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The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would alter its Conditions of Participation for hospitals, including Critical Access Hospitals, to allow them to use information provided by other Medicare-approved hospitals in making credentialing and privileging decisions for off-site physicians providing telemedicine services.
Currently, hospitals accredited by The Joint Commission (TJC) may accept privileging decisions made by other TJC hospitals, skirting more strenuous CMS requirements. The Medicare Improvements for Patients and Providers Act of 2008 requires TJC to secure CMS approval of TJC standards in order to confer Medicare-deemed status on hospitals after July 15, 2010, effectively ending TJC’s “privileging by proxy” policy.
According to CMS, many small, particularly rural, hospitals have expressed concerns that they may not be able to meet longstanding CMS privileging requirements while sustaining their current telemedicine agreements, given the staffing and expertise necessary to meet the requirements. To address these concerns, CMS proposes to allow hospitals whose patients receive telemedicine services from physicians located in a distant location to rely on information from the distant site in making credentialing and privileging decisions.
Accrediting distant-site hospitals must participate in Medicare; physicians practicing telemedicine must be privileged at the distant-site hospital and licensed in the state their services are delivered; and physician performance must be regularly reviewed, which includes a report of all adverse events and complaints that may have resulted from telemedicine services.
CHA will issue comments on the proposed rule by the July 20 deadline.
