Payment Matters: Streamlined Credentialing and Privileging Process Under the Final Telemedicine Rule

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On May 2, 2011, CMS released the final telemedicine credentialing and privileging rule clearing the way for credentialing agreements for telemedicine services between hospitals, as well as with non-hospital telemedicine entities. The final telemedicine rule follows on the heels of recent regulations promoting health care reform goals including providing cost effective and timely delivery of healthcare services. This telemedicine rule ends years of confusion for hospitals stuck in the middle of feuding between CMS and the Joint Commission (TJC) related to credentialing for telemedicine services. TJC previously allowed for “privileging by proxy” but CMS put its foot down, requiring hospitals after site surveys to change policies inconsistent with CMS Hospital Conditions of Participation. The final telemedicine rule requires that the hospital with patients in need of telemedicine services ensure through a written agreement that the parties meet certain credentialing obligations. Rural communities, which often suffer from a shortage of primary and specialty physicians and practitioners, will benefit from the ability to receive telemedicine services. Telemedicine may become more commonplace as the physician shortage becomes a reality. The effective date of this final rule is July 5, 2011.

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