programs that physicians can use to meet the requirements of an MOC program vary by specialty. ABMS Member Boards tailor their MOC programs to the needs of their specific medical specialties.

http://abms.org/News_and_Events/Media_Newsroom/Releases/release_Announcing_PublicReportingMeetingMOC_10112011.aspx

amednews.com: 5 ways to manage your online reputation

2011-10-11T11:32:00.003-04:00

Hello Members. Here is a good article from the AMA that affects all of us as well as your medical staffs:

5 ways to manage your online reputation
Pamela Lewis Dolan, Sept. 12, 2011

In the days of social media, negative online content could have far-reaching legs and a devastating impact on a physician unless it's managed efficiently.
By Pamela Lewis Dolan, amednews staff. Posted Sept. 12, 2011.

Even if some physicians themselves are not online, their names, comments on their style of practice, and complaints or compliments about them probably are.

All of the online content devoted to a particular physician could negatively impact his or her reputation, and subsequently his or her business, if steps aren't taken to manage that content and -- when necessary -- defend it. This is often referred to as online reputation management.

Online reputation management has become big business, as evidenced by the number of radio and online ads offering to help physicians. But physicians can manage their own reputations, help build positive ones, and prevent negative content from turning into a crisis that needs to be dealt with professionally.

As quickly as online content can spread, especially in the age of social media, experts say online reputation management should be a key component to any business plan.

"The best defense in these cases is good offense," said Scott Sobel, president of Media and Communications Strategy, a Washington-based public relations firm specializing in crisis management.

Christian Olsen, vice president of Levick Strategic Communication's digital and social media practice, said social media has changed the dynamics of reputation management, because in addition to physicians communicating with their patients, their patients are now communicating with one another on social media websites.

For most physicians, there are five simple steps they can take to manage and maintain a good reputation online. For others, managing their online reputations may require more time and expertise than they have available.

One: Google yourself
Olsen said many make the mistake of thinking that because they don't have a website or are not involved in social media they are not online. "It just means your voice is not being heard in a conversation about you," he said.

The first step in managing a reputation is knowing what there is to manage. Reputation management experts recommend that physicians conduct Google searches on themselves at least once a month, preferably more often. Things can spread quickly online, so seeing what content is there on a regular basis will help doctors stay ahead of a potential crisis. It's also a good way to see what positive things are being said about you, which you may be able to build on.

Steven Wyer, managing director of Reputation Advocate Inc. and author of the book Violated Online, said physicians should set up alerts on Google and Yahoo. These alerts work by registering keywords, such as a name, that the search engines will use to comb the Internet looking for any new mention of those keywords on blogs, websites, online forums and other sites. When it finds a new mention, it will send an email detailing where the keywords were mentioned, what was said and a link to the website.

The mistake many physicians make, however, is to not include all reasonable variations of their name in an alert, Wyer said. For example, John Smith, MD, could have several variations, including Dr. John Smith, Dr. John C. Smith, Dr. John Smith, MD, etc. Alerts for a handful of those variations should be set up.

Two: Correct mistakes and false information
The easiest places to start are websites that show up high in Google searches. Those sites are likely to be physician finder or rating sites or health plan physician finders. The sites often include wrong or outdated contact information and incomplete biographical and educational history.

Many of these sites give doctors the opportunity to edit their own profiles, which they should do by bolstering the information that is presented and highlighting positive aspects. Experts say physicians should complete their CVs by adding professional achievements such as awards and published articles. They also can use the forum to talk about their style of practice and what patients can expect from them.

The overwhelming majority of online physician reviews are positive. Dealing with false or inflammatory content can be trickier, Olsen said. How physicians handle false or misleading information on a site could make a situation worse, depending on how it's handled. They should do what they can to correct the information without being too aggressive, he said. One suggestion is to acknowledge the problem and then ask the author of the content to take things offline to find a resolution.

"Respond in public, but ... definitely don't play it out in the open," Olsen said.

Wyer said most websites have posted terms and conditions. If content on the site clearly violates those terms, a request can be made to the website's site administrator to have the information removed. The same request can be made of content that violates privacy laws or Health Insurance Portability and Accountability Act regulations. Insults are generally not violations, but Web posts that contain personal identifiable information would be considered violations.

Three: Create your own content
The best way physicians can steer conversations in the direction they want, or help hide the conversation they hope no one sees, is to start the conversation themselves. Experts say doctors can do this on many online venues: personal blogs, websites and personal social media pages, which all tend to rank high in search engine results.

If you already have done a search on yourself, you would know which sites are ranked high and need to stay high, and which sites you may want to push down in the results. Posting information on sites that generally rank high in Google searches, such as physician finder sites and LinkedIn profiles, will help push other content down in the search results. The farther down the better, as 90% of people won't go past the first page of search results and 99% won't go past page 2, said Noah Lang, director of business development for Reputation.com.

Wyer said it's important for physicians to own their own name online, starting with claiming their profiles on finder and review sites. On most physician profile sites, a link asks if you are the doctor being profiled. If you are, you can register with the site to take ownership of that listing and edit it as you see fit.

Owning your name could include buying website domains under the physician or practice name, creating social media pages and creating blogs in your name.

A misconception, Wyer said, is that all of these sites must be managed daily. If a physician wants to establish him or herself as a blogger, the goals and strategies are different. But simply populating the sites with basic information such as the doctor's bio, contact information and a link to a website, combined with the appropriate keywords and elements to ensure good placement in Google searches, doesn't require daily or even weekly maintenance.

Four: Embrace constructive criticism
Studies have found that an overwhelming majority of online reviews of physicians are positive. But even if a doctor does not achieve unanimous positive reviews, that's all right, experts said.

Sobel says having only simple and positive reviews will raise red flags. "You want to look for good but balanced comments. There will always be someone unhappy," he said. But it's important for patients to use reputable sites that rate doctors fairly.

Physicians should find a handful of rating sites they trust and direct patients to them. They can do so by having staff verbally tell patients about the sites, hang signs in the waiting room that list the Web addresses, and hand out fliers at the check-out desk.

Five: Address actionable items
Sobel said many of the things patients complain about online are things physicians can work to change immediately and publicize online.

Knowing what the "hot button issues" are among patients -- long waits, lack of response or slow responses, and leaving a message for the doctor and having someone else call them back -- and addressing those things in practice and online will go a long way toward improving your reputation. Part of managing your online reputation is managing how you come across online addressing those issues.

Lang said physicians should broadcast online when changes have been made due to complaints.

Sobel said a physician's website not only can be a source of the positive information they want patients to find but also can serve as a way to respond to negativity in a positive way.

When a physician's reputation has taken a beating, Sobel said, ignoring it and hoping it goes away is not a sound option. Besides their knowledge of medicine, physicians' reputations are their highest commodity, he said.

ADDITIONAL INFORMATION:
Think twice before taking legal action for something online
Things read online might be blatantly false and even harmful to a physician's reputation. But in most cases, taking legal action may make the situation worse.

When opinions and reviews include false information that would constitute libel or defamation, legal action might be warranted, said Craig Newman, a New York-based attorney. But he warns clients to think long and hard before filing a lawsuit or drafting a cease-and-desist letter.

Because of the many exceptions, libel and defamation are very hard to prove in a court of law. Therefore, physicians take a risk when filing a suit, bringing more attention to the matter, and not being able to prove their case.

Noah Lang, senior director of business development at Reputation.com, said it's generally better just to let things live and die. A physician could send a cease-and-desist letter, but then a blogger could post that online, only exacerbating the issue.

However, experts said legal action might be warranted -- including a call to law enforcement -- if a physician sees something threatening to family or staff members as well as the physician.

Here's what to look for in a reputation management firm
Not all reputation management firms are created equal. If a reputation management company doesn't handle things correctly, a bad situation could be made worse.

First, experts say, a good reputation management firm will have a good understanding of the physician's business. If it specializes in services for physicians specifically, the better.

Scott Sobel, president of Washington-based Media & Communications Strategies, said a good firm will have a relationship with a reputable lawyer or law firm and have some knowledge of public relations. The firm also should be familiar with First Amendment and copyright laws.

While a good firm should never talk about specifics of a prior case, it should be able to talk in general terms about the techniques it will use, such as search engine optimization, Sobel said. A firm that talks about committing some of the same actions it should be protecting clients from, such as verbal attacks, libel or defamation, also should be avoided.

http://www.ama-assn.org/amednews/2011/09/12/bisa0912.htm#top

HRSA: HIPDB to Merge with NPDB

2011-10-03T11:32:00.001-04:00

The Division of Practitioner Data Banks (DPDB) is anticipating the merge of the Healthcare Integrity and Protection Data Bank (HIPDB) into the National Practitioner Data Bank (NPDB). The merger is planned for 2012.

Please see the following links for more information:

http://www.gpo.gov/fdsys/pkg/FR-2011-09-23/pdf/2011-24403.pdf
http://www.npdb-hipdb.hrsa.gov/resources/section1921.jsp
http://www.npdb-hipdb.hrsa.gov/resources/brochures/NewInfoNPDBUnderSection1921.pdf

HFAP Manual Updates Posted

2011-09-29T15:17:00.003-04:00

HFAP updates standards relating to telemedicine credentialing and privileging.

ACUTE CARE
________________________________________
01.00.06 Governing Body Responsibilities – Revision of Standard
Effective Immediately

03.00.07 Telemedicine Privileging Provisions – New Standard
Effective Immediately

03.00.08 Telemedicine Privileging Provisions Through Distant Site – New Standard
Effective Immediately

03.01.09 Bylaws – Granting of Privileges – Revision of Standard
Effective Immediately

CRITICAL ACCESS
________________________________________
01.00.08 CEO Appointment – Standard Revision
Effective Immediately

05.00.14 Telemedicine Privileging Provisions Through Distant Site Hospital Agreement – New Standard
Effective Immediately

05.00.15 Telemedicine Privileging Provisions Through Distant Site Entity Agreement – New Standard
Effective Immediately

12.00.24 Diagnosis & Treatment Review – New Standard
Effective Immediately

For more information, visit HFAP's website:
http://www.hfap.org/manualupdates.aspx

NYT: Withdrawal of Database on Doctors Is Protested

2011-09-21T16:25:00.000-04:00

DUFF WILSON -- September 15, 2011

Three journalism organizations on Thursday protested a decision by the Obama administration to remove a database of physician discipline and malpractice actions from the Web.

The National Practitioner Data Bank, created in 1986, is used by state medical boards, insurers and hospitals. The “public use file” of the data bank, with physician names and addresses deleted, has provided valuable information for many years to researchers and reporters investigating oversight of doctors, trends in disciplinary actions and malpractice awards.

On Sept. 1, responding to a complaint from Dr. Robert T. Tenny, a neurosurgeon in Kansas, the Health Resources and Services Administration, an agency of the Department of Health and Human Services, removed the public use file from its Web site, said an agency spokesman, Martin A. Kramer. The agency also wrote a reporter a letter to warn he could be liable for $11,000 or more in civil fines for violating a confidentiality provision of the federal law. Both actions outraged journalism groups.

“Reporters across the country have used the public use file to write stories that have exposed serious lapses in the oversight of doctors that have put patients at risk,” Charles Ornstein, president of the Association of Health Care Journalists and a reporter for ProPublica, an investigative newsroom, said in an interview. “Their stories have led to new legislation, additional levels of transparency in various states, and kept medical boards focused on issues of patient safety.”

