Telemedicine Flashcards
TJC
Telemedicine
Telemedicine standards for originating site only:
All physicians or licensed practitioners providing patient care services via telemedicine are subject to credentialing and privileging processes of the originating site.
Three options are available for credentialing at the originating site:
A. The originating site can fully privilege and credential the practitioner according to MS standards.
B. The practitioner may be privileged at the originating site using credentialing information from the distant site if the distant site is a TJC accredited or Medicare participating organization. The distant site practitioner must have a license issued or recognized by the state in which the patient is receiving telemedicine services.
C. The originating site can use credentialing and privileging decision from the distant site to make final determination if all the following requirements are met:
- the distant site is a TJC accredited or Medicare participating organization
- the practitioner is privileged at the distant site for those services to be provided at the originating site
- for hospitals that use TJC for deemed status, the originating site receives a current list of physicians or licensed practitioner’s privileges from the distant site.
- the originating site provides the distant site with internal performance review information that can be utilized to assess the practitioner’s quality of care, treatment, and services for us in PI and privileging including adverse outcomes related to sentinel events resulting from the telemedicine services provided; and complaints about the distant site physician or licensed practitioner from patients, physicians, licensed practitioners or staff at the originating site.
- the distant site practitioner has a license that is issued or recognized by the state in which the patient is receiving telemedicine services
If an ambulatory care organization, the hospital must verify that the distant site made its decision using the process described in the standards MS.06.01.03 through MS.06.01.07 (excluding EP 2 from MS.06.01.03).
For hospitals that use JC accreditation for deemed status purposes; the originating site makes certain that all distant site telemedicine providers’ credentialing and privileging processes meet, at a minimum, the Medicare CoPs for credentialing medical staff.
In addition, the medical staffs at both the originating and distant sites must recommend the clinical services to be provided by physicians or other licensed practitioners through a telemedicine link at their respective sites and clinical services offered must be consistent with commonly accepted quality standards.
NCQA Health Plan with CVO
Telemedicine
Not specifically addressed
ACHC Acute Care Hospitals
Telemedicine
HFAP standards are a direct quotation of the CMS regulations 482.12(a). See CMS section.
DNV NIAHO for Hospitals
MS 15 SR 1
The governing body shall ensure that, when telemedicine services are furnished to the hospital’s patients through an agreement with the distant site telemedicine entity, the written agreement specifies that the distant site telemedicine entity is a contactor of services to the hospital and as such, in accordance with GB.4, SR 2, furnishes the contracted services in a manner that permits the hospital to comply with all applicable requirements for the contracted services, including, but not limited to, the requirements in Medical Staff (MS.2, MS.3(SR.2), MS.4 (SR.1 and SR.3) with regard to the distant site telemedicine entity’s physicians and practitioners providing telemedicine services.
SR 1b
When telemedicine services are furnished to the hospital’s patients through an agreement with a distant site telemedicine entity, the governing body of the hospitals whose patients are receiving the telemedicine services may choose, in lieu of the requirements in MS.6 to have its medical staff rely upon the credentialing and privileging decisions made by the distant site telemedicine entity when making recommendations on privileges for the individual distant site physicians and practitioners providing such services.
The hospital’s governing body shall also ensure, through its written agreement with the distant site telemedicine entity, that all of the provisions are met:
SR 1b(1)
The distant site telemedicine entity’s medical staff credentialing and privileging process and standards at least meet the standards stated in 42 CFR 482.12(a)(1) through (a)(7) and 482.22(a)(1) through (a)(2)
SR.1b(2)
The individual distant site physician or practitioner is privileged at the distant site telemedicine entity providing the telemedicine services, which provides the hospital with current list of distant site physician’s or practitioner’s privileges at the distant site.
SR.1b(3)
The individual distant site physician or practitioner holds a license issued or recognized by the state in which the hospital whose patients are receiving such telemedicine services is located.
SR.1b(4)
with respect to a distant site physician or practitioner, who holds current privileges at the hospital hose patients are receiving the telemedicine services, the hospital has evidence of an internal review of the distant site telemedicine entity such performance information for use in the periodic appraisal of the distant site physician or practitioner. At a minimum, this information shall include all adverse events that result from telemedicine services provided by the distant site physician or practitioner to be the hospital’s patients, and all complaints the hospital has received about the distant site physician or practitioner.
SR 2
The governing body shall ensure that, when telemedicine services are furnished to the hospital’s patients through an agreement with a distant site hospital, the agreement is written and that it specifies that it is the responsibility of the distant site hospital to mee the requirements in the Medical Staff (MS.2, MS.3(SR.2), MS.4 (SR.1 and SR.3) and governing body.
URAC Health Plan
Telemedicine
Not specifically addressed
AAAHC for Ambulatory Health Care
Telemedicine
Not specifically addressed. If provided by contract, the governing body maintains responsibility.
Medicare Hospital CoPs and Interp Guidelines
Telemedicine
482.12(a)
Standard: Medical Staff: The governing body must:
(8) Ensure that, when telemedicine services are furnished to the hospital’s patients through an agreement with the distant site hospital, the agreement is written and specifies it is the responsibility of the governing body of the distant site hospital to meet the requirements in paragraphs (a)(1) through (a)(7) of this section with regard to the distant site hospital’s physicians and practitioners providing telemedicine services.
The governing body of the hospital whose patients are receiving the telemedicine services may, in accordance with 482.22(a)(3) of this part, grant privileges based on its medical staff recommendations that rely on information provided by the distant site hospital.
(9) Ensure that when telemedicine services are furnished to the hospital’s patients through an agreement with a distant site telemedicine entity, the written agreement specifies that the distant site telemedicine entity is a contractor of services to be hospital and as such, in accordance with 482.12(e), furnishes the contracted services in a manner that permits the hospital to comply with all applicable conditions of participation for the contracted services, including, but not limited to, the requirements in paragraph (a)(1) through (a)(7) of this section with regard to the distant site telemedicine entity’s physicians and practitioners providing telemedicine services.
The governing body of the hospital whose patients are receiving the telemedicine services may, in accordance with 482.22(a)(4) of this part, grant privileges to physicians and practitioners employed by the distant site telemedicine entity based on such hospitals medical staff recommendations; such staff recommendations; such staff recommendations may rely on information provided by the distant site hospital
482.22(a)(3)
When telemedicine services are furnished to the hospital’s patients through an agreement with the distant site hospital, the governing body of the hospital whose patients are receiving the telemedicine services may choose, in lieu of the requirements in paragraphs (a)(1) and (a)(2) of this section, to have its medical staff rely upon the credentialing and privileging decisions made by the distant site hospital when making recommendations on privileges for the individual site physicians and practitioners providing such services, if the hospital’s governing body ensures, through its written agreement with the distant site hospital, that all the following provisions are met:
i. the distant site physician or practitioner is privileged at the distant site hospital providing the telemedicine services, which provides a current list of distant site physician’s or practitioner’s privileges at the distant site hospital
