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November 2015
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A Word from the President


Welcome to the November issue of NAMSS Gateway!

With the success of the NAMSS 39th Educational Conference and Exhibition behind us, I am looking forward to the upcoming NAMSS Education Summit, taking place March 11-12, 2016 at the Hyatt Regency Orlando in Orlando, Florida! This is a great opportunity for those who couldn’t attend the conference in Seattle to still take advantage of the same hands-on educational workshops that were offered. The summit will feature three interactive, two-day workshops: NAMSS Credentialing Specialist (CPCS) Certification Preparation, NAMSS Medical Services Management (CPMSM) Certification Preparation, and Credentialing 101. So if you’re preparing to take a certification exam, want an in-depth look at the credentialing process, or just want to connect with other MSPs, make sure to register for this valuable educational event.

And while on the topic of certification, this is a reminder that those who received initial certification in 1982, 1985, 1988, 1991, 1994, 1997, 2000, 2003, 2005, 2009 or 2012 are due to recertify by December 1, 2015. Visit the NAMSS website for everything you need to know about recertification.

Linda Waldorf, BS, CPMSM, CPCS
NAMSS President
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Headlines


News From NAMSS
2016 NAMSS Education Summit
The Recertification Deadline is December 1st!
NAMSS Conference Recordings
Upcoming Webinars
Social Corner
Monthly Discount

Industry News
"Ruling Opens Hospitals to Lawsuits"
"Hospitals Turn to Managed Service Providers to Handle All Temporary Staffing Chores"
"An Uproar Over How to Certify Doctors"
"Some New Doctors Are Working 30-Hour Shifts at Hospitals Around the U.S."
"State Launches New Background Check System for Long-Term Care Employees"
"Health Facilities May Be Insuring Doctors Without Knowing It"
"The Most Crucial Half-Hour at a Hospital: The Shift Change"
"Groups Want More Notice About Bad Docs"


News From NAMSS


2016 NAMSS Education Summit

The 2016 NAMSS Education Summit will be held March 11-12, 2016 at the Hyatt Regency Orlando in Orlando, Florida! Take advantage of high-quality educational workshops and connect with fellow MSPs from across the country!

If you’re preparing for NAMSS certification exams and missed the preparation courses offered at the Annual Conference, consider attending the NAMSS Education Summit and participate in one of our three workshops:
Click here for registration and hotel information!
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The Recertification Deadline is December 1st!

All certificants due for recertification in 2015 must submit their recertification applications online by December 1st, 2015! The application is now available at www.namss.org/recertification. Paper applications will no longer be accepted.

A full listing of those due for recertification in 2015 as well as 2015 Recertification Policies and Guidelines can be found at www.namss.org/recertification.
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NAMSS Conference Recordings

The 2015 NAMSS Educational Conference Recordings are Now Available for purchase in our online store.

2015 Package 1: Credentialing & Privileging
  • “The Growing Controversy over Maintenance of Certification: What’s All the Fuss?” presented by Todd Sagin, MD, JD.
  • “Physicians Assistants: Certification, Credentialing, Competencies, and Case Studies” presented by Tricia Marriott, PA, MDAS and Greg Thomas, PA, MPH
  • “Attention Shoppers! I have an OPPE/FPPE Process what Works!” presented by Leslie Duncan, Nina Bush, RN, CPHQ, and John Pastrano, CPMSM, CPCS
2015 Package 2: Executive Leadership
  • “Assessing the Aging Physician: Reviewing the Findings of a Screening Battery Study” presented by David Bazzo, MD, FAAFP
  • “Top Performing Healthcare Organizations Do’s and Don’ts” presented by Jonathan Burroughs, MD, MBA, FACHE, FACPE
  • “Physicians Returning to Practice: Do They Have a Place on Your Medical Staff?” presented by Elizabeth Korinek, MPH
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Upcoming Webinars

The New Era of Electronic Provider Data
Thursday, November 19 - 1:00 - 2:00 PM EST
Presented By: Sorin Davis, Managing Director, CAQH
This webinar has been approved for 1.0 CE Credits

The healthcare industry has redundant, inefficient data gathering processes. Provider credentialing places an enormous burden on medical staff personnel who spend hours completing multiple, duplicative forms. As the movement from pay-for-service to pay-for-value payment models gains popularity, more non-traditional types of healthcare providers – including social workers, behavioral health specialists and even fitness trainers – must be credentialed as they become part of the healthcare system and increase the credentialing workload.

Along with new reimbursement models, population health management requires the need for more granular provider data that can be used for credentialing and also for provider directories in order for the medical record to accurately follow the patient through all points of care.

No single organization or company currently captures, maintains, or integrates all of the data that providers are asked to continuously supply, and that health plans, third party administrators, hospitals, labs, pharmacies, and others use on a daily basis.