Two other national journalism organizations, Investigative Reporters and Editors and the Society of Professional Journalists, joined the health reporters’ group in a letter to Mary K. Wakefield, administrator of the federal office. “If anything, the agency erred on the side of physician privacy,” they wrote.

Mr. Kramer said the agency, contacted by a doctor, had become concerned that a Kansas City reporter obtained information from the full data bank, not just its public use file.

“We have in the past sent letters like this, but it is the first time in our knowledge one has gone to a journalist,” Mr. Kramer said.

That concern and the letter, though, were made moot when the reporter explained that he had been getting information from the public use file, Mr. Kramer said. “That’s the end of that,” he said.

Nonetheless the agency is reviewing the public use file and may change it to further assure confidentiality before placing it back on the Web, he said, adding that he hoped it would be public again within six months.

“We are going to do everything we can to get the data back up in a public use file as quickly as we possibly can,” Mr. Kramer said. “We want to make sure the public, researchers and reporters have access to all the information that we can legally make available.”

Mr. Kramer said he could not speculate about how the public use file would be changed. He said the agency was still reviewing complaints made by the journalist organizations.

The Kansas City Star, despite the letter to its reporter, published its article on Sept. 3, titled, “Doctors With Histories of Alleged Malpractice Often Go Undisciplined.”

“To see whether other doctors with long malpractice payment histories are practicing in Kansas and Missouri, The Star analyzed thousands of records in the National Practitioner Data Bank,” the article said. It found 21 doctors had at least 10 malpractice payments but had never been disciplined by the states.

Mr. Ornstein said the Star reporter, Alan Bavley, like many others across the country, had performed broad research of courts, state agencies and hospital actions, “allowing them to connect the dots” to individual doctors. But he said the federal database itself did not reveal identities.

Other recent notable articles based partly on the database have appeared in The Duluth News Tribune in Minnesota and The St. Louis Post-Dispatch, which published a series last year titled, “Who Protects the Patients?”

American-Statesman: New state law bans anonymous complaints against physicians

2011-09-20T16:08:00.001-04:00

Karen M. Cheung – September 20, 2011

Following the fallout of two Winkler County whistle-blowing nurses who lost their jobs, a new Texas law that goes into effect this month bars the Texas Medical Board from considering anonymous complaints against physicians.

Adjusting the complaint process, House Bill 680 requires the Medical Board know the identity of those persons filing complaints, including pharmaceutical companies and insurers, while keeping those identities confidential, reports the American-Statesman.

The Texas rule follows the case of two Winkler County Memorial Hospital nurses Anne Mitchell and Vickilyn Galle, who in 2009 sent an anonymous ethics complaint about physician Rolando Arafiles Jr. to the Texas Medical Board, accusing him of dangerous practices. Winkler County Sheriff Robert L. Roberts Jr. and friend to Dr. Arafiles identified the two nurses, which resulted in the nurses losing their jobs and indictment. Charges were dropped against Galle before trial, and Mitchell was found not guilty. The Medical Board put the physician on probation, and the Sheriff was found guilty of retaliation.

"Though I do not know if the Winkler County nurses would have filed their complaints if they had to attach their names, the new law would keep their names confidential," said State Rep. Donna Howard (D-Austin) in the article.

Supporters and critics of the legislation argue how widespread its effects could be. Anonymous complaints make up 4 percent of the 6,849 complaints the Texas Medical Board received last year, according to the article. Patient safety advocates say that maintaining anonymity ensures protection from retaliation, while provider supporters say banning anonymous sources ensures valid complaints.

For full article:
http://www.statesman.com/news/texas-politics/new-law-bans-anonymous-complaints-about-doctors-1865789.html

Medscape Medical News: Top Performing Hospitals Listed in Joint Commission Report

2011-09-19T11:11:00.000-04:00

Mark Crane, September 15, 2011

Small and rural hospitals headed the list of top performing hospitals in using evidence-based processes closely linked to positive patient outcomes, according to the Joint Commission's annual report on quality and safety, Improving America's Hospitals.

The 405 hospitals identified as attaining excellence in accountability measure performance for 2010 represent approximately 14% of Joint Commission–accredited hospitals. The top performers were the most diligent in following best-practice protocols, such as giving aspirin to a person who is having a heart attack on arrival at the hospital, or the use of corticosteroids in children admitted with asthma, said the report, which was issued this week.

The nation's most highly regarded hospitals (the Mayo Clinic in Rochester, Minnesota; Johns Hopkins in Baltimore, Maryland; Massachusetts General Hospital in Boston; and the Cleveland Clinic in Ohio) were not included among the top performers. The list also did not include a single hospital in New York City or the most prominent facilities in Chicago and Houston.

Hospital performance nationwide continued to improve in using evidence-based treatments related to 22 accountability measures for heart attack, heart failure, pneumonia, surgical care, and children's asthma care.

In 2002, hospitals achieved 81.8% composite performance to perform care processes related to accountability measures. In 2010, hospitals achieved 96.6% composite performance, a 9-year improvement of almost 15 percentage points, the report found. More than 9 in 10 hospitals had scores of at least 90%, which is more than 4 times the figure of 9 years ago. The top performing hospitals all had scores of 95% or better.

"While the data across the annual report show impressive gains in hospital quality..., further improvements can still be made," Joint Commission President Mark R. Chassin, MD, MPH, said in a news release. "By following evidence-based care processes, hospitals can improve the quality of care they provide and meet national mandates regarding performance."

Hospitals had relatively low performance on providing fibrinolytic therapy within 30 minutes of arrival to patients having heart attacks (only 60.5% of hospitals achieved 90% compliance or better), and on providing antibiotics to immunocompetent intensive care unit patients with pneumonia (only 77.2% of hospitals achieved 90% compliance or better).

The list of top performers included a disproportionate share of small and rural hospitals, as well as 20 Veterans Affairs Medical Centers. "It is certainly true that larger hospitals, particularly if they are reporting on more measures than smaller hospitals, have a lot more work to do," Dr. Chassin told reporters during a conference call yesterday. "But on the other hand, they have more resources than small hospitals to do that. It may be a question of priority setting.

"I hope [the list] is both a wake-up call to the larger hospitals to put more resources into these types of programs, and a recognition that a small, rural hospital can do an excellent job," he said.

Starting in January, Joint Commission–accredited hospitals will be required to meet an 85% composite compliance target rate for performance on accountability measures. Some 121 hospitals would not pass that mark based on their 2010 scores.

"They know who they are," Dr. Chassin said. "We'll see if they have heeded the warning."

HealthLeaders Media: Overhaul of Physician Education System Recommended

2011-09-16T14:26:00.002-04:00

Cheryl Clark, September 12, 2011

The nation's system for training physicians is in dramatic need of a complete overhaul to adequately provide future patient care, says a report from the Josiah Macy Jr. Foundation, which issued 14 recommendations to make that happen.

"Although notable changes have occurred in graduate medical education (GME) over the past decade, including the introduction of a competency-based framework and limitations on duty hours, many people feel that much broader reforms are needed to keep pace," says the 39-member panel that authored the report.

The panel, consisting of physicians and surgeons as well as medical school deans and faculty members, said the nation will be short more than 100,000 doctors by the middle of the next decade, in part because of the current system's entrenched ways of educating and assuring the quality of the physician workforce.

"Unless we in academic medicine are self-critical and show a willingness to change, the political and public support for graduate medical education will disappear," warns Macy President George Thibault, MD, in a statement. "This is a huge enterprise built on tradition, but the system has to change to be more responsive to public needs."

One of panel’s key recommendations is that medical education should shift from gauging competency by months and years of training to actual measurements of individual physicians' readiness for independent practice. This is because medical school residents "vary significantly in how quickly they achieve competency, yet the current system of training all residents for a fixed duration fails to recognize or accommodate this reality."

The panel also prioritizes its recommendation to diversify training sites from traditional teaching hospitals to federally qualified and school-based health centers "and to expand content related to professionalism, population medicine, and team-based practice.”

A third key recommendation is for educational institutions to eliminate historic boundaries so that other health provider professions can learn with their physician colleagues. "This will require revising regulations that now prevent supervision across specialties or professions," the group says.

The panel also wants to require a period of "monitored independence" during GME to confirm each physician's readiness for independent practice. "Program directors and teaching faculty express widespread concern that residents are not given sufficient opportunity to act independently within the present teaching environment and are consequently less well prepared for practice," the statement says.

The report lists four trends that make a major shift in medical training necessary:

1. New approaches to physician practice are necessary to meet the needs of an aging population, as the number of people 65 and older will double by 2020. This population will live longer with more chronic, cognitive, and functional issues and will be more racially and culturally diverse.

2. Care continues to move outside the hospital to the home, clinics, and other community settings, and care providers are assuming new roles to meet these needs. The Affordable Care Act's directives will accelerate this trend, giving 32 million more people health coverage. This influx will require trainees to be "prepared to work in different organizations and sites of care, and in teams of health professionals."

3. Trainees must enter practice trained to use new healthcare technologies safely and efficiently. "Advances in medical diagnostics, therapeutics, and information technology can significantly improve health outcomes. However, we have fallen short in consistently using technology optimally to improve the quality and efficiency of healthcare," the panel writes.

4. The next generation of physicians must help lower costs and be more efficient. "Physicians in training must understand the financial implications of their patient management decisions, and their training must include new and efficient models of care so that they will be prepared to practice cost-effective medicine and be responsible stewards of resources while providing high-quality patient care," the report says.

However, to change the graduate medical system, medical educators face many obstacles, including the growing tension between work-hour restrictions and competition for curricular time and non-educational tasks. Another important obstacle is the difficulty in persuading sufficient numbers of medical students to choose primary care.

"In the past decade, the number of residents in subspecialty training has risen five times faster than the number of residents in the core specialties (those representing primary board certification). The number of residents expected to practice primary care has declined by more than 10%," the report notes.

The panel was chaired by Debra Weinstein, MD, Massachusetts General Hospital, and Vice President for Graduate Medical Education for Partners Healthcare System, Inc.

From Samueli Institute's 2010 Complementary and Alternative Medicine Survey of Hospitals

2011-09-09T09:51:00.004-04:00

More hospitals (42 percent) offered complementary and alternative medicine (CAM) last year than in 2007 (37 percent), according to a survey by Health Forum and the Samueli Institute. Hospitals cited patient demand (78 percent), evidence of effectiveness (74 percent), and practitioner availability (58 percent) as reasons for offering CAM services. Report (.pdf)

http://www.siib.org/news/2468-SIIB/version/default/part/AttachmentData/data/CAM%20Survey%20FINAL.pdf

Medscape.com: Board Certification Varies With Demographics, Education

2011-09-09T09:44:00.005-04:00

Specific demographic and educational factors are associated with board certification of physicians. These include race and education debt, according to a study published in the September 7 issue of JAMA.

Certification by an American Board of Medical Specialties member board is an important credential, and it is becoming increasingly common. Previous studies have shown better outcomes in patients who are in the care of board-certified physicians, and health maintenance organizations, hospitals, and insurance plans use board certification as an evaluation tool for physicians.

Donna B. Jeffe, PhD, and Dorothy A. Andriole, MD, both from Washington University School of Medicine, St Louis, Missouri, investigated how demographic, medical school, and graduate medical education were associated with American Board of Medical Specialties board certification. They conducted a retrospective study of a national cohort of 42,440 medical students who graduated from US medical schools between 1997 and 2000. Participants were followed up through March 2, 2009.

