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Updated: 25 min 38 sec ago

New Guidelines Released as Telemedicine Services Expand

Wed, 09/20/2017 - 19:38
Telemedicine continues to expand into the healthcare delivery system, and the recent natural disasters across the country have demonstrated just how useful telemedicine can be in a crisis and beyond. As federal and state governments, accrediting organizations, and other healthcare stakeholders recognize the growth and potential of these services, new rules, regulations, and guidelines are beginning to be released. Two major telemedicine efforts were released this month by The Joint Commission and the National Quality Forum.
First, The Joint Commission released proposed revisions to their hospital accreditation standards for hospitals providing “direct-to-patient telehealth services.” TJC, one of the largest and most widely accepted accreditation organizations for hospitals in the United States, introduced changes to two existing standards (Provision of Care Standard 01.01.01 and Rights & Responsibilities of the Individual Standard 01.03.01) and introduced a new standard, Ri.01.08.01. The proposed changes, which are examined in detail here, include requirements for informed consent for patients about the nature of the telehealth services and the provider. The National Law Review article linked above examines how the proposed standards go beyond statutory requirements in some cases, and how they may affect hospitals and other telehealth providers.
The National Quality Forum, an organization contracted by the federal government to develop healthcare performance measures, recently released a report developing a framework for a telehealth quality measurement program. NQF’s Telehealth Committee recommended various methods to measure telemedicine as a care delivery system along four basic categories: access to care, financial impact to patients and providers, patient and clinician experience, and clinical and operations effectiveness. The report, analyzed hereby mHealthIntelligence, also highlights specific existing measures that can be applied to telehealth, as well as examining how telehealth activities can fit into the Merit-based Incentive Payment System (MIPS) introduced in the Medicare Access and CHIP Reauthorization Act (MACRA).

NAMSS will continue to monitor developments in telemedicine and their impacts on MSPs. Specifically, NAMSS recently formed a working group in partnership with the American Telemedicine Association to examine the issue of credentialing by proxy for hospitals attempting to credential telemedicine providers at other locations. The group will be developing a packet of educational and instructional materials to introduce MSPs who may not be as familiar with telemedicine to the topic and provide guidelines for developing credentialing by proxy programs at their own facilities. 

CMS Clarifies Guidance on Hospital Definitions

Tue, 09/12/2017 - 02:34
The Centers for Medicare and Medicaid Services recently released a memoclarifying guidance under Appendix A of the State Operations Manual (SOM). This guidance is meant to shed light on the definition of a hospital under the Social Security Act.
With the rise of “microhospitals,” small facilities that operate like acute care hospitals with a low number of inpatient beds, there has been some confusion regarding the certification process for such facilities. A variety of other facility models have run into the same issues, as care providers attempt new innovations in care and locations that may stray from the traditional idea of a hospital facility.
The CMS memo clarifies that the federal Medicare definition of a hospital under the Social Security Act may not always mesh perfectly with state requirements for the same certification. That is, “a facility may have a license from a state to operate as a hospital,” but “that facility may still not meet the Medicare definition of a hospital.” Hospitals approved, certified, and licensed by state or local authorities are still required to fit the Medicare criteria, including Conditions for Coverage (CfCs), Conditions of Participations (CoPs), and observations by the CMS Regional Office in order to be approved to accept Medicare patients. The details of these observations are described in the memo, linked above.
To read more about microhospitals and their growing role in the care delivery system, click here

Illinois Blockchain Initiative to Pilot Credentials Verification Program

Thu, 08/17/2017 - 19:12
On August 8th, 2017, the Illinois Blockchain Initiative announceda pilot program in partnership with Hashed Health to use blockchain technology to streamline the medical credentialing process in the state. By exploring opportunities through distributed ledger technologies, the program could be able to reduce the complexity of licensing and credentialing. The program will look to provide a new blockchain-based registry to act as a repository for credentialing data.
Eric Fish, senior vice president of legal services at the Federation of State Medical Boards, praised the initiative, remarking that, “If successful, this effort may prompt other state medical boards, as well as others within healthcare, to investigate potential benefits that can be derived from the use of distributed ledgers, and may ultimately result in a more efficient regulatory process without any sacrifice to patient safety.”
To read more on the pilot program, see the full story at Health IT Analytics.
Blockchain technology is a decentralized peer-to-peer system through which digital transactions are created, shared, verified, and stored. This technology consists of three main components: a distributed network, a shared ledger, and digital transactions. The network is the basic skeleton of the blockchain: individual network members generate, verify, and store data on the blockchain, instead of contributing to one central database. The ledger provides a mechanism to share and verify information in the network, protecting the data from tampering and ensuring quick and easy verification of the information within. Finally, a digital transaction is the actual act of generating or verifying data.
NAMSS is continuing to monitor the development of blockchain technology in healthcare, especially with regards to the credentialing process. In May, we hosted our 4th annual Government Relations Industry Roundtable, entitled Building Blocks for the Future. A panel of NAMSS staff, stakeholders and strategic partners discussed the impact of blockchain and its potential applications for the industry. Be on the lookout for further information from NAMSS on blockchain technology and its potential impacts on MSPs!

Obamacare Repeal and Replace Dead, For Now

Sat, 07/29/2017 - 01:12
In the early hours of the morning on July 28, 2017, the Senate held its final vote on Republican efforts to repeal and replace the Affordable Care Act (ACA). The Health Care Freedom Act, referred to by some as “skinny repeal,” fell 51-49, with Republican Senators John McCain (R-AZ), Lisa Murkowski (R-AK), and Susan Collins (R-ME) joining all Democrats in voting against the bill.
The path towards repeal in the Senate had been winding at best. After multiple delays, the Senate narrowly voted to proceed to debate on the House version of the bill, the American Health Care Act (H.R. 1628). Sens. Murkowski and Collins were opposed to the motion, requiring Vice President Mike Pence to provide the tiebreaking vote. The Senate then considered several different options on the repeal efforts, which were all defeated. Senate Republican’s own original plan, the Better Care Reconciliation Act, was soundly defeated, with 9 Republicans from the conservative and moderate wings voting against (57-43).

[Republicans voting against the BCRA were Susan Collins, Lisa Murkowski, Bob Corker (TN), Tom Cotton (AR), Lindsey Graham (SC), Dean Heller (NV), Mike Lee (UT), Jerry Moran (KS), and Rand Paul (KY)]
Next, Senate Majority Leader Mitch McConnell brought up a partial repeal bill, the Obamacare Repeal and Reconciliation Act, which would have repealed essential ACA provisions like the individual mandate, Medicaid expansion, and premium subsidies after a period of two years, during which the Senate hoped to draft a replacement plan. This was voted down 55-45, with Sens. Collins, Murkowski, Heller, McCain, Shelley Moore Capito (R-WV), Rob Portman (R-OH), and Lamar Alexander (R-TN) voting against.
The “skinny repeal” bill was brought up as a last-ditch effort to garner consensus from the Republican caucus on repeal efforts, with the intention of passing a bare-bones bill in order to come up with a fuller plan in conference with the House of Representatives. It would have repealed selected provisions of the ACA, including the individual mandate, delay the employer mandate until 2025, extend the moratorium on the medical device excise tax through December 31, 2020, and modify ACA State Innovation Waivers, among other provisions. For the moment, Republican efforts to repeal the ACA are dead, and Senate leadership has expressed a desire to move onto other business. However, some House Republicans, including Rep. Tom MacArthur (R-NJ), Greg Walden (R-OR) and Freedom Caucus Chairman Mark Meadows (R-NC) have stated they will continue in their efforts to take down the ACA.