Some experts believe a national database is a logical solution to solve the growing problem of the need for a single source of truth for provider data. While nearly all stakeholders acknowledge the need to improve the collection, maintenance and distribution of provider data, streamlining and improving these processes will not be easy.

What does the ultimate provider database in the era of the ACA and healthcare reform look like? In this session, attendees will discover how a fully electronic solution that enables the collection of a more robust provider data set could save time during the credentialing process and also be used for much more. A reliable and complete source of provider data could also increase claims adjudication accuracy to speed reimbursement and help to improve overall healthcare quality as new payment models require analysis of aggregated clinical, claims and administrative data.

Click here to register now!




Attend the Final NAMSS PASS Training Webinar of 2015!
“Patient Safety: The Critical Role of NAMSS PASS”
Thursday, November 19 - 1:00 - 2:00 PM EST

This is a new webinar focusing on Patient Safety and how NAMSS PASS is the critical solution to one of the on-going challenges we face as MSPs. When practitioners do not fully disclose their work history, MSPs are not able to verify what they don't know and places their patients and facilities at risk. This important webinar covers the critical role of how NAMSS PASS addresses this issue. This webinar is free and you will receive one CE credit for attendance.

Click here to register now!


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Social Corner

Looking for NAMSS 39th Educational Conference and Exhibition photos? Like our Facebook page to view photos from the entire conference including social events, exhibit hall time, and Seattle selfies. If you are in one of the photos, feel free to “tag” yourself or share it on your personal page.

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Monthly Discount

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Industry News


Ruling Opens Hospitals to Lawsuits
Argus Leader (10/26/15) Ellis, Jonathan

Judge Bruce Anderson recently ruled that hospitals in South Dakota that grant doctors privileges to practice medicine can be sued if they acted in bad faith or were unreasonable in granting those privileges. Anderson's ruling paves the way for lawsuits against the individual members of committees that granted those privileges. It also opens the door for South Dakota to become a state that allows lawsuits against health providers under a concept known as "negligent credentialing." Anderson wrote: "It appears South Dakota has all the necessary legal precedents as ingredients other courts have found prerequisite to adopting such a claim including a hospital's duty of care for patient safety." The ruling could be appealed to the South Dakota Supreme Court. As it stands, it is a major triumph for 36 plaintiffs who are suing Dr. Allen Sossan, a spine surgeon; Lewis & Clark Specialty Hospital, where Sossan was one of the doctor owners; and Avera Sacred Heart, where Sossan was also credentialed. The physicians on the credentialing committees are also being sued. The plaintiffs are trying to prove Sossan was credentialed by the hospitals because of the profits he would bring them by performing lucrative spine surgeries. Sossan got credentials even though the local medical community knew he had lost them at a hospital in Norfolk, Neb., and that he had other past problems.
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Hospitals Turn to Managed Service Providers to Handle All Temporary Staffing Chores
Crain's Detroit Business (11/09/15) Sandler, Michael

More hospitals are working with staffing firms under the managed-service provider (MSP) model, which they say has helped them deal with severe shortages of physicians and nurses. Hospitals also contend that MSPs are better than having to work directly with individual staffing firms to locate and place candidates, as MSPs handle recruiting and even credentialing so hospitals can focus on providing care. However, the number of clients that would recommend an MSP service fell from 27 percent in 2011 to 18 percent in 2014, according to the 2014 Contingent Buyers Survey: Satisfaction With Staffing Suppliers, VMS, MSP, and Job Boards by Staffing Industry Analysts. Temporary employees account for less than 5 percent of total staffing at U.S. hospitals. As a result, competition has heated up among staffing firms, prompting more to offer an MSP. However, there are concerns about payments and lack of communication with physicians, as MSPs do not allow communication between the subcontractor and the hospital.
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An Uproar Over How to Certify Doctors
Biloxi Sun Herald (MS) (11/05/15) Brubaker, Harold

Last year, the American Board of Internal Medicine (ABIM) -- the largest of the boards that certify physicians -- botched the introduction of an expanded certification process, which was decried by many as "paper-pushing busy work not worth the time and money." For instance, doctors had to manually input data from patient records into ABIM's system to receive certification credit. Physician dissent resulted in the creation of a small rival, the National Board of Physicians and Surgeons, which has certified approximately 2,600 doctors since the first of this year. The issue is a critical one for patients because board certification is supposed to be one of the best ways to identify the most effective physicians. However, passing the test has never been shown to denote a better-performing doctor. So, where did ABIM go wrong? American Board of Medical Specialties CEO Lois Margaret Nora cited the breadth of the internal medicine board, which offers certificates in 20 sub-specialties. She notes that it tried to create "a program that would fit the entire specialty of internal medicine." However, she noted, everyone from cardiologists to pulmonologists to gastroenterologists said, "That doesn't fit well enough with who I am and what I do.'"
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Some New Doctors Are Working 30-Hour Shifts at Hospitals Around the U.S.
Washington Post (10/28/15) Bernstein, Lenny