Of the participants, 37,054 (87.3%) were board certified. The researchers found that board certification was associated with first-attempt passing scores in the highest percentile (compared with those who failed on the first attempt) on US Medical Licensing Examination Step 2 Clinical Knowledge. This trend held true in all physician categories. The lowest adjusted odds ratio (AOR) was found in emergency medicine (87.4% vs 73.6%; AOR, 1.82; 95% confidence interval [CI], 1.03 - 3.20). The highest was found for radiology (98.1% vs 74.9%; AOR, 13.19; 95% CI, 5.55 - 31.32).

Participants who self-identified as underrepresented racial/ethnic minorities had a lower likelihood of being board-certified — a trend that held for every physician category except family medicine. The percentage in pediatrics was 83.5% (vs 95.6% of whites; AOR, 0.44; 95% CI, 0.33 - 0.58). In other nongeneralist specialties, the percentage was 71.5% (vs 83.7% in whites; AOR, 0.79; 95% CI, 0.64 - 0.96).

Increased debt also had an effect. Among obstetrics/gynecology specialists, every $50,000 stepped increase in debt was associated with a lower likelihood of board certification (AOR, 0.89; 95% CI, 0.83 - 0.96) compared with those who had no debt. The reverse was true among family medicine specialists (ie, family practitioners with higher educational debt were more likely to be board certified; AOR, 1.13; 95% CI, 1.01 - 1.26).

The authors noted that the observational nature of the study makes it impossible to assign causal associations, and longer follow-up times may increase the rates of board certification. The results also cannot be applied to osteopathic physicians or students at international medical schools.

"Nevertheless, our findings can inform an understanding of factors contributing to US medical school graduates' advancement along the medical education continuum to board certification, an outcome of interest for medical school graduates, their patients, and the relevant professional organizations involved in undergraduate medical education, [graduate medical education], and board certification," the authors write.

The study was supported by the National Institutes of Health National Institute of General Medical Sciences. The authors received travel funds from the National Institutes of Health for meeting attendance. One author received an honorarium and travel reimbursement from the University of Cincinnati supporting a lecture on MD-PhD programs and their graduates.

JAMA. 2011;306:961-970.

Jim Kling, September 6, 2011

http://www.medscape.com/viewarticle/749172?sssdmh=dm1.716474&src=nldne

Alert: NIMS Guideline for the Credentialing of Personnel

2011-09-06T11:07:00.000-04:00

The purpose of this NIMS Alert is to announce the availability of the NIMS Guideline for the Credentialing of Personnel.

The NIMS Guideline for the Credentialing of Personnel (Guideline) is now final and available for use. The Guideline provides guidance on credentialing for Federal, State, Tribal and Local Personnel, as well as for persons affiliated with Critical Infrastructure and Key Resources, voluntary and not-for-profit response organizations. This Guideline was developed with the participation of stakeholders from key sectors of our society, and builds on the doctrine established in NIMS Guide 0002 NATIONAL CREDENTIALING DEFINITION AND CRITERIA dated March 27, 2007. The Guideline addresses the full range of responders who may be called upon and need to establish their legitimacy through proof of Identity, Qualification/Affiliation and Authorization to deploy.

The Guideline and the NIMS Guide 0002 can be found at the NIMS Resource Center at the following URLs:

The Guideline - http://www.fema.gov/emergency/nims/ResourceMngmnt.shtm#item3

The NIMS Guide 0002 - http://www.fema.gov/pdf/emergency/nims/ng_0002.pdf

For more information on NIMS visit: www.fema.gov/emergency/nims

All questions can be directed to the NIC via e-mail: FEMA-NIMS@dhs.gov or via telephone: 202.646.3850.
• NIMS Alert 02-11 Guidelines for the Credentialing of Personnel.pdf

IDFPR: State Revokes Licenses of Health Care Workers Convicted of Sex Crimes or Crimes against Patients

2011-09-02T16:41:00.000-04:00

CHICAGO – Earlier today, the Illinois Department of Financial and Professional Regulation (IDFPR) revoked the licenses of 11 health care workers who have been convicted of sex offenses or violent crimes against their patients. These revocations are required by a new law signed by Governor Quinn last month. HB 1271 (Public Act 97-0156) provides that the professional license of any health care worker who has been convicted of a sex offense or of a violent crime against their patients is permanently revoked without a hearing and further provides that sex offenders cannot be licensed as health care workers in Illinois.

“The State takes its responsibilities to protect our residents seriously,” said Brent E. Adams, Secretary of Financial and Professional Regulation. “This new law establishes tough outcomes that are intended to shield Illinois patients from health care workers who have been convicted of sex offenses and certain violent crimes.”

While many health care workers are covered by the new law, regulations will be proposed to specifically list all the types of health care workers that are covered by the law. The law also lists most of the crimes requiring permanent revocation, but regulations will be proposed to make clear all the crimes that trigger permanent revocation. These proposed regulations will be filed later this year.

Each health care worker whose license was revoked today appears below, along with the city at which he/she was licensed, and the crime that triggered the permanent revocation.

For Missouri Members: Upcoming Change in State Law

2011-09-02T12:21:00.005-04:00

DIFP: New state law allows consumers to learn more about their physicians

Also gives state regulators more tools against dangerous doctors

Jefferson City, Mo. - Under a new state law, Missouri consumers can now learn more about the educational history of their doctors. House Bill 265, signed by Gov. Jay Nixon, took effect yesterday and allows the State Board of Registration for the Healing Arts to release extensive information about licensed doctors for the first time. The board's website now allows consumers to learn about medical and professional schools attended by physicians, as well as any specialties or board certifications.

In addition, more information will soon be available to the public: Under the law, any future information submitted to the board may be released if it pertains to discipline by another government agency or court-ordered limitations on a doctor's practice.

"This law is a significant step toward better transparency for patients in Missouri," said John M. Huff, director of the Missouri Department of Insurance, Financial Institutions and Professional Registration. "We always encourage consumers to learn as much as they can about the professionals they're doing business with, and that's especially important in a doctor-patient relationship."

House Bill 265 also gives more authority to the board to discipline doctors who violate the law. The board can now:

More effectively seek an immediate suspension of a physician's license when the board believes the doctor is a danger to patients;
Streamline the process for discipline of doctors;
Move cases more quickly through the state Administrative Hearing Commission, which conducts hearings related to the discipline of doctors; and
Discipline doctors for alcohol dependency, being on a sex offender registry or failing to cooperate with board investigations.
Consumers who would like to learn more about their physicians can use the licensee search feature on the board's website at pr.mo.gov, or they can contact the board by phone at 573-751-0098.

About the Missouri Department of Insurance, Financial Institutions & Professional Registration

The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP) is responsible for consumer protection through the regulation of financial industries and professionals. The department's seven divisions work to enforce state regulations both efficiently and effectively while encouraging a competitive environment for industries and professions to ensure consumers have access to quality products.

August 29, 2011

H&HN: Mobile Apps That Bring Patients to Your Door

2011-09-01T12:16:00.002-04:00

Mobile medical applications may get all the attention, but apps that effectively market your hospital to patients may be equally important

The explosion of mobile applications has been one of the biggest health IT stories of 2011, and with good reason: Mobile apps can offer hospitals and doctors portable versions of medical devices and instant access to stores of medical research. And at a time when cost pressures are forcing providers to envision a care delivery process that can serve patients with fewer inpatient interactions, mobile apps also offer a way to reach those ends.

Lately, though, I've been coming across an increasing number of examples of how hospitals are harnessing the power of mobile applications beyond the clinical setting as a way to connect with potential patients and offer them real-time, valuable information on where to go for their care in a pinch.

For instance, Baptist Health in South Florida now offers patients real-time information on wait times for physicians at its urgent care centers and emergency rooms. For its efforts, Baptist Health received a 2011 Most Wired Innovator Award, and my colleague, H&HN Senior Editor for Data and Research, Suzanna Hoppszallern, recently talked to Baptist Health's Petter Melau, the project lead for the mobile app initiative. Melau said the service has been extremely popular; within two days of the app launching, 1,000 users signed up. Melau added that the application also has helped users clarify the difference between services offered by Baptist Health's urgent care facilities and its emergency rooms, a critical distinction in an era of overcrowded EDs.

And industry momentum for mobile apps is definitely quickening. Earlier this week, Carolinas Health System, a 30-hospital system based in Charlotte announced the rollout of a new, free mobile app that allows patients to find locations, check wait times or even search for physicians via their location and specialty.

Beyond the advantages these types of mobile apps offer patients, many IT experts are convinced that if current usage trends continue, it won't be long before smart phones will supplant web-based browsers as the chief access point for online information. For H&HN Daily, for instance, roughly 20 percent of our daily readers access the publication via their phone and not a traditional browser. And on a personal level, I'm a huge fan of the mobile sites in Chicago that allow me to check train and bus times on the go. In other words, in a few years time patients will view mobile apps with real-time information not as an added amenity but as an expected service.

By Haydn Bush August 31, 2011

Medscape Medical News: Hospitals Begin to Reopen in the Aftermath of Irene

2011-09-01T12:15:00.002-04:00

Woes Left in Hurricane's Wake Are Enormous

East Coast hospitals that had evacuated their patients before Hurricane Irene struck during the weekend have begun to admit them again as diminished winds continue to blow northward in the form of Tropical Storm Irene.

In New York City, for example, Staten Island University Hospital reopened its doors last night, as did Palisades Medical Center in North Bergen, New Jersey. However, nobody has given the all-clear sign just yet. St. Clare's Hospital in Sussex, New Jersey, is discharging or transferring 14 patients today because of a malfunctioning emergency generator, said a hospital spokesperson.

Although Irene has been downgraded from a hurricane to a tropical storm, the woes it left behind are enormous. An estimated 4.2 million homes and businesses along the Eastern seaboard lacked power as of Sunday night. Meanwhile, storm-swollen rivers continue to flood inland cities and threaten to contaminate drinking water.

Irene has been a troublemaker with a wide reach. A healthcare research company called Stratasan estimated through computer mapping technology that more than 60 million people, 135,000 physicians, and 459 hospitals lay within the storm's path.

Well Prepared

Irene did not wreak the havoc that Hurricane Katrina did in 2005, but nevertheless it caused the deaths of at least 16 individuals in 6 states, according to news accounts.

At the same time, storm-battered hospitals continued to usher in new lives. Seventeen babies were born during the weekend at New Hanover Regional Medical Center in Wilmington, North Carolina, said Stephanie Strickland, a spokesperson for the North Carolina Hospital Association.

Similar to other facilities up and down the seaboard that suffered power outages, New Hanover Regional kept its monitors and lights on thanks to an emergency generator.

Good preparation translated into good patient care during the weekend, said Donna Leusner, a spokesperson for the New Jersey Department of Health and Senior Services.

"Two weeks before the storm, coastal hospitals, the Department of Health and Senior Services, and county Offices of Emergency Management completed a hurricane exercise that really ensured that the state's plans were up to date and [that] the issues that we found in training were addressed appropriately," Ms. Leusner told Medscape Medical News.

Coping with the storm also required the best of Hippocratic spirits. Some physicians and nurses spent the weekend at East Coast hospitals, not knowing when they might be relieved.

"Many slept in rooms where their patients were housed," said Ms. Leusner.

'Priceless' Experience

At Kings County Hospital Center in Brooklyn, New York, psychiatric resident Kendra Campell, MD, curled up on a bed in a resident on-call room Saturday night.

"I got 4 or 5 hours of sleep," said Dr. Campbell. "It wasn't bad."

