CMS Issues Memo on Telemedicine Rule for Hospitals and CAHs

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

Register for a NAMSS Webinar on the New Telemedicine Rule!

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.

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

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

AHA Responds to Recent CMS Telemedicine Expansion: "We Believe the Proposed Changes Do Not Go Far Enough"

In response to CMS' proposed changes regarding credentialing and privileging requirements for telemedicine, the American Hospital Association (AHA) submitted a letter to the new CMS Administrator, Donald Berwick, stating that it is in support of the rule but that the changes do not apply to physician groups or other entities that provide telemedicine service.

Click here to read the letter in it's entirety.

CMS Extends TJC's Telemedicine Hospital Standards

Hospitals and Critical Access Hospitals do not have to make changes to implement new telemedicine credentialing and privileging elements of performance by a July 15, 2010 deadline, says The Joint Commission (TJC). The deadline for implementing the new elements of performance has been pushed to March 2011.

TJC had issued new elements of performance which were in compliance with the Centers for Medicare & Medicaid Services' (CMS) requirements for telemedicine services. The CMS requirements currently disallow the "credentialing by proxy" system that is supported by The Joint Commission's current standards. The "credentialing by proxy" system is intended to support access to telemedicine services by allowing the hospital where the patient is located, to rely on the credentialing and privileging data of a hospital where the provider is currently privileged in making its own decisions on that provider.

CMS has issued a proposed rule that would make the CMS telemedicine requirements in accordance with TJC's "credentialing by proxy" system. For this reason, CMS allowed TJC to delay implementation of the new elements of performance that are aligned with the current CMS CoPs until March 2011.


Source: The Joint Commission
http://www.jointcommission.org/AccreditationPrograms/Hospitals/telemed_requirements_hap_cah_delayed.htm

CMS to Announce Proposed Rule on Telemedicine Credentialing

The May 25 issue of the Federal Register will include a notice of proposed changes to the Medicare and Medicaid Conditions of Participation (CoPs) regarding the credentialing and privileging of telemedicine providers.

The proposed rule would permit the governing body at a hospital where a patient is receiving telemedicine services to rely on information from a hospital where the provider is currently privileged (distant-site) when making its own privileging decisions. In order to rely on information from the distant-site, the hospital where services are being received must ensure that

• "the distant-site hospital providing the telemedicine services is a Medicare-participating hospital;
• the individual distant-site physician or practitioner is privileged at the distant-site hospital providing telemedicine services, and that this distant-site hospital provides a current list of the physician's or practitioner's privileges;
• the individual distant-site physician or practitioner holds a license issued or recognized by the State in which the hospital, whose patients are receiving the telemedicine services, is located; and
• with respect to a distant-site physician or practitioner granted privileges by the hospital, the hospital has evidence of an internal review of the distant-site physician's or practitioner's performance of these privileges and sends the distant-site hospital this information for use in its periodic appraisal of the individual distant-site physician or practitioner."

The proposed rule would also require that the periodic review information submitted to the distant-site include adverse events and complaints received about the physician or practitioner.

The proposed rule was created to address the redundant collection of information at both the distant-site and the site where services are received. CMS also recognized that the current requirements were burdensome on small hospitals where telemedicine would be an asset, but the collection of credentialing and privileging information for all telemedicine providers would be a burden.

Under the proposed rule, CMS estimates that the cost to hospitals to implement the rule will be minimal. In its cost analysis, CMS included a breakdown of the cost and time that would be spent by Medical Staff Coordinators or Medical Staff Credentialing Managers to prepare and send performance reports to hospitals receiving telemedicine services.

CMS is collecting comments through July 26. NAMSS has identified the telemedicine CoPs as a source of redundancy in the credentialing and privileging and is pleased to see that CMS is taking steps to streamline these processes.

To read the full announcement, click here:
http://www.federalregister.gov/OFRUpload/OFRData/2010-12647_PI.pdf

Question of the Week: Telemedicine

Today we're launching a "Question of the Week" on the NAMSS Blog. Each week, we will feature a new poll on an issue facing MSPs. This will allow you to get a pulse on what your colleagues think, and on practices that are implemented in other facilities.

This week's topic is telemedicine. The following article from Scripps Howard News Service includes comments from several health experts who believe that although telemedicine is addressed in health reform proposals, the government is not making enough of an investment in this technology. (Link to article: http://www.scrippsnews.com/content/telemedicine-getting-short-shrift-congress-health-care-reforms)

We all know that telemedicine can expand access to care, especially in rural areas. However, we also know that there is still debate over how credentialing of telemedicine providers should be handled. Recently, The Joint Commission amended its credentialing by proxy standards in order to comply with the CMS Conditions of Participation, which currently do not recognize this practice.

So this week's question is, how does your facility currently perform credentialing for telemedicine providers? Vote in the poll to the right, and feel free to discuss your views on the issue in the comment field below.

We are also looking for other "Questions of the Week." If there is a topic or question you would like to see on the NAMSS Blog, e-mail your idea to news@namss.org.

TJC Releases Telemedicine Revisions to Hospital Standards

The Joint Commission (TJC) has released revisions to the Leadership and Medical Staff chapters of the Hospital Standards in order to comply with CMS requirements for deeming authority.

Currently, TJC accepts credentialing and privileging by proxy. CMS currently requires that telemedicine providers be credentialed by both the originating and distant sites. TJC would have allowed the originating site (where the patient is located) to accept the credentials and privileges granted by the distant site (where the provider is located) if the distant site is TJC accredited and complies with the appropriate Medical Staff standards.

TJC has revised its telemedicine standards to comply with the CMS rule, but continues to work with CMS and Congress to accept credentialing by proxy by the distant site.

The revised standard is effective July 15, 2010 and can be found here:
http://www.jointcommission.org/NR/rdonlyres/73A1C766-37B6-4EB2-BEB3-2A59C2BE841E/0/CMS_ChangestoCMSHospitalStandards_EPs_July15_20090929.pdf.


Source: The Joint Commission