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October 2014

 

A Word from the President

Welcome to the October issue of NAMSS Gateway, your resource for industry news around the country.

As autumn continues and holidays approach, the healthcare industry continues to see changes and developments. One article highlights the new accredited medical schools, while another looks at the growing concerns for ASCs heading into 2015. I also recommend an interesting read about the license application delays in Arizona.

For those of you interested in accreditation standards or CMS regulation requirements, NAMSS has released the 2014 Comparison of Accreditation Standards which serves as a one-stop resource to help you understand the credentialing verification requirements of multiple agencies. Visit the NAMSS store to purchase the updated version.

As always, I hope you enjoy this month’s articles. Continue reading for the latest industry news.

John Pastrano, BBA, CPCS, CPMSM
NAMSS President

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Headlines


News From NAMSS
Webinar Series - A Graduate Series on Advanced Practice Professionals
2014 Comparison of Accreditation Standards
Update to the Certification Examinations and Recertification Information
Online Dues Renewal Coming Soon
Upcoming Webinars

Industry News
"State Board Lifts Moratorium on Issuing Doctor Licenses"
"California Docs Protest Tenet Hospitals' Plan to Use Outside Staffing Firm to Manage Contracts"
"Fayetteville VA Medical Center Target of Safety Allegations"
"10 Concerns Facing ASCs Heading Into 2015"
"Health Market Science Announces Credentials Verification Organization (CVO) Accreditation in Progress With URAC"
"Hospitals Cut Costs by Getting Doctors to Stick to Guidelines"
"Telehealth and Health IT Policy: Considerations for Stakeholders"
"Accountability Slow to Reach Rural Hospitals"
"UNLV Takes Step Toward Accredited Medical School"
"California Expands Training and Staffing Requirements for Assisted Living Facilities and Enacts Workplace Safety Bill to Address Violence in Hospitals"
"Heavyweights Lead Charge for More Time on EHR Meaningful Use"


News From NAMSS


Webinar Series - A Graduate Series on Advanced Practice Professionals

Join NAMSS for Part III of A Graduate Series on Advanced Practice Professionals: A Comprehensive Review of the Role and Use of Nurse Practitioners, Nurse Anesthetists, Midwives, Clinical Nurse Specialists, and Physician Assistants.

Billing and Reimbursement for Advanced Practice Professionals: Opportunities and Pitfalls
October 28, 2014

Advanced Practice Professionals face a practical challenge regarding reimbursement issues and compliance considerations. This webinar will provide an overview of the general approach and efforts to improve reimbursement for Advanced Practice Professionals.
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2014 Comparison of Accreditation Standards

Don’t refer to outdated standards—visit the NAMSS store to purchase the newly-updated 2014 Comparison of Accreditation Standards. This electronic document (revised September 2014) serves as a one-stop resource to help you clearly understand the credentials verification requirements of multiple agencies. Standards change frequently, and only the most recent version of the NAMSS Comparison of Accreditation Standards includes the latest updates from:
  • The Joint Commission
  • NCQA
  • DNV
  • URAC
  • The Accreditation Association for Ambulatory Health Care
  • Medicare Conditions of Participation
The 2014 Comparison of Accreditation Standards creates a side by side comparison of the requirements for each agency. Visit the NAMSS store today to purchase the 2014 Comparison of Accreditation Standards.
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Update to the Certification Examinations and Recertification Information

Effective fall 2014, all CPCS and CPMSM examinations administered will contain multiple choice questions with three possible answer options, a decrease from the present format of four. For more information regarding the 2014 CPCS and CPMSM examination content outlines, please visit our Candidate Handbook.

All candidates due to recertify in 2014 must submit their recertification application by December 1, 2014. For more information, view the NAMSS Recertification page and/or the 2014 Recertification Policies & Guidelines.