Dr. Campbell worked during the weekend in the psychiatric emergency department, where stressed-out patients came for shelter, medications, and a listening ear. Clinicians kept them occupied with games and art exercises. One of the attending physicians strummed an acoustic guitar to brighten the mood.

"I felt an overwhelming sense of teamwork," said Dr. Campbell.

Dr. Campbell was able to go off-duty at 5 pm on Sunday. She Tweeted her sense of relief: "Hours worked at the hospital: 33. Meals eaten out of paper bags: 3. Showers taken: 1. Walking home post-call and post-hurricane: Priceless."

Robert Lowes

American Medical News: Criminal convictions and discipline of Illinois doctors returning online

2011-09-01T12:05:00.006-04:00

Profiles were posted on a website for a few years, but a court required the state to remove the information.

Illinois has rejoined the nation's other 49 states in making physician profiles available to the public in some form.

Disciplinary actions, criminal convictions, medical liability payments going back five years and other information on the state's physicians will be provided online by the Illinois Dept. of Financial and Professional Regulation.
A "key to good health is a great doctor, which is why we are ensuring that all of the important information needed to select a physician is online and available 24 hours a day," Illinois Gov. Pat Quinn said after signing the legislation Aug. 9.

Physician profiles went online as part of the state's 2005 comprehensive medical liability reform. But they were removed from the public eye when the Illinois Supreme Court struck down the liability reform in February 2010 because legislation included caps on noneconomic damages.

Under the new law, physicians will have the right to review the information posted about them and will be able to have inaccurate information corrected. Having the opportunity to review and correct information is a positive thing, said Illinois State Medical Society President Wayne V. Polek, MD, an anesthesiologist.

More than 30 states require background checks at licensure for health professionals. "And we encourage patients to confirm information with a physician," he said.

Dr. Polek said physicians are more comfortable with physician profiles than they were five or 10 years ago. But he said one sticking point is putting medical liability claims in the profiles.

"People are sued for a variety of reasons, and they settle for a variety of reasons. For example, an insurance company or employer says you have to [settle]. That information is not necessarily helpful to patients," Dr. Polek said.

ISMS was neutral on the Patient Right to Know Act because it was a stand-alone measure and not part of more comprehensive legislation to extend the state's Medical Practice Act, Dr. Polek said. The act, which governs the practice of medicine in Illinois, is scheduled for sunset repeal on Nov. 30.

The medical society has supported online physician profiles, including those that were part of the 2005 medical liability reform.

With the new Illinois law, all states now make some type of physician profile information available to the public in some form, said the Federation of State Medical Boards.

"We have come a long way," said FSMB President and CEO Humayun J. Chaudhry, DO. "Back in 1996, no boards had physician profiles. State boards recognize the value of physician profiles. We see Illinois as an example of this continuing trend."

How physician profiles are made public varies among states, Dr. Chaudhry said. But the trend is moving toward states making more information publicly available, he said.

Meanwhile, physicians applying for a new medical license in Indiana must pay for and complete a national criminal background check. Under a law that took effect July 1, doctors also must provide fingerprints. More than 30 states require background checks at licensure for health professionals.

Tanya Albert Henry, Posted Aug. 29, 2011.

From the BNA: HHS Challenges Software Developers To Make Facebook Applications for Disasters

2011-08-24T12:25:00.002-04:00

the Department of Health and Human Services announced Aug. 22 that federal officials are challenging software application developers to design new Facebook applications to help people prepare for emergencies and get support from friends and family after an emergency strikes.

HHS said its Office of the Assistant Secretary for Preparedness and Response (ASPR) issued the ASPR Lifeline Facebook Application Developer Challenge in collaboration with the Federal Emergency Management Agency (FEMA). According to HHS, the online challenge runs throughout National Preparedness Month in September and the remainder of the 2011 hurricane season, closing Nov. 4.

“After disasters, a tremendous number of people use Facebook to post and share information,” Assistant HHS Secretary Nicole Lurie said. She added, “We're challenging our country's most innovative developers to create apps that help people use Facebook not only to reach out to friends and family for any kind of help they may need after emergency but also to become better prepared in the first place.”

The person or team developing the best application will receive $10,000 from HHS and free admission from Health 2.0 to the 2012 Health 2.0 conference, and will be invited to an HHS event with Lurie, according to HHS. The second-place winner will get $5,000, and third place will receive $1,000.

According to HHS, the submissions will be judged on the application's ability to enhance community connections and improve individual preparedness. “The goal is an app that enables a Facebook user to invite three Facebook friends to become lifelines, points of contact who agree to act as a source of support during disasters such as providing transportation, a place to stay or anything else the Facebook friend may need,” the department said.

HHS said that all submissions will be reviewed by judges from Facebook, ASPR, FEMA, and the New Orleans Health Commissioner.

The Aug. 22 announcement by HHS follows publication of an Aug. 10 notice on the “Lifeline Facebook App Challenge” in the Federal Register (76 Fed. Reg. 49485).

From Medscape Medical News: Two Physicians Indicted in Pain-Med Deaths of 4 Patients

2011-08-15T10:57:00.003-04:00

Medscape News has reported that two physicians who once practiced in Colorado face federal charges of illegally prescribing opioid analgesics and other controlled substances that led 4 patients to overdose and die. They also face charges of healthcare fraud and money laundering.

If convicted, Sam Jahani, DO, of Cleveland, Texas, and Eric Peper, MD, of Summerland Key, Florida, could receive long prison sentences and pay millions of dollars in fines. The charges related to the patient deaths come with the most severe punishment — life imprisonment.

Read the entire article at the Medscape Medical News website.

From The BNA: HHS, Treasury Issue Proposed Exchange Rules on Enrollment, Premium Subsidies, Tax Credits

2011-08-15T10:49:00.002-04:00

The BNA has reported that the departments of Health and Human Services and Treasury Aug. 12 released three proposed rules regarding implementation of new state-based health insurance exchanges.

As both HHS and the Treasury Department have reported, the rules detail enrollment and eligibility standards, including small employer participation, and how premium tax credits for low-income individuals will be administered.

The HHS rule on Exchange Eligibility and Employer Standards proposes standards and procedures for enrolling individuals in the online insurance exchanges through a simplified, coordinated system that verifies income and eligibility in “near real-time.”

The same proposed rule also sets out standards for employer participation in the Small Business Health Options Program (SHOP), which permits small employers to purchase health insurance on the exchange.

Read more about the proposed rules here: http://www.healthcare.gov/news/factsheets/exchanges08122011a.html

"HHS, Treasury Issue Proposed Exchange Rules on Enrollment, Premium Subsidies, Tax Credits." BNA's Healthcare Daily Report. 12 Aug. 2011

From the Public Citizen Press Room: California Is Delinquent in Disciplining Dangerous Doctors

2011-08-14T18:06:00.001-04:00

710 Doctors Escaped Medical Board Action, Including 102 Considered an ‘Immediate Threat to Health and Safety.’

Read more at the Public Citizen website.

From the New York Times: The Phantom Menace of Sleep-Deprived Doctors

2011-08-14T18:04:00.001-04:00

After decades of debate and over the opposition of nearly every major medical organization and 79 percent of residency-program directors, new rules went into effect that abolished 30-hour overnight shifts for first-year residents.

Read the rest of the article at the New York Times website.

Joint Commission Telemedicine Pre-Publication Standards

2011-08-04T17:51:00.002-04:00

The Joint Commission has released its pre-publication standards regarding Telemedicine.

Read more about the requirements here: http://www.jointcommission.org/assets/1/6/Pre_Pub_Telemedicine_HAP.pdf

From InformationWeek: How social media is being utilized to prepare for emergencies.

2011-08-04T17:49:00.002-04:00

A recent article in InformationWeek's Healthcare section indicates that Twitter, Facebook, and online communities can help healthcare organizations, emergency personnel, and government agencies better prepare for and respond to emergencies, so it's a good idea to integrate these technologies into planning.

Read the full article here: http://www.informationweek.com/news/healthcare/mobile-wireless/231002905?cid=InformationWeek-Twitter

From the AMA: Call for civility aims to stop disruptive behavior in the OR

2011-08-01T18:00:00.000-04:00

In the following article, the AMA reports on continued concerns regarding disruptive behavior and medicine. The article reports that the chair of Surgery and Transplant Medicine at Cedars-Sinai Medical Center in Los Angeles arranges social events so surgical teams can get to know each other as individuals, help to build relationships and improve patient safety. Share your strategies with other MSP’s by leaving a comment about what your medical staff has implemented to improve disruptive behavior.

Read more from the AMA: http://www.ama-assn.org/amednews/2011/08/01/prsb0801.htm

Announcement for TX - From the Texas Medical Association: DPS Extends Controlled Substance Certificate Renewals

2011-08-01T17:58:00.002-04:00

The Texas Department of Public Safety (DPS) says it will grant physicians 30 days to correct incomplete or inaccurate applications to renew controlled substance certificates.

Read more here: http://www.texmed.org/Template.aspx?id=22105

Joint Commission: New APRs on Focused Standards Assessment

2011-07-27T16:27:00.001-04:00

The new Accreditation Participation Requirements on the Focused Standards Assessment (FSA), the new name of the improved Periodic Performance Review (PPR), are now available on The Joint Commission website. The requirements will become effective January 1, 2012 for the ambulatory care, behavioral health care, home care, hospital, laboratory services and long term care programs. The new name more appropriately reflects an emphasis on an organization’s assessment combined with The Joint Commission’s knowledge of high risk areas that are critical to patient safety and quality. The FSA is part of a broad initiative called the Intracycle Monitoring (IM) process which, when complete, will focus on activities to help identify risk points in health care organizations along with resources for addressing patient safety and quality problems. During 2012, pilot tests of the new IM process will occur; results of these pilot tests will be communicated in future issues of Joint Commission Online. Full implementation is planned for 2013

NCQA Updates

2011-07-25T12:19:00.002-04:00

NCQA has just posted their updates to the HP and CVO standards. All corrections, clarifications and changes can be found here: http://www.ncqa.org/tabid/120/Default.aspx.

Checklists more effective when physicians are prompted to use them: A case-study in teamwork.

2011-07-25T11:38:00.002-04:00

2011 NAMSS Conference Key-Note Speaker, John Nance, is a world-class speaker, consultant and best selling author, who brings a rich diversity of professional training and background to the quest of patient safety and medical practice improvement. In his book , Why Hospitals Should Fly: The Ultimate Flight Plan to Patient Safety and Quality Care Nance explains, “The reality is that hospitals are people, and when, as a team, they can climb free of the failed methods of the past, they indeed can fly, in both spirit and accomplishment.

This story published by the AMA gave an example of such teamwork put into place at Northwestern Memorial Hospital in Chicago. As we all know, checklists can be found everywhere but as this article demonstrates can only be effective when challenged as a team effort. Read the story here.

CMS Issues Memo on Telemedicine Rule for Hospitals and CAHs

2011-07-22T11:10:00.003-04:00

The Centers for Medicare and Medicaid Services (CMS) has issued a memorandum with information on the final rule streamlining telemedicine credentialing in hospitals and critical access hospitals (CAHs).

