The Centers for Medicare and Medicaid Services (CMS) has issued a revised rule designed to streamline the telemedicine physician-credentialing process. Published in the Federal Register on May 5 ( http://www.gpo.gov/fdsys/pkg/FR-2011-05-05/html/2011-10875.htm) and slated to go into effect on July 1, the final rule revises the conditions of telemedicine participation for hospitals and critical-access hospitals (CAHs) by implementing a new credentialing and privileging process applicable to physicians and practitioners who provide telemedicine services.
The rule eliminates what CMS deems" burdensome" regulatory requirements that might have hampered innovation in health-care delivery. It also eases the credentialing rules hospitals must follow for physicians and practitioners who want to confer with their patients via telemedicine, but do not work onsite or need hospital privileges (for example, specialists at large academic medical centers who confer with local physicians via teleconference or who interpret MRI images remotely). Under its terms, individual hospitals and CAHs will no longer be required to credential and grant privileges to each physician and practitioner who provides telemedicine services to its patients from a distant hospital or other telemedicine location. Instead, hospitals as a whole will be permitted to rely on the credentialing and privileging decisions of the distant hospital. The original rules mandated that practitioners who had already been credentialed by their own hospitals were still obligated to undergo a multi-step credentialing process for the rural hospital.
Additionally, the rule eases burdens for small hospitals and CAHs in rural areas and regions where there may be a limited supply of primary care and specialist physicians. It allows them to leverage teleradiology in providing patients with more flexible and cost-effective medical care.
"The removal of unnecessary barriers to the use of telemedicine may enable patients to receive medically necessary interventions in a more timely manner" and enhance the management of chronic diseases, according to a CMS document released with the rule. "These revisions will provide more flexibility to small hospitals and CAHs in rural areas and regions with a limited supply of primary care and specialized providers. In certain instances, telemedicine may be a cost-effective alternative to traditional service delivery approaches and, most importantly, may improve patient outcomes and satisfaction."