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Online Dues Renewal Coming Soon

NAMSS Members – It’s that time of the year again! Keep an eye out for emailed instructions on how to renew your NAMSS membership in the next month. Maintain your membership in a network of over 5,000 MSPs across the country and, for renewing, you will also receive a special giveaway! If you require a paper renewal invoice to submit a personal or facility check, you can move through the renewal process online and select the “pay by check” option at checkout. NAMSS will also be mailing invoices later this year.
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Upcoming Webinars

Physician Assistants: Rules, Regulations and Realities” - November 25 2:00 pm - 3:30 pm EST
Tricia Marriott, PA-C, MPAS, DFAAPA
Director, Regulatory and Professional Advisory Services
Staff Liaison to the Joint Commission
American Academy of Physician Assistants

“How to Privilege for New Privileges and New Technology” - December 10 2:00 pm – 3:00 pm EST
Jon Burroughs, MD, MBA, FACHE, FACPE
President and CEO, The Burroughs Healthcare Consulting Network, Inc.
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Industry News


State Board Lifts Moratorium on Issuing Doctor Licenses
Arizona Daily Star (10/08/14) Innes, Stephanie

Earlier this month, the Arizona Medical Board lifted a freeze on issuing new physician licenses. However, it remains unclear whether severe applications delays stretching six months and longer will improve. The board regulates Arizona's 22,400 allopathic doctors. The freeze on issuing new physician licenses began Sept. 3. The eventual standstill was becoming increasingly critical because the board was already dealing with a backlog of more than 700 applications from doctors who have been waiting for months to obtain a license to practice. Hospitals and other health-care providers lament that the delays are not only worrisome in a competitive market for recruiting out-of-state doctors, they threaten to aggravate Arizona’s existing physician shortage and problems with access to care. According to board members, the freeze was because of a legal problem with the FBI over fingerprinting information. On Oct. 8, the medical board opted to put an end to the freeze but didn’t directly address the months-long delays that applicants have been experiencing since last year that created the backlog.
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California Docs Protest Tenet Hospitals' Plan to Use Outside Staffing Firm to Manage Contracts
Modern Healthcare (09/10/14) Kutscher, Beth

Doctors in California are opposing a plan to appoint an outside staffing firm to manage physician contracts at up to a dozen hospitals owned by Tenet Healthcare Corp. The facilities currently use independent physicians to provide such inpatient care as emergency medicine and anesthesiology. The plan calls for these contracts to be managed via a national staffing firm. Up to three vendors were being evaluated as of press time. Yet local professional societies are concerned that the move could result in some physicians losing their jobs if they are not offered a contract or offered rates that are too low. The group is urging Tenet's hospitals to instead negotiate with the doctors directly. According to Dr. Marc Futernick, president-elect of the California chapter of the American College of Emergency Physicians, there are about 33 contracts that stand to be affected by the change. The bigger contracts might cover as many as 40 physicians. The Coalition for Quality Hospital Care -- whose members include the California chapters of the American College of Emergency Physicians and the American Academy of Emergency Medicine -- is now circulating a petition to increase pressure on Tenet.
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Fayetteville VA Medical Center Target of Safety Allegations
Fayetteville Observer (NC) (10/08/14) Brooks, Drew

In North Carolina, the Department of Veterans Affairs' Office of the Inspector General is reviewing allegations of "unfair and unsafe practices" in the Fayetteville VA Medical Center's Department of Surgery. The allegations, outlined in a letter sent to the Fayetteville Observer by "concerned surgical staff," detail practices the anonymous writers said are "discriminatory and have placed our veterans at risk for delayed care and increased surgical complications." No timetable has been set for a final report. Fayetteville VA officials say the allegations may be due to a recent change of leadership, specifically a recently hired chief of surgery. "As is often the case with new leadership, change for the staff can be difficult and push back may occur or a desire to not change even when changes are needed," Fayetteville VA officials said. The letter to the Observer alleges that personnel changes at the medical center were made in a push to increase the number of surgeries. However, input from nursing and anesthesia staff has allegedly been ignored. While surgeries have increased, there also have been increased complications and increased staff overtime and fatigue, the letter charges. Finally, the letter charges that at least four surgical deaths were not properly reviewed between late 2013 and early this year.
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10 Concerns Facing ASCs Heading Into 2015
Becker's ASC Review (09/14) Dyrda, Laura