To read the memorandum, click here:
http://www.namss.org/Portals/0/Advocacy/CMS%20Final%20Rule%20-%20CAH.pdf

Source: CMS

NCQA Promotional Item Pre-Approval No Longer Required

2011-07-20T11:20:00.002-04:00

NCQA has issued the following announcement regarding pre-approval of promotional material, which is of interest to MSPs who work in the commercial CVO setting:

As of August 1, 2011, NCQA will no longer routinely require that you submit for our advance approval your promotional materials referencing your NCQA status. Instead, we will be instituting an audit of promotional materials to ensure they comply with NCQA's Marketing and Advertising Guidelines as more fully described below for NCQA Accreditation, Certification, Recognition, Distinction and Health Insurance Plan Rankings.

The new streamlined process is described in the NCQA Marketing and Advertising Guidelines and is intended to reduce your burden when you publicize your NCQA status. The updated guidelines will be available on our Web site www.ncqa.org.

Source: NCQA

TJC Changes PPR to Focused Standards Assessment

2011-07-12T14:26:00.004-04:00

The following announcement was published in the June 29, 2011 issue of Joint Commission Online:

In 2012, The Joint Commission will develop and test multiple components of a broad initiative called the Intracycle Monitoring (IM) process. One of the components is an incrementally improved Periodic Performance Review (PPR), which will be renamed the Focused Standards Assessment (FSA). The new name more appropriately reflects an emphasis on an organization’s assessment combined with The Joint Commission’s knowledge of high risk areas that are critical to patient safety and quality. The IM process, when complete, will focus on activities to help identify risk points in health care organizations along with resources for addressing patient safety and quality problems. The FSA – the improved PPR – will be effective January 1, 2012. Also effective January 1, 2012, the FSA will only need to be submitted 12 and 24 months following the organization’s last triennial survey. The FSA will not need to be submitted during the third year of accreditation (the year the organization is due for the on-site survey). All four of the options for participating in the FSA will continue to be available; results of the FSA will also continue not to impact an organization’s accreditation decision. During 2012, pilot tests of the new IM process will occur; results of these pilot tests will be communicated in future issues of Joint Commission Online. Full implementation is planned for 2013. (Contact: Gail Weinberger, gweinberger@jointcommission.org)

Have You Experienced the NPDB "Rejected" Message?

2011-07-11T14:00:00.003-04:00

A NAMSS member recently contacted the blog, asking for help with a problem. The member submitted two reports manually, receiving a "Rejected" message for each report. This is the first time the member has received the messages and is wondering if other members are having the same issue, or can provide any insight as to what may solve the problem.

Vote in the poll below and feel free to leave comments and suggestions that may help a fellow member!

CMS Proposes Rule Retracting Physician Signature Requirement

2011-07-08T13:01:00.002-04:00

The Centers for Medicare and Medicaid Services (CMS) published a proposed rule eliminating the requirement that a physician or qualified non-physician sign test requisitions in order for the tests to be paid for under the Clinical Laboratory Fee Schedule.

The rule was supposed to go into effect on January 1, 2011, but was indefinitely delayed after many argued that the rule would create inefficiency.

The proposed rule is open for a 60-day comment period and will likely be finalized later this year.

To see the Federal Register announcement, click here:
http://www.gpo.gov/fdsys/pkg/FR-2011-06-30/pdf/2011-16366.pdf

CA Podiatrists and Physicians Pursue Collaborative Education

2011-07-05T12:11:00.002-04:00

Podiatrists and physicians are working together in California to even out the educational differences between podiatric and medical schools in the state. The effort is being led by the California Podiatric Medical Association, California Medical Association, and California Orthopaedic Association.

The change would allow California podiatrists to practice as licensed physicians and surgeons with a nationally recognized scope and license.

This collaboration is unique as efforts to align licensure and scope of practice between physicians and other health professionals has been an ongoing debate in many states.

To read the full article, click here:
http://www.ama-assn.org/amednews/2011/06/27/prl20627.htm

Source: amednews.com

WV Upholds $500,000 Malpractice Cap

2011-06-24T10:52:00.003-04:00

The Supreme Court of West Virginia has upheld a $500,000 malpractice cap on pain and suffering damages. The cap was put in place by a 2003 law that was designed to address growing malpractice judgements.

Supporters of malpractice caps state that the caps are necessary to ensure that doctors are not pushed out of the profession by growing malpractice insurance costs. Opponents state that malpractice caps limit victims of egregious actions from obtaining appropriate compensation.

To read more about the West Virginia decision, click here:
http://www.dailymail.com/News/statenews/201106221188

Source: Charleston Daily Mail

Louisiana Health System May Face Class Action Lawsuit on Negligent Credentialing

2011-06-17T11:35:00.005-04:00

A Louisiana judge has ruled that a case filed by five former patients against Willis-Knighton Health System can move forward. The plaintiffs allege that the health system failed to properly credential neurosurgeon Dr. Ravish Patawardhan. They also claim that after Dr. Patawardhan was given privileges, the health system failed to investigate concerns raised by nurses regarding his surgical skills.

No hearing date has been scheduled.

To read a full article on the lawsuit, click here:
http://www.shreveporttimes.com/article/20110616/NEWS01/106160328/Lawsuit-against-health-system-may-move-forward

Source: shreveporttimes.com

New Residencies in Addiction Medicine Begin Next Month

2011-06-09T12:45:00.002-04:00

In July, the first ten residency programs accredited by the American Board of Addiction Medicine (ABAM) will begin. There are currently 20 physicians enrolled in the program. The programs were designed to address the growing needs of those suffering from substance abuse. They will focus on developing skills screening, intervention, detoxification, and rehabilitation.

At this time, the ABAM is not seeking ABMS membership of ACGME accreditation of its programs.

Source: amednews.com
http://www.ama-assn.org/amednews/2011/06/06/prsa0606.htm

Hands on Surgical Training (HoST)

2011-05-31T10:47:00.002-04:00

Read the latest on a new surgical simulator that can physically guide the hands of novice surgeons and provides scenarios that traditional VR can not replicate: http://www.fastcompany.com/1755317/robo-simulator-gives-shaky-new-surgeons-the-strokes-of-smooth-operators.

TJC Launches Primary Care Medical Home Option

2011-05-26T12:35:00.003-04:00

The Joint Commission (TJC) is now accepting applications from accredited ambulatory care organizations for a Primary Care Medical Home option (PCMH) that will launch in July 2011.

The PCMH is a delivery model that provides patients with coordinated care by a primary care physician and team of healthcare professionals. The model emphasizes improved communication among clinics, facilities, and healthcare professionals to improve patient satisfaction and health outcomes.

To learn more about the PCMH option and to see TJC's PCMH standards for ambulatory care organizations, click here:
http://www.jointcommission.org/joint_commission_primary_care_medical_home_option_to_launch_in_july/

Source: The Joint Commission

State Spotlight: Missouri

2011-05-26T10:37:00.005-04:00

MoAMSS Advocacy Efforts - House Bill 347, "The Prompt Credentialing Act"

In March of 2011, House Bill 347 the “Prompt Credentialing Act” was introduced in the Missouri House of Representatives. The Bill stated that every health carrier shall complete the process of verifying health care professional’s credentialing information and make a final determination to credential the health care provider within 60 calendar days of receipt of a complete application. It also stated that immediately after becoming credentialed, every health carrier shall retroactively compensate health care professionals for services rendered from the date of the application. Working with NAMSS, we sent a letter to the bill's sponsor, Representative Kirkton, outlining our concerns if the legislation was passed in its written form. Our letter also proposed revisions that would preserve the bill's purpose without diminishing the value of proper credentialing.

The Bill did not make it through the Missouri Legislative session which ended May 13, 2011. House Bill 347 was rolled into another Bill, House Bill 863 and MoAMSS will continue to monitor any progress that it may have in the future.

NAMSS thanks the Missouri Association of Medical Staff Services for sharing this update. To learn more about MoAMSS, visit: http://www.moamss.org/

Does your state have news that you would like to share on the State Spotlight section of the NAMSS Blog? E-mail news@namss.org with a summary of your news item, and your contact information.

Register for a NAMSS Webinar on the New Telemedicine Rule!

2011-05-25T09:58:00.008-04:00

What You Need to Know About the Telemedicine Credentialing Rule
A Live Webinar Brought to You by NAMSS
Wednesday, June 15, 2011 at 1:00 PM EDT
Presented by Commander Scott J. Cooper, MMSc, PA-C

On May 5, 2011, the Centers for Medicare and Medicaid Services (CMS) published a final rule for hospitals and critical access hospitals (CAHs) that will allow for a new credentialing and privileging process for physicians and practitioners providing telemedicine services. The new rule has a 60-day implementation window. This final rule gives hospitals and CAHs more flexibility in credentialing and privileging telemedicine providers. Starting July 5, 2011, the governing body of a hospital or CAH will be allowed to rely on the credentialing and privileging decisions of a distant-site hospital or telemedicine entity when making its own credentialing and privileging decisions. The rule also allows hospitals and CAHs to rely on information from non-hospital telemedicine providers such as teleradiology and other telehealth centers.

The revision is intended to make it easier for hospitals to adopt and implement telemedicine, providing patients with access to a greater range of services. But what does this mean for medical staff departments and your current credentialing and privileging practices?

Join Commander Scott J. Cooper, MMSc, PA-C of the Centers for Medicare and Medicaid Services on Wednesday, June 15 from 1:00 to 2:30 PM Eastern as he walks through the final rule and answers questions.

Webinar participants will have the opportunity to ask the speaker additional questions following the presentation.

What You Will Learn:

What is new about the revised Conditions of Participation?

What is the difference between telemedicine, telehealth, and teleradiology?

What should the written agreement between the hospital and telemedicine provider look like?

What specific information must be received in order for a hospital to rely on the credentialing and privileging decisions of another entity?

Speaker:

Commander Scott J. Cooper, MMsc, PA-C is a member of the United States Public Health Service. He currently serves as a Senior Health Insurance and Policy Analyst with the Clinical Standards Group in the Office of Clinical Standards and Quality at the Centers for Medicare and Medicaid Services (CMS). Commander Cooper and his team at CMS are responsible for the development of CMS standards and policies, including the latest telemedicine final rule.

Who Should Attend:

All MSPs are invited to attend.

CEs:

Webinar participants will receive 1.5 CE credits.

Cost:
NAMSS members: $49 Non-members: $69
You will have the opportunity to purchase additional CE certificates for $10 each. A multi-registrant form will be included with your registration information.

To Register:
Visit the NAMSS Online Store to purchase this course.

New NPSG Targeted at Reducing CAUTIs

2011-05-24T09:57:00.003-04:00

One Joint Commission National Patient Safety Goal (NPSG) has been approved for 2012. NPSG 07.06.01 states that hospitals and critical access hospitals should: "implement evidence-based practices to prevent indwelling catheter-associated urinary tract infections (CAUTI). (This goal is not applicable to pediatric populations). "

The CAUTI NPSG comes from The Joint Commission's ongoing effort to reduce hospital-acquired infections. No other NPSGs were approved for 2012.

For more information, visit:
http://www.jointcommission.org/new_2012_national_patient_safety_goal_cauti/

Source: The Joint Commission

NAMSS Extends Our Thoughts to Joplin, Missouri

2011-05-24T09:10:00.004-04:00

NAMSS would like to extend our thoughts and condolences to all those affected by the severe weather that has hit our country this season. Our thoughts lie especially with the town of Joplin, Missouri, which was devastated by a tornado this past weekend.

We especially would like to recognize the staff of St. John’s Regional Medical Center. As the storm approached, they acted quickly to move patients to safety; now, they are working to implement their disaster plan while accounting for colleagues in the area.

Our thoughts will continue to lie with those who are working tirelessly to help the community to recover and rebuild.

