The Joint Commission Announces Revisions in Response to CMS Final Rule

The Joint Commission recently announced standards changes in response to the Centers for Medicare & Medicaid Services (CMS) final rules on Burden and Discharge Planning. The first set of changes pertains to the hospital deeming renewal application with CMS, effective July 1, 2020. The second set of changes applies to both hospitals and critical access hospitals, effective September 13, 2020.

Prepublication standards:

• Hospital – July
• Critical Access Hospital – September
• Hospital – September

Visit the Joint Commission Standards Page additional information on these updates. Stay connected to NAMSS by visiting the NAMSS COVID-19 Resources Page.

The Joint Commission COVID-19 Related Blogs

Each week the Joint Commission shares relevant updates and information about COVID-19. This week, the Joint Commission released several blogs under the Webinars and Communications from The Joint Commission Section of their COVID-19 page:

• Availability of Non-Invasive Ventilators in Home Care
• Decontaminating & Disinfecting Single Use Respirators
• Quality Control for COVID-19 Tests  
• Validation of COVID-19 Tests
• Using Ambulatory Surgery Centers as Alternate Care Sites
• Documentation Challenges When Operating Under an Emergency Operations Plan
•           Providing Behavioral Health Care Via Telehealth
•           COVID-19 Test Complexity
•           Sterile Compounding Considerations During COVID-19

Visit the Joint Commissions Coronavirus Resource Page for more resources. Stay connected to NAMSS by visiting the NAMSS COVID-19 Resources Page.

Medicare Clarifies Recognition of Interstate License Compacts

On May 5, CMS recognized several new interstate license compacts for physicians and non-physician practitioners. The uptick of telehealth services due to COVID-19 has increased the urgency for these compacts.

CMS will require practitioners under a compact to fulfill both the licensure requirements in their primary state and the requirements outlined by the interstate compact laws that each state participating in the compact adopts. The interstate license compacts will be handled as credible licenses that meet CMS federal license requirements.

Medicare Administrative Compacts (MACs) will now accept CMS-855 enrollment applications from practitioners with an interstate license compact and allow previously denied applications to be reconsidered for processing. The following resources are available for additional information:

•  Chapter 15, Section 15.5.2.1 of the Program Integrity Manual
• CMS MAC Website

View the full CMS article here for additional information. Stay connected by visiting NAMSS COVID-19 Response Page.

Joint Commission Statement on Mental Health Care for Providers and Healthcare Staff

On May 12, the Joint Commission released a statement on the importance removing the barriers to mental health treatment for healthcare providers and non-clinical staff. The COVID-19 pandemic places additional pressures on healthcare workers, but many do not seek mental health support or treatment because they believe that it could negatively affect their careers, credentials, or licensing statuses.

The Joint Commission strongly encourages organizations not to inquire about a practitioner’s history of mental health and supports the FSMB's and AMA's recommendation, “to limit inquiries to conditions that currently impair the clinician’s ability to perform their job.”

The Joint Commission supports eliminating any obstacles and policies that discourage healthcare workers from obtaining mental health services. It is critical that organizations pay attention to healthcare workers’ mental health and ensure they have access to mental health treatment during this time.

Visit the Joint Commissions Coronavirus Resource Page for more resources on staff health and wellbeing. Stay connected to NAMSS by visiting the NAMSS COVID-19 Resources Page.

CMS Expands Emergency Declaration Blanket Waivers for Health Care Providers

On May 11, the Centers for Medicare & Medicaid Services (CMS) expanded telehealth services and relaxed certain requirements with the issuance of additional waivers. The recent waivers and further expansion of telehealth services add to those CMS released at the end of March will remain in place through the end of the COVID-emergency declaration. Among other areas, the waivers:

• Expand the types of healthcare practitioners who may be reimbursed for Medicare telehealth services to all practitioners who are eligible to bill Medicare for non-telehealth services. 
• Permit more services via audio-only technology. CMS no longer requires two-way, real-time interactive communication between patient and practitioner for certain services. Please review the CMS list of Medicare telehealth services.
• Allow physicians to continue practicing at the hospital where their privileges would otherwise expire and for new physicians to practice prior to full review and approval by the credentialing body.
• Waive the minimum personnel qualifications for clinical nurse specialists and physician assistants.
• Defer staff licensure, certification, or registration to state law.
• Enable long-term care facilities to take 10 working days to provide a resident a copy of their requested records.

