Provides for the credentialing of health care providers providing telemedicine services

Summary of provisions

Section 1 amends section 2805-u of the public health law to permit a hospital where a patient is receiving telemedicine services to enter into an agreement with a distant site hospital for credentialing, privileging and peer review of a distant site healthcare practitioner. The distant site hospital must be licensed and if from another state, must comply with federal Medicare regulations.

The agreement requires the distant site hospital where a consulting physician is located to collect information and perform all required verification, quality assurance and peer review activities imposed upon the originating site hospital. The agreement must, at a minimum, provide that the originating site hospital is ultimately responsible for physician credentialing. The agreement must also enumerate: the categories of healthcare providers eligible for appointment to the originating site hospital medical staff, the credentialing information collected and verification activities performed by the distant site hospital; that the distant site provider is licensed in New York state and credentialed at the distant site hospital, the privileges held by the distant site provider at the distant site hospital; and that the distant site hospital is required to conduct periodic reviews in accordance with requirements applicable to the distant site hospital and share the findings of such reviews with the originating site hospital. In addition, the distant site hospital must immediately notify the originating site hospital of any suspension, revocation, or limitations to the distant site health care practitioners privileges at the distant site hospital.

The originating hospital is required to conduct periodic internal reviews, at least every two years, of the distant site health care practitioner's performance of telemedicine services and provide such report to the distant site hospital. In addition, the originating site hospital must report all adverse events resulting from a distant site health care provider's telemedicine services to the distant site hospital.

Justification

Hospitals are required by the New York State Public Health Law to credential practitioners before granting them privileges to treat patients. The required credentialing involves verification of

training, experience and licensure as well as performance. The assessment of practitioner performance is known as "peer review. II Peer review refers to an assessment of a practitioner's performance by his or her peers, normally meaning by physicians who practice in the same or similar areas of specialty. Peer review is normally conducted as a part of the hospital's overall quality assurance program.

The New York State Department of Health has determined, consistent with CMS requirements, that the credentials verification portion of the credentialing process for telemedicine purposes can be fulfilled by the distant site hospital where the physician providing the telemedicine consult resides. This part of credentialing is basically a documentation review that verifies medical school graduation, residency training in the area of specialty in which the physician practices and that the physician is currently licensed in New York State.

However, the originating site hospital receiving the consult via telemedicine (which is required to credential the physician in order to grant them the privilege of providing consultations) has an obligation to conduct a peer review/ performance assessment of that physician's practice in recommending treatment of patients at the originating site hospital to ensure the services provided are of high quality. Unfortunately, in situations where telemedicine is used, there are often no peers on the medical staff at the originating site hospital, thus requiring a telemedicine consult with a distant-site hospital to access the services of a specialist.

This requirement forces the originating site hospital to either rely on the limited information they have at the originating site hospital or to seek expert assistance elsewhere, with an additional cost to the originating site hospital. This phenomenon creates a barrier to the expansion of telemedicine.

This legislation would remove that barrier by allowing the originating site hospital to rely upon the hospital where the physician who provides the telemedicine consult resides to be able to fulfill the peer review responsibility of the hospital where the consultation is received by virtue of the peer review already being conducted at the site providing the consultation.

Legislative history

New Bill.

Fiscal implications

None.

Effective date

Effective immediately.