Optometrists' Surgery Rights, Physician Dress Code Rules

2011-05-23T09:52:00.004-04:00

Today's edition of American Medical News highlights two legislative developments in Kentucky and New York.

Kentucky: A recently passed law that allows optometrists to perform certain surgeries, including postcataract and glaucoma procedures, has created a debate between physician organizations and the American Optometric Association. The physician groups argue that optometrists lack the necessary training and education necessary to perform surgeries and handle complications. The American Optometric Association argues that optometrists have a record of providing quality services and that the expanded scope of practice will improve access to eye care in underserved communities.

To read the full article, click here:
http://www.ama-assn.org/amednews/2011/05/23/prl20523.htm

New York: A proposed bill in New York would require health professionals to adopt a "bare below the elbow" dress code when interacting with patients. The bill is an effort to reduce hospital-acquired infections resulting from bacteria that can travel on neckties, long sleeved clothing, watches, and jewelry. Opponents of the bill state that there is no clear evidence linking the presence of bacteria on clothing and jewelry to the rate of hospital-acquired infections.

To read the full article, click here:
http://www.ama-assn.org/amednews/2011/05/23/prsa0523.htm

Source: amednews.com

New TJC Standards FAQ: Unlicensed Persons Acting as Scribes

2011-05-19T10:28:00.002-04:00

The Joint Commission (TJC) has released new Standards FAQ information related to the use of unlicensed persons acting as scribes for physicians and licensed independent practitioners.

The FAQ clarifies TJC's position on who is considered a scribe, the use of scribes, and the definition of "verbal orders" related to entries by a scribe.

To read the FAQ, click here:
http://www.jointcommission.org/standards_information/jcfaqdetails.aspx?StandardsFAQChapterId=66&StandardsFAQId=345

Source: The Joint Commission

Submit News for the State Spotlight!

2011-05-18T12:45:00.003-04:00

Does your state have a legislative victory to share? Is your workplace creating new credentialing policies and best practices due to regulatory changes? Has your state association made an impact on the development of any policies in your state?

If you answered "yes" to any of the questions above, we would like to feature your state on the NAMSS Blog as part of a "State Spotlight" series of posts. The State Spotlight will give you the opportunity to share news of your state's public policy and advocacy-focused activities with a national audience.

To be considered, submit the following information to news@namss.org:

Name

Address

E-mail Address

Phone Number

Whether or not you are a member of a state association, and if so, if you hold an officer or leadership position with the state association

A brief summary of the news that you would like to highlight on the blog.

NCQA Announces Completion of ACO Pilot Tests

2011-05-06T11:10:00.002-04:00

NCQA has announced that 10 pilot programs in its Accreditation Program for Accountable Care Organizations (ACOs) has just been completed.

NCQA will use the feedback from the pilot program to create final ACO standards, which are expected to be released in July.

For NCQA's full press release, click here:
http://www.ncqa.org/tabid/1330/Default.aspx

North Carolina Expands Providers Subject to Proof of Licensure Requirements

2011-05-05T12:06:00.004-04:00

On April 14, North Carolina Governor Beverly Perdue signed S.B. 505, which requires that podiatrists, advanced practice nurses, physician assistants, psychologists, acupuncturists, and certified professional midwives wear identification with photo and licensing information when meeting with patients.

Chiropractors, dentists, practitioners of medicine and surgery, optometrists, and osteopathic physicians are already required to comply with the requirement under existing law. The purpose of the requirement is to ensure that the public can easily identify the qualifications of the providers they visit.

Source: BNA

Michigan Enacts "I'm Sorry" Law

2011-05-05T11:26:00.002-04:00

On April 19, Michigan enacted Public Act 21, which provides that in civil lawsuits,

“a statement, writing or action expressing sympathy, compassion, commiseration, or a general sense of benevolence relating to the pain, suffering, or death of an individual, that was made to that individual or to his or her family, is inadmissible as evidence of an admission of liability in a medical malpractice action.”

The law is intended to protect healthcare providers who are afraid to say "I'm sorry" to a patient or his or her family members out of fear that the statement may be used against them in a civil malpractice suit. It is also intended to reduce unnecessary suits.

36 states and the District of Columbia have "I'm Sorry" statutes.

Source: BNA

Regulatory Alert: CMS Releases Final Rule on Telemedicine Credentialing and Privileging

2011-05-03T09:00:00.006-04:00

WASHINGTON (May 2, 2011) -

On May 2, the Centers for Medicare and Medicaid Services (CMS) released a final rule that will make it easier for hospitals and critical access hospitals (CAHs) to credential and privilege telemedicine providers.

The rule allows hospitals and CAHs delivering telemedicine services to rely on the credentialing and privileging information of the distant-site facility. The distant-site facility is defined as the location where the provider is located. Members of the governing body of the hospital or CAH where the patient is located will still need to make their own privileging decision; however, the new rule allows them to rely on the credentialing information and privileging decision of the distant-site facility.

One major change from the May 26, 2010 proposed rule is that CMS will allow hospitals and CAHs to accept credentialing and privileging information from facilities other than Medicare-participating entities as long as there is a written agreement between facilities stating that the distant-site entity will “furnish services that permit the hospital to comply with all applicable conditions of participation and standards for contracted services.” This includes the credentialing and privileging requirements of the conditions of participation.

The proposed rule had originally been written to exclude non-Medicare participating telemedicine entities since CMS would have no oversight over them. These entities include teleradiology providers, telepathology providers, and others, including ambulatory surgery centers accredited by The Joint Commission. CMS realized that preventing hospitals and CAHs from applying the new rule to these providers would do little to increase patient access to services or to reduce the burden on small hospitals and CAHs that want to provide telemedicine services.

The final rule will be published in the Federal Register on May 5. Hospitals and CAHs will be given 60 days from its publication date to implement the rule.

NAMSS is hosting an upcoming webinar with Lieutenant Commander Scott Cooper of the CMS Office of Clinical Standards and Quality. Lt. Cmdr. Cooper will give an overview of the final telemedicine rule and answer any questions you may have. Be sure to watch your e-mail and the NAMSS Homepage at www.namss.org for the date and registration information.

Read the final rule and see CMS’ responses to comments submitted

Read NAMSS’ comments submitted on the proposed rule in July 2010

Need Guidance on the New ACA Provider Screening Rule?

2011-05-02T11:07:00.002-04:00

On March 25, a new CMS rule went into effect to strengthen provider and supplier screening requirements under Medicare, Medicaid and SCHIP. The rule, which was ordered under the Affordable Care Act, is intended to crack down on waste and fraud.

The rule outlines various risk categories of providers and the screening methods that should be used for each category, such as checking for licensure and querying the NPDB.

In February, Reed Smith LLP published a comprehensive review of the rule. To read their summary and outline of the rule's requirements, click here:

http://www.reedsmith.com/_db/_documents/RS_HIWW_Alert11039[1].pdf

Article Highlights Risks of Social Media in Medicine

2011-04-22T13:25:00.004-04:00

Dr. Alexandra Thran was fired from Westerly Hospital in Rhode Island after posting information about a patient on a social media website. Dr. Thran did not mention the patient by name, but had provided details that could be used to identify the patient.

In addition to being fired, Dr. Thran was also reprimanded by the state medical board and fined $500.

The increase in communication through social media has led to the blurring of patient privacy boundaries. Some healthcare professionals have faced stiffer penalties under HIPAA for posting pictures of, or discussing patients over social media outlets. The best piece of advice for those who use social media and work in the healthcare setting may be to keep your professional life separate from your personal life -- especially online.

Source: Boston.com
http://articles.boston.com/2011-04-20/lifestyle/29451939_1_social-media-patient-emergency-room

Cardiologists Seek Supreme Court Review of Economic Credentialing Case

2011-04-21T12:06:00.005-04:00

Three cardiologists have petitioned the US Supreme Court to review an appellate court decision finding that they did not have a claim against a hospital that had allegedly terminated their privileges based on their refusal to refer patients to the hospital's only cardiac surgeon. (Gaalia v. Citizens Medical Center).

The cardiologists claimed that in 2007, they refused to refer patients to Citizens Medical Center's cardiac surgeon because the surgeon's mortality rate exeeded that of other surgeons in the area. They claimed that CMC took action against them, imposing an on-call duty requirement that they were unable to fulfill, essentially leading to the termination of their privileges. They claimed that under the federal Anti-Kickback Act, the hospital wrongfully terminated their privileges under a practice of economic credentialing.

The U.S. Court of Appeals for the Fifth Circuit ruled that CMC had a rational basis for terminating the cardiologists' privileges and that the hospital committed no violation. The cardiologists are seeking review of the decision by the Supreme Court, stating that the healthcare industry needs clarification on when the federal anti-kickback statute applies.

Source: BNA

There's an App for That!

2011-04-20T14:24:00.005-04:00

Did you know there are 17,000 medical applications available for download from major app stores for the Apple iPhone and iPad, and for smart phones and mobile computers? Technology is exploding and physicians are starting to use an iPad and other devices to track their patients through EMR.

Has anyone transitioned their credentials committee or MEC to use an iPad for committee work? If so share your best practices with other members.

For the full story click here:
http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/04APR2011/0411HHN_Coverstory&domain=HHNMAG

Source: H&HN

Oregon Medical Board Investigating Surgeon and Distributorship Relationship

2011-04-18T12:12:00.004-04:00

The Oregon Medical Board is investigating neurosurgeon Dr. Vishal James Makker after his privileges were revoked by Providence Portland Medical Center at the end of March.

Medicare claims data showed that Makker was performing spinal surgeries at 10 times the national average rate. In 2006, Makker underwent training for performing unnecessary surgeries and billing for procedures not performed.

The Oregon Medical Board is also investigating Makker's relationship with Omega Solutions, a medical-device manufacturer that engaged in the practice of paying dividends to surgeons who used their products. Omega denies having any relationship with Makker where he was paid. It is also unclear whether or not the revocation of Makker's privileges is related to the investigation.

To read the full story, click here: http://online.wsj.com/article/SB10001424052748704336504576259142044058726.html

Source: The Wall Street Journal

Introducing a New Look for the NAMSS Blog!

2011-04-15T14:39:00.005-04:00

We have redesigned the NAMSS Blog to better match the NAMSS homepage, which was updated last year. The NAMSS Blog is still your source for all the latest news relevant to the medical staff and credentialing professions, just with a new look.

What do you think of the changes? Let us know by providing your comments on the blog, or by e-mailing news@namss.org.

AHA Supports Bill Allowing for General Supervision for Outpatient Services

2011-04-14T10:27:00.002-04:00

The following announcement was released by the American Hospital Association (AHA):

The AHA today voiced support for S. 778, legislation that would allow general supervision by a physician or non-physician practitioner for many outpatient therapy services. Introduced last week by Sen. Jerry Moran (R-KS), the bill would require the Centers for Medicare & Medicaid Services to allow a default setting of general supervision, rather than direct supervision, for outpatient therapy services and create an advisory panel to establish an exceptions process for risky and complex outpatient services. The legislation would create a special rule for critical access hospitals that recognizes their unique size and Medicare conditions of participation. The bill also would hold hospitals and CAHs harmless from civil or criminal action for failing to meet CMS' current direct supervision policy for the period 2001 through 2011. "Although CMS claims its policy is a 'restatement and clarification' of existing policy, it is, in fact, a significant change that has left hospitals and CAHs vulnerable," AHA said in a letter of support for the legislation. The AHA also continues to urge the administration to address hospitals' concerns with the requirement.