Visit CMS Coronavirus Waivers & Flexibilities Page for additional information. Stay connected by visiting NAMSS COVID-19 Response Page.

CMS Releases COVID-19 Interim Final Rule and Updates Flexibilities

The Centers for Medicare & Medicaid Services (CMS) recently issued an Interim Final Rule detailing all COVID-19-related waivers and flexibilities for hospitals, practitioners, service providers, and other CMS programs.  CMS provides facts sheets on its Waivers and Flexibilities Resources Page as well as a full list of emergency declaration blanket waivers for healthcare providers. CMS is accepting comments on its Interim Final Rule for 60 days from its May 8, 2020 official publication in the Federal Register.

Stay connected by visiting NAMSS COVID-19 Response Page.

NAMSS and ATA Host Webinar: Telemedicine Legal Considerations: Credentialing by Proxy

On April 23, NAMSS teamed up with the American Telehealth Association to host a webinar “Telemedicine Legal Considerations: Credentialing by Proxy.” The webinar covered the legal and practical aspects of credentialing by proxy, telemedicine lessons learned from the COVID-19 crisis, and the NAMSS-ATA Credentialing by Proxy (CBP) Guide.

Webinar presenters described telemedicine’s rising status amid COVID-19 because it enhances care for those in COVID-19 hotspots, remote locations, provides quality and timely specialty care in areas without specialized practitioners, improves care continuity and case management, and enables patients to receive care without sacrificing quality over convenience.

Diane Meldi, MBA, CPCS, CPMSM, NAMSS Government Relations Liaison, Ty Bozkurt, MBA, FACHE, ATA Board Member, and Maureen Kozlowski, CPCS, CPMSM presented the NAMSS-ATA Credentialing By Proxy- A Guidebook, a resource medical staffs can use to modify credentialing and privileging requirements to facilitate telehealth services.

 

The webinar highlighted the challenges the traditional credentialing process imposes on telemedicine, especially for tertiary facilities or specialty groups who deploy multiple practitioners to provide services, many of whom are providing services in multiple facilities and perhaps in multiple states. The webinar provided guidance on how healthcare facilities could use proxy credentialing to address these barriers.

CBP is an alternative credentialing mechanism medical staffs can use to obtain telemedicine services for their patients and credential telemedicine practitioners who deliver their services from distant-site entities. Originating-site entities can use CBP to streamline the credentialing process to efficiently expand service offerings and clinical support, without burdening medical staff personnel. For distant site entities, CBP reduces the paperwork, time, and expenses associated with credentialing practitioners at the originating sites.

The “Telemedicine Legal Considerations: Credentialing by Proxy” webinar speakers:

• Alan Einhorn, JD, Foley & Lardner, LLP
• Ann Mond Johnson, CEO - American Telehealth Association
• Diane Meldi, MBA, CPCS, CPMSM, Senior Consultant - Ministry Medical Staff Mercy Quality & Safety Center, NAMSS Government Relations Liaison
• Maureen Kozlowski, CPCS, CPMSM, Director - Support Services Mercy Virtual
• Ty Bozkurt, MBA, FACHE, Chief Technology Officer - Burn and Reconstructive Centers of America, ATA Board Member

The “Telemedicine Legal Considerations: Credentialing by Proxy” webinar recording will be available for purchase on the NAMSS website this Friday, May 8. In the meantime, stay connected by visiting NAMSS COVID-19 Response Page.