{"id":245249,"date":"2010-07-06T08:08:39","date_gmt":"2010-07-06T08:08:39","guid":{"rendered":"http:\/\/eugenesis.com\/update-on-rules-for-telemedicine-privileges\/"},"modified":"2010-07-06T08:08:39","modified_gmt":"2010-07-06T08:08:39","slug":"update-on-rules-for-telemedicine-privileges","status":"publish","type":"post","link":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/pathology\/update-on-rules-for-telemedicine-privileges.php","title":{"rendered":"Update on Rules for Telemedicine Privileges"},"content":{"rendered":"<div><span><p><span>In the midst of The Joint Commission&rsquo;s revisions to its&nbsp;<\/span><span><span>telemedicine<\/span><\/span><span>&nbsp;privileges standards, the Centers for Medicare &amp; Medicaid Services (&ldquo;CMS&rdquo;)&nbsp;<\/span><a href=\"http:\/\/edocket.access.gpo.gov\/2010\/pdf\/2010-12647.pdf\" target=\"_blank\"><span><\/span><\/a><a href=\"http:\/\/edocket.access.gpo.gov\/2010\/pdf\/2010-12647.pdf\" target=\"_blank\">published a proposed rule<\/a><span>&nbsp;in May that would revise the current conditions of participation (&ldquo;CoPs&rdquo;) for both hospitals and critical access hospitals regarding&nbsp;<\/span><span><span>telemedicine<\/span><\/span><span>&nbsp;services.&nbsp;&nbsp;&nbsp;&nbsp;<\/span><\/p><p><span>The Joint Commission (&ldquo;TJC&rdquo;) had previously issued new changes to TJC Standards MS.13.01.01 (<\/span><span><span>Telemedicine<\/span><\/span><span>) and LD.04.03.09 (Oversight of Care, Treatment and Services Provided Through Contractual Agreement) that were to become effective July 15, 2010, for Medicare-participating hospitals. However, after CMS issued its proposed rule, TJC on June 9, 2010, announced the effective date of these changes was being delayed until March 2011.<\/span><\/p><p><span>CMS regulations currently require hospitals and critical access hospitals to privilege practitioners providing&nbsp;<\/span><span><span>telemedicine<\/span><\/span><span>&nbsp;services as if the practitioner were on-site. In the present CoPs there is no mechanism for &ldquo;privileging by proxy,&rdquo; such as is permitted by the TJC&nbsp;<\/span><span><span>telemedicine<\/span><\/span><span>&nbsp;standard. In the preamble to the newly proposed regulations, CMS notes that, &ldquo;One TJC policy that has been in direct conflict with the CoPs has been TJC&rsquo;s practice of permitting &lsquo;privileging by proxy&rsquo; &hellip; In short, TJC privileging by proxy standards allowed for one TJC-accredited facility to accept the privileging decisions of another TJC-accredited facility.<\/span><\/p><p><span>Hospitals that have used this method to privilege distant-site medical staff technically did not meet CMS requirements that applied to other hospitals even though they were TJC-accredited.&rdquo; The proposed rule would address this issue by making changes to 42 CFR 482.12 and 42 CFR 482.221 that would make it permissible for the medical staff to &ldquo;rely upon information furnished by the distant-site hospital when making recommendations on privileges&rdquo; for individual distant-site practitioners providing&nbsp;<\/span><span><span>telemedicine<\/span><\/span><span>&nbsp;services if:<\/span><\/p><ol><li><span>The distant-site is a Medicare participating hospital. &nbsp;<\/span><\/li><li><span>The practitioner has privileges at the distant-site hospital and the distant-site provides a current list of the practitioner&rsquo;s privileges to the originating-site. &nbsp;<\/span><\/li><li><span>The practitioner holds an appropriate state license in the state of the originating-site hospital. &nbsp;<\/span><\/li><li><span>The originating-site hospital conducts reviews of the practitioner&rsquo;s performance in the exercise of&nbsp;<\/span><span><span>telemedicine&nbsp;<\/span><\/span><span>privileges and sends the distant-site hospital such performance information for use in the periodic appraisal of the practitioner. At a minimum, this information must include all adverse events that result from the&nbsp;<\/span><span><span>telemedicine&nbsp;<\/span><\/span><span>services provided by the practitioner to patients at the originating-site and all complaints received by the originating-site about the practitioner.