Source: American Hospital Association

HFAP Updates Standards to Align with CMS

2011-04-12T13:59:00.003-04:00

The Healthcare Facilities Accreditation Program (HFAP) has released updates to their standards that better align them with CMS requirements. The following standards have been updated:

15.01.08: Exercise of Patient Rights

16.00.03: Nursing Organization

17.00.06: Orders for Services Provided

26.00.20: Delivery of Services

26.01.09: Treatment Plan (Physical Therapy)

26.02.09: Treatment Plan (Occupational Therapy)

26.03.09: Treatment Plan (Speech Therapy)

26.04.09: Treatment Plan (Audiology)

For more information and to see the revised standards, click here: http://www.hfap.org/blog/?p=1611

Source: HFAP

CMS Expands Hospital Compare to Include HAC Data

2011-04-11T09:58:00.003-04:00

CMS announced the expansion of their publically reported data to include “Hospital Acquired Conditions (HAC). MSPs play an important role in patient safety and compliance with these measures as we assist our hospitals by providing education to our medical staffs during orientation and ongoing education opportunities.

For the first time, Medicare patients can see how often hospitals report serious conditions that develop during an inpatient hospital stay and possibly harm patients with important new data about the safety of care available in America’s hospitals added today to the Centers for Medicare & Medicaid Services’ (CMS) Hospital Compare website.

The Hospital Compare website can be accessed at www.HealthCare.gov/compare.

Independent data from the Institute of Medicine estimates that as many as 98,000 people die in hospitals each year from medical errors that could have been prevented through proper care. Although not every HAC represents a medical error, the HAC rates provide important clues about the state of patient safety in America’s hospitals. In particular, HACs show how often the following potentially life-threatening events take place:

· Blood infections from a catheter placed in the hospital;
· Urinary tract infections from a catheter placed in the hospital;
· Falls, burns, electric shock, broken bones, and other injuries during a hospital stay;
· Blood transfusions with incompatible blood;
· Pressure ulcers (also known as bed sores) that develop after a patient enters the hospital;
· Injuries and complications from air or gas bubbles entering a blood vessel;
· Objects left in patients after surgery (such as sponges or surgical instruments);
· Poor control of blood sugar for patients with diabetes.

Today, there is so much information to communicate to our medical staffs. To accommodate our busy doctors have you come up with any innovative ways to provide education using new methods of technology that you would like to share with fellow MSPs?

Source: Centers for Medicare and Medicaid Services

Congress Continues Debate on Tort Reform

2011-04-08T15:27:00.005-04:00

This week, the House Energy and Commerce Committee held a hearing on H.R. 5, the "Help Efficient, Accessible, Low-cost, Timely Act (HEALTH) of 2011." The Act would impose a cap of $250,000 on non-economic damages in medical malpractice cases.

Supporters of the bill state that it will save billions of dollars by eliminating frivolous suits, lowering the cost of malpractice insurance, and by preventing "defensive medicine," where practitioners may order unnecessary tests and treatments to avoid being sued by a patient. Opponents of the Act believe that providers should be held liable for their actions and that there should be no limit on an injured patient's right to seek relief.

Source: House Energy and Commerce Committee http://energycommerce.house.gov/News/PRArticle.aspx?NewsID=8436&IID=9

TJC Announces Field Review of Influenza Standards

2011-04-06T09:42:00.005-04:00

The Joint Commission has announced a field review of proposed standards addressing influenza vaccination requirements for staff and licensed independent practitioners. To read the proposed standards and provide comment, click here:

http://www.jointcommission.org/standards_information/field_reviews.aspx?StandardsFieldReviewId=KUB%2fsbNgRkNRMRqj62GdO2RnacCewOVZR6%2bkn1VlplY%3d

The comment period closes May 17, 2011

Source: The Joint Commission

Top Metro Hospital Rankings Released

2011-03-30T11:03:00.005-04:00

US News & World Report has released rankings for the top metropolitan hospitals in the nation. The list supplements the publication's annual list of Best Hospitals.

Forty-six hospitals made the list after being assessed on criteria such as reputation, specialty offerings, standing as a teaching hospital, and patient safety. The work of MSPs plays a huge role in the recognition of these facilities. MSPs are responsible for being the first-line of defense against providers who may be unfit to provide quality care. We also help hospitals maintain the quality data that can be used to catch and remedy medical error rates.

Congratulations to fellow MSPs who work in the nation’s top hospitals recognized in this ranking. Your contributions and support of the medical staff are a very important part of this national recognition.

To see the rankings, click here:
http://health.usnews.com/best-hospitals/area

Source: US News & World Report

Happy Doctor's Day to Our Medical Staffs!

2011-03-30T10:55:00.003-04:00

The first Doctor's Day observance was March 30, 1933 in Winder, Georgia. Eudora Brown Almond, wife of Dr. Charles B. Almond, decided to set aside a day to honor physicians. This first observance included the mailing greeting cards and placing flowers on graves of deceased doctors. The red carnation is commonly used as the symbolic flower for National Doctor's Day.

Doctor's Day marks the date that Crawford W. Long, M.D., of Jefferson, GA, administered the first ether anesthetic for surgery on March 30, 1842. On that day, Dr. Long administered ether anesthesia to a patient and then operated to remove a tumor from the man’s neck. Later, the patient would swear that he felt nothing during the surgery and wasn’t aware the surgery was over until he awoke.

On March 30, 1958, a Resolution commemorating Doctor's Day was adopted by the United States House of Representatives. In 1990, legislation was introduced in the House and Senate to establish a national Doctors Day. Following overwhelming approval by the United States Senate and the House of Representatives, on October 30, 1990, President George Bush signed S.J. RES. #366 (which became Public Law 101-473) designating March 30 as "National Doctor's Day."

Are you and your medical staff doing anything to celebrate Doctor's Day today? Share your stories in the comment area below this post on the NAMSS Blog.

Celebrate Doctor's Day on March 30

2011-03-28T10:02:00.006-04:00

Chevalier Jackson, MD a laryngologist, pediatrician, inventor and designer saved thousands of children in the late 1800 and early 1900’s by removing objects that they had swallowed from their esophagi, traheae and lungs. Some 2,000 of the items he retrieved and catalogued are on display at Philadelphia's Mütter Museum.

As we approach Doctor’s Day, this is a timely article to share. As MSPs, each day we are truly honored to work with the most intelligent and respected men and women in our nation, who like Dr. Jackson, make significant contributions to the advance of medicine.

Join me in showing your appreciation for our medical staffs this week as we celebrate Doctor’s Day on Wednesday, March 30, 2011.

Read more about Dr. Chevalier Jackson here:
http://www.ama-assn.org/amednews/2011/03/21/prsa0321.htm

Source: amednews.com

Hospital Corporation Settles with Families of Hurricane Katrina Victims

2011-03-24T14:58:00.003-04:00

Tenet Healthcare Corp. has settled with the families of patients who died at Memorial Medical Center in New Orleans, LA following Hurricane Katrina in 2005. The families filed a class action lawsuit against the corporation, claiming that the hospital was not prepared to provide patient care in an emergency.

The suit also claimed that Memorial Medical failed to implement a plan for evacuating patients, leaving several patients in the hospital for days without power or life support as the temperature of the facility rose. Since these claims had been circulated in the news, Tenet claimed that it would have been impossible to find an impartial jury in the New Orleans area.

The details of the settlement will not be disclosed until it is approved by the court.

Source: Bloomberg
http://www.bloomberg.com/news/2011-03-23/tenet-healthcare-settles-class-action-lawsuit-over-katrina-hospital-deaths.html

Report Highlights Inconsistency Between Hospital and State Licensing Actions Against Physicians

2011-03-17T14:38:00.005-04:00

A March 2011 report by Public Citizen, a non-profit consumer advocacy group, found that out of the 5,887 physicians in the National Practitioner Data Bank (NPDB) "with one or more clinical privilege actions -- revocation or restriction of their clinical privileges," more than half had no state licensing actions taken against them. The report questions whether or not state medical boards are receiving reports of hospital actions and whether or not the medical boards are properly responding to reports of discipline through appropriate action at the state level.

Public Citizen examined clinical privilege reports, medical malpractice payment reports, as well as the NPDB Public Use File, which does not disclose the identity of the practitioners queried. It found that many physicians who had clinical privilege disciplinary actions related to incidents such as incompetence, sexual misconduct, fraud, malpractice, and being deemed "an immediate threat to health and safety" had reports in the NPDB, bit had no state licensure action taken against them.

The report issued several recommendations. First, it encouraged states to strengthen medical board oversight to improve performance in taking action against disciplined physicians. It also called on the boards to work with the Health Resources and Services Administration (HRSA) to ensure that action is taken against the physicians in the NPDB who curerntly have clinical privilege reports but no state licensure action. Finally, the report called on the Department of Health and Human Services Office of the Inspector General to resume investigations of state medical board effectiveness. This oversight review was last performed 18 years ago.

In response to the report, Humayun Chaudhry, D.O., president and CEO Federation of State Medical Boards (FSMB) stated:

“While not every hospital action requires a medical license disciplinary action, many states have indicated that there is significant under-reporting to them of hospital sanctions. Recognizing this, several state medical boards and the Federation of State Medical Boards have been collaborating with HRSA since 2010 to explore ways of cross-referencing information contained in the National Practitioner Data Bank with the information the boards have in order to create a more effective reporting system. State medical and osteopathic boards do the best they can with the resources they have, but they cannot take an action against a physician if they are unaware of the problem. The report by Public Citizen is a reminder of the value of collaboration among many different groups (e.g., physicians, hospitals, state boards, federal agencies and the public) and the need for them to seek ways to work together in protecting the public and promoting quality health care.”

To read the Public Citizen report, click here:
http://www.citizen.org/documents/1937.pdf

Sources: Public Citizen, FSMB

New FAQ on MS.01.01.01

2011-03-15T12:03:00.002-04:00

The Joint Commission has posted new FAQ on Standard MS.01.01.01. The questions address the role of the medical staff in governing body decision making and when formal meetings are needed to obtain approval on medical staff bylaws and amendments thereto.

The FAQ can be found here:
http://www.jointcommission.org/standards_information/jcfaqdetails.aspx?StandardsFAQChapterId=74&StandardsFAQId=332

Source: The Joint Commission

Bills Introduced in Congress to Discourage Frivolous Lawsuits

2011-03-15T10:48:00.004-04:00

Members of both the House and Senate have introduced tort reform bills in the House and the Senate, which would increase penalties for those who file meritous lawsuits in federal court.

The Lawsuit Abuse Reduction Act of 2011 was introduced by Rep. Lamar Smith (R-TX) in the House and Sen. Chuck Grassley (R-IA) in the Senate. This bill would impose mandatory sanctions on lawyers including the payment of the defendant's attorney's fees and court costs. The bill reinstates stricter provisions and penalties which were reduced in 1993.

The Help Efficient, Accessible, Low-Cost Timely Healthcare (HEALTH) Act of 2011 was introduced in the House by Rep. Dave Scott (D-GA), Rep. Lamar Smith (R-TX), and Rep. Phil Gingrey (R-GA). This bill would impose a cap of $250,000 on noneconomic damages awarded in malpractice cases and would lower premiums for malpractice insurance. Supporters of the bill say that it will reduce the ordering of unnecessary services by physicians practicing "defensive medicine." The Congressional Budget Office (CBO) estimates that this bill would reduce the federal deficit by $40 billion between 2011 to 2021. It is predicted that while this bill has support to pass the Republican-dominated House, it will fail in the Senate.