Ambulatory surgery centers (ASCs) face 10 fairly major market challenges in today's healthcare environment. The first is the transition to value-based care. Healthcare is moving more toward pay-for-performance rather than fee-for-service. The second challenge is EMR implementation. The federal government provided incentives for hospitals and doctors to start using electronic medical records, but not for ASCs. Consequently, a large number of them have yet to implement EMR and are now behind in data collection. Three, data collection and optimization. The Ambulatory Surgery Center Association is currently offering a benchmarking program collecting data from a large number of ASCs nationwide with the potential to offer both broad benchmarks as well as very specific numbers for certain types of centers. The fourth challenge is promoting ASC benefits. "As a result of their smaller size, ASCs often lack the brand recognition of local health systems," states Adam C. Powell, president of Adam PowellPayer+Proivder Syndicate. "Furthermore, some patients may be hesitant to receive care outside the walls of a hospital." Physician recruitment is a fifth challenge, with rural ASCs especially hit hard as surgeons often train in urban areas and decide to start practicing in such locales. Patient experience with higher acuity cases is another challenge, as is case cancellations. An eight challenge is drug shortages. ASCs can combat this challenge by compounding drugs, but that can be an expensive and time consuming process. A ninth challenge is high deductible insurance plans/patient collections. Finally, there is the matter of leadership under healthcare reform. ASC leaders and staff must be flexible and responsive to new legislation and market changes.
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Health Market Science Announces Credentials Verification Organization (CVO) Accreditation in Progress With URAC
SYS-CON Media (10/09/14)

Health Market Science (HMS), a supplier of provider data and end-to-end solutions that address everything from regulatory compliance to market intelligence, is undergoing Credentials Verification Organization (CVO) Accreditation from URAC. The independent nonprofit organization promotes healthcare quality through accreditation, education, and measurement programs. The accreditation process will validate the process and procedures that HMS uses to help healthcare payers ensure their provider data is up to date and accurate. URAC President and CEO Kylanne Green comments, "It is critically important for healthcare organizations to make a commitment to quality and accountability." Credentialing is indeed a mission-critical function that allows healthcare organizations to properly identify qualified healthcare practitioners for participation in their networks. The process protects patients and minimizes legal exposure for healthcare organizations due to malpractice claims.
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Hospitals Cut Costs by Getting Doctors to Stick to Guidelines
Wall Street Journal (09/23/14) Whalen, Jeanne

Researchers from Wilmington, Del.-based Christiana Care Health System found that when the hospital group changed its computer system to encourage doctors to follow American Heart Association guidelines for using cardiac monitors for patients outside of intensive care, the daily costs of monitoring declined 70 percent without any harm to patient care. The study, published in JAMA Internal Medicine, illustrates the benefits of pushing physicians to follow evidence-based guidelines. Researchers found that the hospital group's mean daily number of non-ICU patients monitored with telemetry fell 70 percent from 357.5 to 109.1, while the mean daily cost for delivering non-ICU telemetry declined 70 percent from $18,971 to $5,772. The study also indicates that the changes had no negative effect on patient care. Mortality rates remained stable, as did the number of "code blue" emergency calls to resuscitate patients. Some hospitals are reminding physicians of the guidelines through education and training, while others like Christiana Care are changing their computer systems to make it harder to deviate from the guidelines.
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Telehealth and Health IT Policy: Considerations for Stakeholders
Lexology (09/04/14) Hecht, Alexander; Shin, Andrew J.; Matousek, Abby

Legislators and industry officials alike are recognizing the cost, quality, and accessibility benefits of telehealth, and momentum for implementation is growing as a result. In the current Congress, at least 46 bills that relate to telehealth have been introduced. The progress in recent years is best demonstrated by a recent study finding that the number of patients around the globe using telehealth services is expected to grow from 350,000 patients last year to approximately 7 million by 2018. By some estimates, telehealth could deliver more than $6 billion in annual healthcare savings to U.S. companies. Still, there are still significant barriers to deployment. For one, current federal law is extremely restrictive on how telehealth is paid for, resulting in a disincentive to provider adoption. In addition, there is currently no federal standard of clinical guidelines for telehealth. Medical boards and state regulatory boards nationwide are each responsible for setting the standards for the appropriate practice of medicine via telehealth in their state. The result has been a patchwork of state laws that inhibit the proliferation of telehealth solutions in both the private and public sectors.
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Accountability Slow to Reach Rural Hospitals
Chicago Tribune (09/26/14) Rau, Jordan