A number of first-year doctors are working 30 hours in a row at dozens of hospitals nationwide in a test of work-hour limits that were imposed four years ago due to fears that inexperienced, sleep-deprived physicians might put patients at risk. Banned in 2011, the 30-hour shifts are one element of a $9 million research project partly funded by the National Institutes of Health to determine the optimal way to train novice doctors while maintaining patient care. Critics of the study contend that exhausted physicians can make mistakes that cost lives. However, the research team and some experts say the work limits force more handoffs of patients from doctor to doctor, which can be more dangerous than leaving them in the care of sleep-deprived physicians. The researchers got permission to change the doctors' work hours from the organization that regulates physician training. Because it involves actual patients, the study also required approval from the ethics panel at the University of Pennsylvania, which is spearheading the research. Panel members deemed the study's risk to patients and new doctors minimal, adding that hospitals did not have to inform either. The "minimal risk" designation by the university's Institutional Review Board was critical to the decision to waive the usual requirement to inform patients and doctors that they would be taking part in an experiment.
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State Launches New Background Check System for Long-Term Care Employees
Connecticut Post (11/09/15) Cuda, Amanda

The Connecticut Department of Public Health (DPH) this month launched a background check program for employees of nursing homes and other long-term care agencies. The goal of this comprehensive program is to strengthen protections for the elderly and disabled residents. It helps nursing homes and other providers determine whether a job applicant has a disqualifying criminal conviction or other patient abuse or neglect information that could make him/her not a good match to work with residents. DPH Commissioner Dr. Jewel Mullen remarks, "With this system, Connecticut has implemented an important safeguard which will help protect the health and safety of some of our most vulnerable residents and clients."
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Health Facilities May Be Insuring Doctors Without Knowing It
JDSupra (10/08/15) Tabler Jr., Norman

A recent ruling by the New Jersey Supreme Court makes a health facility liable for the professional negligence of a medical staff member who does not have malpractice insurance or who has insurance that does not cover the acts in question. Dr. Kaul performed a spinal fusion on Jim Jarrell at the Market St. Surgical Center. The procedure went so badly that a jury awarded the patient and his wife $750,000. State law requires doctors to maintain malpractice coverage of at least $1 million per occurrence. Dr. Kaul had a policy, but it specifically excluded spinal surgery. The court ruled that the plaintiffs had a "negligent hiring" claim against the surgery center for giving credentials to a physician who wasn't in compliance with the statutory malpractice insurance requirement.
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The Most Crucial Half-Hour at a Hospital: The Shift Change
Wall Street Journal (10/26/15) Landro, Laura

New research shows that bedside shift reports, with both nurses meeting during the shift change in the presence of the patient during the handover, help these healthcare professionals better communicate with each other and with patients and their families. This strategy not only helps lower the number of patient falls, it also helps identify other safety issues. Institute for Patient-and-Family-Centered Care CEO Beverley Johnson comments, "It is a very tangible way to ensure that complete and accurate information is shared and there is mutual understanding of the care plan and other priorities." Traditionally, the shift change has involved nurses going off duty and conferring in a hallway or at the nursing station with the nurse coming on for the next shift. However, critical information is often overlooked during such shift changes. Furthermore, there is less of an opportunity for patients and their family members to ask questions, voice concerns, or communicate their own goals. Bedside reporting can help improve patients' ratings of their hospital experience at a time when Medicare is tying some payments to quality measures that include how well hospitals score on patient satisfaction surveys.
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Groups Want More Notice About Bad Docs
San Diego Union Tribune (10/30/15) Sisson, Paul

Hundreds of physicians throughout California are currently on probation for infractions ranging from sexual assault to poor record-keeping. While state regulators automatically alert hospitals and malpractice-insurance firms about these violations, they allow most of the doctors to avoid telling their patients about the disciplinary actions. Probation notices have become the latest flash-point in the long-running debate over whether problematic doctors are duly disciplined. A growing number of patient advocacy and safety groups are probing into whether medical boards across the country are giving the public sufficient information to make the best medical choices. They are also prodding these agencies to be more forceful in removing doctors from bedsides, examination rooms, and surgery suites when there is clear proof of wrongdoing. The controversy came into focus in San Diego late last month when the Medical Board of California rejected a request from Consumers Union to compel the 130,000 doctors it regulates to notify their patients whenever they are placed on probation. While the board voted down the proposal, it did vow to create a task force that would examine how regulators might better handle several aspects of the agency's enforcement process, including patient notification.
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