Sources:

LegalNewsline
http://legalnewsline.com/news/231646-tort-reform-bill-introduced-in-congress

Medscape Today
http://www.medscape.com/viewarticle/738839?sssdmh=dm1.672690&src=nldne

Utah Approves Bill on Negligent Credentialing

2011-03-10T10:57:00.003-05:00

Both the Utah House and Senate have approved a bill that bars negligent credentialing as a cause of action in medical malpractice suits.

SB 150 reverses a May 2010 Utah Supreme Court decision which allows plaintiffs to include hospitals in malpractice suits on the grounds that the hospital should not have given credentials to a practitioner with a past history of questionable actions. The majority of states still recognize negligent credentialing as a cause of action in malpractice suits.

History of the bill can be found here:
http://le.utah.gov/~2011/htmdoc/sbillhtm/sb0150.htm

An overview of arguments for and against the bill can be found here (Salt Lake City News):
http://www.cityweekly.net/utah/article-13298-sb150-could-let-hospitals-off-the-hook-for-hiring-bad-docs.html

TJC Granted Deeming Authority for Psychiatric Hospitals

2011-03-08T12:04:00.002-05:00

The Joint Commission (TJC) has been granted deeming authority for psychiatric hospitals by the Centers for Medicare and Medicaid Services (CMS). For the next four years, hospitals accredited by TJC will be considered as meeting CMS requirements.

In addition to psychiatric hospitals, TJC has deeming authority for ambulatory surgical centers, clinical laboratories, critical access hospitals, durable medical equipment suppliers (DMEPOS), advanced diagnostic imaging centers, hospitals, home care agencies; and hospices.

To read TJC's announcement, click here:
http://www.jointcommission.org/cms_recognizes_the_joint_commission’s_accreditation_of_psychiatric_hospitals/

AAPA Provides Clarification on the Medicare Enrollment of PAs

2011-03-03T15:38:00.004-05:00

The American Academy of Physician Assistants (AAPA) recently contacted NAMSS, providing the information below, which may be helpful to MSPs who are responsible for the credentialing and Medicare enrollment of Physician Assistants (PAs):

With the new PECOS requirement, hospitals have been scurrying to get employed PAs enrolled to meet the “ordering/referring” rule.

Some MSPs who are responsible for physician credentialing and enrollment in Medicare have been asked to present Medicare contractors with current certification information. In some states, maintenance of certification is not a requirement for licensure; nor is it a requirement for Medicare enrollment. The PA must have passed the certifying exam. There is no mention of maintenance of certification. Transcripts from the PA program are not required if proof can be presented that the PA is NCCPA certified. In this case, certification and license are all that is required.

The relevant Medicare regulations are below:

Medicare Benefit Policy Manual
Chapter 15 – Covered Medical and Other Health Services
Table of Contents
(Rev. 117, 12-18-09) http://www.cms.gov/manuals/Downloads/bp102c15.pdf

190 - Physician Assistant (PA) Services
(Rev. 1, 10-01-03)
B3-2156

Effective for services rendered on or after January 1, 1998, any individual who is participating under the Medicare program as a physician assistant for the first time may have his or her professional services covered if he or she meets the qualifications listed below and he or she is legally authorized to furnish PA services in the State where the services are performed. PAs who were issued billing provider numbers prior to January 1, 1998 may continue to furnish services under the PA benefit.

See the Medicare Claims Processing Manual, Chapter 12, “Physician and Nonphysician Practitioners,” §110, for payment methodology for PA services. Payment is made under assignment only.

A. Qualifications for PAs

To furnish covered PA services, the PA must meet the conditions as follows:

1. Have graduated from a physician assistant educational program that is accredited by the Accreditation Review Commission on Education for the Physician Assistant (its predecessor agencies, the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and the Committee on Allied Health Education and Accreditation (CAHEA); or
2. Have passed the national certification examination that is administered by the National Commission on Certification of Physician Assistants (NCCPA); and
3. Be licensed by the State to practice as a physician assistant

The AAPA contacted CMS to seek clarification on this issue. The following response was received on January 19, 2011:

“The regulations at 42 CFR 410.74 that contain the PA qualifications should be
interpreted as follows:

1. Have graduated from a PA educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs and be licensed by the State to practice as a PA; or

2. Have passed the national certification examination that is administered by the National Commission on Certification of PAs and, be licensed by the State to practice as a PA.”

For more information, or questions regarding the credentialing and enrollment of PAs, please contact:

Tricia Marriott, PA-C, MPAS
Director, Reimbursement Policy
American Academy of Physician Assistants
tmarriott@aapa.org

Celebrating Women's History Month with the History of NAMSS

2011-03-01T14:32:00.006-05:00

The month of March is National Women’s History Month. In his article, Mr. Umbdenstock of the American Hospital Association (AHA) recognizes the pivotal role that women have historically played in the leadership and workforce of hospitals. Mr. Umbdenstock asks us to ponder the extraordinary contributions of women in a field that has benefited from their efforts longer and more profoundly then perhaps any other.

So, let’s take a minute and look back at the history of NAMSS. Years ago, in 1971, 22 women who were medical staff secretaries met in California, sharing the following common goals:

To provide educational workshops;
To foster standards of excellence nationwide, with the objectives of professional and personal development;
To provide an information exchange;
To provide a communication resource; and
To provide career development

Six years later, on October 13, 1977, 31 people attended the first National Educational Conference presented by the California Association Medical Staff Services, which began the launch of the National Association Medical Staff Services.

Those 22 women could never have guessed how NAMSS and the medical staff services profession would grow and the impact it would have on the healthcare industry. Today we are truly medical staff services professionals. We are a community of men and women who continue to gain recognition for our valuable role in ensuring safe, patient care. NAMSS continues to provide education and resources to help us prepare for the growing responsibilities of our profession, just as the founding members of NAMSS envisioned. Furthermore, we are no longer just a resource to other MSPs, but a resource to the healthcare community and policy makers, providing them with a better understanding of the role of medical staff management and credentialing.

The 2011 Theme for Women’s History Month is “Our History Is Our Strength”. I could not have said it better.

To learn more about NAMSS' history, click here:
http://www.namss.org/LinkClick.aspx?fileticket=%2bMCQeqP4PHQ%3d&tabid=154&mid=560

To learn more about Women’s History Month, click here: http://www.nwhp.org/

URAC Releases Revised HIPAA Privacy and Security Standards

2011-03-01T14:23:00.002-05:00

URAC has released revised HIPAA privacy and security standards to align with provisions in the American Reinvestment and Recovery Act (ARRA) and Health Information Technology for Economic and Clinical Health (HITECH) Act.

The revisions recognize the movement toward the patient-centered medical home and use of the electronic health record. The revisions include:

HIPAA Privacy Business Associate and Covered Entity programs have been combined into one URAC HIPAA Privacy Standards accreditation program.
The background and training needed to assume the responsibilities of a “Privacy Official” have been clarified.
New standard language has been added requiring that organizations offer individuals an electronic copy of their health information contained within a designated record set or to have that information forwarded to a third party of their choice.
The background and training needed to assume the responsibilities of a “Security Official” have been clarified.
Clarification around the need to update policies and procedures prior to the effective date of changes to the Security Rule and law or regulation affecting the Security Rule, as well as application for accreditation.
Applicant organization must maintain an archive of superseded policies and procedures for at least six (6) years, which is the same for privacy documentation.

To read the full announcement, click here:
http://www.urac.org/press/cmsDocument.aspx?id=741

HHS Issues $4.3 Million Fine for HIPAA Violations

2011-02-23T13:55:00.002-05:00

The Department of Health and Human Services (HHS) has imposed $4.3 million in fines against Cignet Health of Prince George's County, Maryland for violations of the HIPAA Privacy Rule.

The HHS Office of Civil Rights found that 41 patients were denied access to their medical records. The HIPAA Privacy Rule requires that this information be provided to patients within 30 days of the request.

To read more, click here:
http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/cignetcmpresolution.html

Source: U.S. Department of Health and Human Services

Government Cracks Down on $225 Million in False Claims

2011-02-22T11:08:00.003-05:00

Last week, the Medicare Fraud Task Force brought criminal charges against 111 people including doctors, nurses, and healthcare executives nationwide have been linked to $225 million in false Medicare claims.

The Medicare Task Force is a joint effort between the Department of Health and Human Services, the Department of Justice, and FBI to crack down on Medicare fraud and false claims in an effort to avoid wrongful and wasteful spending.

Actions of the charged individuals include the submission of claims for services and equipment never rendered and the recruitment of patients in order to receive financial kickbacks.

It is reported that since the Task Force started in 2007, it has recovered more than $4 billion. The average prison sentence for those convicted has been 43 months.

To read the full article, click here:
http://articles.latimes.com/2011/feb/17/nation/la-na-medicare-fraud-20110218

Source: Los Angeles Times

Dr. Watson?

2011-02-22T09:23:00.003-05:00

Watson, IBM's supercomputer, gained the world's attention last week when he beat two humans at Jeopardy. But could Watson soon be coming to your hospital?

In a CNN interview, representatives from IBM, Columbia University, and Nuance Healthcare discuss the use of supercomputers like Watson to support clinicians. They do not believe that Watson would provide hands-on robotic care; however, they believe that doctors would be able to run questions past the computer when making treatment decisions to verify that they are taking the correct actions. Doing this, they claim, can help prevent the growing number of medical errors.

To see the full interview, click here:
http://www.cnn.com/video/?/video/tech/2011/02/18/nr.ibm.watson.call.him.doctor.cnn

Source: CNN

HHS Proposes Rule Exempting Certain Law Enforcement Data from NPDB

2011-02-18T10:31:00.003-05:00

The February 17, 2011 Federal Register includes a proposed rule issued by the Department of Health and Human Services (HHS) which would exempt law enforcement data connected to ongoing investigations from having to be reported to the National Practitioner Data Bank (NPDB).

The Privacy Act already exempts law enforcement information connected to ongoing investigations from having to be reported to the Healthcare Integrity and Protection Data Bank (HIPDB). Only law enforcement information connected to final adverse actions taken has to be reported.

The purpose of the rule is to prevent "[t]he premature disclosure of the existence of a law enforcement activity to an outside party(who may also be the subject of the investigation) could lead to, among other things, the destruction or alteration of evidence and the tampering with witnesses.”

HHS is accepting comments on the proposed rule through April 18, 2011. To see the proposed rule and instructions on how to submit comments, click here:
http://frwebgate1.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=nnKHXl/0/2/0&WAISaction=retrieve

Sources: BNA, Federal Register

CMS to Withdraw Physician Signature Rule

2011-02-17T09:54:00.003-05:00

The American Association of Bioanalysts has announced that the Centers for Medicaid & Medicare Services intends to withdraw the current physician signature rule regarding diagnostic laboratory tests. The rule, which was supposed to be in effect starting January 1, 2011, but was delayed, required physicians or qualified nonphysician practitioners to sign requisitions and paperwork for clinical lab tests in order to have the test paid for under Medicare Part B.

Opponents of the rule stated that it was disruptive and complicated matters since many physicians relied on nonphysician staff to process laboratory test paperwork. CMS stated that they will re-evaluate the policy.

To see the American Association of Bioanalysts' announcement, click here:
http://www.aab.org/aab/NewsBot.asp?MODE=VIEW&ID=86&SnID=1949563646

Sources: BNA, American Association of Bioanalysts

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