About 25 percent of hospitals across the United States, mostly rural and critical access hospitals, have not been incorporated into Medicare's pay-for-performance programs. The Affordable Care Act aims to bring greater accountability to hospitals by linking Medicare payments to quality of care by encouraging hospitals to monitor patients' health. These critical access and rural hospitals often are the only acute-care option for patients, and they are often reimbursed more by Medicare than other hospitals, even though recent studies have shown that death rates are higher at these hospitals. One project testing ways to deliver care in rural locations was limited to five states, and no announcements have been made as to which hospitals will be participating. Although these hospitals can participate in incentive or accountable care organization programs, few do so voluntarily, and others are engaging in more regional programs to improve care.
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UNLV Takes Step Toward Accredited Medical School
Las Vegas Review Journal (09/29/14) McCabe, Francis

The University of Nevada, Las Vegas (UNLV) late last month submitted its application for accreditation of its medical school, the initial step in a years-long process. Dr. Barbara Atkinson, dean of the burgeoning school, says building a public medical school in Southern Nevada will encourage graduates to stay put and practice. Nevada is currently ranked near the bottom of national lists in health care in nearly every category, and the state needs doctors in order to turn that around. Other research has shown that nearly 80 percent of students who finish medical school stay to live in that same state. Kevin Page, chairman of the Nevada System of Higher Education Board of Regents, remarks, "The key here is to keep more doctors here." To get the new school started, UNLV is seeking $26.7 million from the Nevada Legislature. A significant amount of funds is also being sought through philanthropy. As part of a 10-year goal, the school is hoping to receive $350 million in such support.
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California Expands Training and Staffing Requirements for Assisted Living Facilities and Enacts Workplace Safety Bill to Address Violence in Hospitals
Littler (10/07/14) Boals, R. Alex

California recently enacted two laws: one that expands the training and staffing requirements for assisted living facilities statewide and another that requires hospitals to implement a workplace violence prevention plan. Assembly Bill 1570 requires applicants who seek to work in an assisted living facility to attend an 80-hour certification program. They are then required to pass a 100-question examination administered by the state. Both the certification program and exam focus on such core topics as the physical and psychosocial needs of elderly residents, medication management, and managing Alzheimer’s disease and related dementias, among other things. Also signed into law was Senate Bill 1299, which requires California's Occupational Safety and Health Standards Board to adopt standards requiring certain hospitals to implement a workplace violence prevention plan by July 1, 2016, as part of their injury and illness prevention policies. By Jan. 1, 2017, and each year thereafter, the Division of Occupational Safety and Health (or Cal/OSHA) will be required to post a report on its website containing specific data related to violent incidents at hospitals.
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Heavyweights Lead Charge for More Time on EHR Meaningful Use
Modern Healthcare (09/16/14) Conn, Joseph

More than a dozen healthcare industry groups -- including the American Medical Association, the American Hospital Association, and the Federation of American Hospitals -- sent a letter to Health and Human Service Secretary Sylvia Mathews Burwell on Sept. 15, asking her to relax electronic health record (EHR) meaningful use requirements for 2015. The letter states that the compliance period for meaningful use criteria should be shortened to just 90 days. The compliance period for hospitals is currently all of fiscal year 2015, while physicians and other eligible professionals have a compliance period that lasts for the entire 2015 calendar year. The letter's signatories note that the proposed change is necessary for making the electronic health record incentive program successful. The authors also point out that with the deadline for meeting Stage 2 meaningful use requirements rapidly approaching, only 143 hospitals and just over 3,150 physicians and other eligible professionals are ready. The letter concludes that giving providers more time to transition to Stage 2 will help keep the incentive program "on track."
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