In late May, CMS issued a proposed rule to streamline credentialing processes for physicians and other practitioners providing telemedicine services. The rule will revise Medicare conditions of participation, which also pertain to the Medicaid program, for hospitals and critical access hospitals. In a statement issued this week, the American Hospital Association largely praised the modifications, although it urged CMS to streamline credentialing for physician groups falling outside its modified criteria.

Among other things, the modifications would, the AHA notes, “allow the hospital receiving the telemedicine services to rely upon credentialing and privileging information from the hospital providing the telemedicine services.” Among the conditions specified in the proposed rule are provisions:
* that the hospital providing the telemedicine services is a Medicare-participating hospital;
* the practitioner providing the telemedicine services is privileged at the hospital providing the telemedicine services; and
* the practitioner is licensed to practice in the state in which the receiving hospital is located.

The modifications, the AHA says, “will both allow for the provision of telemedicine services in a safe and timely manner and minimize the regulatory burden for hospitals.”

However, the AHA goes on to say the proposed changes do not go far enough. Because the proposed requirements would govern only those telemedicine services provided by practitioners privileged at another Medicare-participating hospital, they would omit certain groups that often provide telemedicine services, the AHA says.  These might include physician groups retained for radiology interpretation services.

“The proposed conditions of participation do not address how hospitals might more easily credential and privilege these practitioners in a way that ensures the safe provision of telemedicine services,” the AHA says. It calls on CMS to adopt a process similar to the Joint Commission’s former “privilege by proxy” program that permitted hospitals to use credentialing information from other groups as long as they were accredited by the Joint Commission’s ambulatory care accreditation program. “We urge CMS to develop a similar process whereby hospitals can use the credentialing and privileging information from practitioners who fulfill the Medicare Conditions of Coverage,” the AHA says. 

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