<\/span><\/li><\/ol><p><span>Additionally, for the forgoing to apply under the proposed rule, the&nbsp;<\/span><span><span>telemedicine<\/span><\/span><span>&nbsp;services would need to be furnished under an agreement with a Medicare-certified hospital and that agreement must specify that it is the distant-site hospital&rsquo;s responsibility to conduct credentialing of the&nbsp;<\/span><span><span>telemedicine<\/span><\/span><span>&nbsp;practitioners in accordance with the CoPs.<\/span><\/p><p><span>It should be noted that unlike the TJC standards, CMS makes no distinction between&nbsp;<\/span><span><span>telemedicine<\/span><\/span><span>&nbsp;and tele- interpretive services. Also, note that the rule only permits the use of information from Medicare-certified hospitals, it does not permit hospitals to rely on information from non-hospital entities, such as teleradiology companies. However, the proposed CMS rule does not appear to affect the ability to use a credentialing verification organization when appropriate. The new rule is still only proposed, but if it is finalized Medicare- participating hospitals will be required to follow this rule.<\/span><\/p><p><\/p><\/span><\/div><div><a href=\"http:\/\/feeds.feedburner.com\/~ff\/DigitalPathologyBlog?a=IEG50VU8mOI:3hOJdHld3E4:yIl2AUoC8zA\"><img decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/d5b49_DigitalPathologyBlog?d=yIl2AUoC8zA\" border=\"0\" style=\"padding-left:10px; padding-right: 10px;\"><\/a> <a href=\"http:\/\/feeds.feedburner.com\/~ff\/DigitalPathologyBlog?a=IEG50VU8mOI:3hOJdHld3E4:F7zBnMyn0Lo\"><img decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/d5b49_DigitalPathologyBlog?i=IEG50VU8mOI:3hOJdHld3E4:F7zBnMyn0Lo\" border=\"0\" style=\"padding-left:10px; padding-right: 10px;\"><\/a> <a href=\"http:\/\/feeds.feedburner.com\/~ff\/DigitalPathologyBlog?a=IEG50VU8mOI:3hOJdHld3E4:7Q72WNTAKBA\"><img decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/a1b10_DigitalPathologyBlog?d=7Q72WNTAKBA\" border=\"0\" style=\"padding-left:10px; padding-right: 10px;\"><\/a> <a href=\"http:\/\/feeds.feedburner.com\/~ff\/DigitalPathologyBlog?a=IEG50VU8mOI:3hOJdHld3E4:V_sGLiPBpWU\"><img decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/a1b10_DigitalPathologyBlog?i=IEG50VU8mOI:3hOJdHld3E4:V_sGLiPBpWU\" border=\"0\" style=\"padding-left:10px; padding-right: 10px;\"><\/a> <a href=\"http:\/\/feeds.feedburner.com\/~ff\/DigitalPathologyBlog?a=IEG50VU8mOI:3hOJdHld3E4:qj6IDK7rITs\"><img decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/a1b10_DigitalPathologyBlog?d=qj6IDK7rITs\" border=\"0\" style=\"padding-left:10px; padding-right: 10px;\"><\/a> <a href=\"http:\/\/feeds.feedburner.com\/~ff\/DigitalPathologyBlog?a=IEG50VU8mOI:3hOJdHld3E4:l6gmwiTKsz0\"><img decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/a1b10_DigitalPathologyBlog?d=l6gmwiTKsz0\" border=\"0\" style=\"padding-left:10px; padding-right: 10px;\"><\/a> <a href=\"http:\/\/feeds.feedburner.com\/~ff\/DigitalPathologyBlog?a=IEG50VU8mOI:3hOJdHld3E4:gIN9vFwOqvQ\"><img decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/a1b10_DigitalPathologyBlog?i=IEG50VU8mOI:3hOJdHld3E4:gIN9vFwOqvQ\" border=\"0\" style=\"padding-left:10px; padding-right: 10px;\"><\/a> <a href=\"http:\/\/feeds.feedburner.com\/~ff\/DigitalPathologyBlog?a=IEG50VU8mOI:3hOJdHld3E4:TzevzKxY174\"><img decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/a1b10_DigitalPathologyBlog?d=TzevzKxY174\" border=\"0\" style=\"padding-left:10px; padding-right: 10px;\"><\/a><\/div><p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/eugenesis.com\/wp-content\/plugins\/wp-o-matic\/cache\/a1b10_IEG50VU8mOI\" height=\"1\" width=\"1\" style=\"padding-left:10px; padding-right: 10px;\"><\/p>","protected":false},"excerpt":{"rendered":"<p>In the midst of The Joint Commission&rsquo;s revisions to its&nbsp;telemedicine&nbsp;privileges standards, the Centers for Medicare &amp; Medicaid Services (&ldquo;CMS&rdquo;)&nbsp;published a proposed rule&nbsp;in May that would revise the current conditions of participation (&ldquo;CoPs&rdquo;) for both hospitals and critical access hospitals regarding&nbsp;telemedicine&nbsp;services.&nbsp;&nbsp;&nbsp;&nbsp;The &hellip; 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