On June 2, 2010, a new Wisconsin law became effective that expands reporting obligations for providers licensed by the Medical Examining Board (”MEB”). 2009 Wisconsin Act 382 created a new statute under Wisconsin Chapter 448 (”Medical Practices”) requiring a person licensed by the MEB to “promptly” submit a report to the MEB when the person has reason to believe any of the following about another physician:
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von Briesen Health Law Blog
June 14, 2010
New Wisconsin Law Creates Reporting Obligations for Physicians – And Concerns for Peer Reviewers, Managers, and Treatment Providers for Physicians
June 3, 2010
New Wisconsin Law Creates Reporting Obligations for Physicians – And Concerns for Peer Reviewers, Managers, and Treatment Providers for Physicians
On June 2, 2010, a new Wisconsin law became effective that expands reporting obligations for providers licensed by the Medical Examining Board (“MEB”). 2009 Wisconsin Act 382 created a new statute under Wisconsin Chapter 448 (“Medical Practices”) requiring a person licensed by the MEB to “promptly” submit a report to the MEB when the person has reason to believe any of the following about another physician:
1. The other physician is engaged in acts that constitute a pattern of unprofessional conduct.
2. The other physician is engaged in an act that creates an immediate or continuing danger to one or more patients or to the public.
3. The other physician is or may be medically incompetent.
4. The other physician is or may be mentally or physically unable to engage in the practice of medicine or surgery.
The law further expands the definition of “unprofessional conduct” under Wisconsin Stat. § 448.014(4) to include failure by a physician to make such a report. Previously, Wisconsin physicians had only an ethical, not legal, duty to make such reports under the American Medical Association’s and Wisconsin Medical Society’s codes of ethics. The new Wisconsin law further provides that physicians who make such reports to the MEB “in good faith” may not be held civilly or criminally liable or guilty of unprofessional conduct.
This law raises several serious questions for physicians who have dual roles as peer reviewers, medical managers, and providers for physicians, since failure to report can lead to discipline for unprofessional conduct by the MEB. Unfortunately, the new law does not address the dual role certain physicians play as managers of medical staff and employed physicians. It also does not address the scenario of a physician treating another physician, for example, for mental health or substance abuse issues. Finally, and perhaps most importantly, there is the issue of how this law will interact with the privileges, immunities, and obligations of the Wisconsin peer review law as well as the federal Health Care Quality Improvement Act. We are told that guidance on these issues from the MEB is forthcoming, perhaps in the form of regulations.
Other provisions of 2009 Wisconsin Act 382 grant the Chair of the MEB or his or her designee and two other MEB members the power to summarily suspend a credential without the previous 30-day and 72-hour limitation. The law also includes a provision allowing physicians holding a temporary educational permit to practice medicine and surgery the ability to prescribe narcotics, as well as a provision allowing the MEB to change Continuing Medical Education (CME) requirements by rule rather than by legislation.
To read the entire Act, click here.
von Briesen’s medical staff lawyers will provide updates on these issues as the MEB’s interpretation of the law is developed.
May 24, 2010
CMS ANNOUNCES PROPOSED RULE ON TELEMEDICINE CREDENTIALING
The May 25 issue of the Federal Register includes a notice of proposed changes to the Medicare and Medicaid Conditions of Participation (CoPs) regarding the credentialing and privileging of telemedicine providers.
The proposed rule would permit the governing body at a hospital where a patient is receiving telemedicine services to rely on information from a hospital where the provider is currently privileged (distant-site) when making its own privileging decisions. In order to rely on information from the distant-site, the hospital where services are being received must ensure that
- “the distant-site hospital providing the telemedicine services is a Medicare-participating hospital;
- the individual distant-site physician or practitioner is privileged at the distant-site hospital providing telemedicine services, and that this distant-site hospital provides a current list of the physician’s or practitioner’s privileges;
- the individual distant-site physician or practitioner holds a license issued or recognized by the State in which the hospital, whose patients are receiving the telemedicine services, is located; and
- with respect to a distant-site physician or practitioner granted privileges by the hospital, the hospital has evidence of an internal review of the distant-site physician’s or practitioner’s performance of these privileges and sends the distant-site hospital this information for use in its periodic appraisal of the individual distant-site physician or practitioner.”
The proposed rule would also require that the periodic review information submitted to the distant-site include adverse events and complaints received about the physician or practitioner.
The proposed rule was created to address the redundant collection of information at both the distant-site and the site where services are received.
CMS is collecting comments through July 26.
For more information, click here:
March 15, 2010
The Joint Commission Board of Commissioners Approves Standard MS.01.01.01
The Joint Commission’s (TJC) Board of Commissioners has approved the Task Force revision of MS.01.01.01 (formerly MS.1.20) for implementation.
MS.01.01.01 will be effective beginning March 31, 2011, and TJC will be releasing educational documents in the next few days to help facilities understand the standard and how to implement it. There are also plans to hold an audio-conference in April, which will allow participants to ask TJC staff specific implementation questions.
Feedback from TJC’s field review, which ended earlier this year, revealed that sixty-six percent of respondents thought that the Task Force’s revision was a positive improvement, four percent thought it was worse, and the remaining respondents wanted more clarification.
Continue to check vonbriesenhealth.com for further updates.
February 15, 2010
NPDB Reporting Requirements Expand on March 1
On March 1, 2010, changes to section 1921 of the Social Security Act will go into effect. Section 1921 is intended to provide increased protection against unfit and fraudulent healthcare providers. The new rule expands the information contained in the National Practitioner Data Bank (NPDB) to include adverse licensure actions taken against all licensed healthcare practitioners by state and federal licensing agencies, peer review organizations, and private accreditation organizations. Under the rule, this data will be available for the first time to non-federal institutions. As the NPDB is recognized as one of the main credentialing resources, these changes have raised a lot of questions among medical services professionals.
Click here to view the Federal Register, which includes charts that offer a side-by-side comparison of the HCQIA (NPDB), Section 1921 (NPDB), and Section 1128E (HIPDB) to answer the questions:
- Who reports?
- What information is available?
- Who can query?
February 12, 2010
The Joint Commission Issues Sentinel Event Alert
The Joint Commission recently issued a Sentinel Event Alert on maternal death, which includes specific prevention measures for hospitals health care providers. Download the alert on maternal death.
February 8, 2010
New CMS Regulation for Foreign-Born Physicians
The Centers for Medicare and Medicaid Services (CMS) has issued a new regulation regarding the verification of legal status of foreign-born healthcare professionals. CMS provides that:
“If a newly-enrolling physician or non-physician practitioner indicates in Section 2 of his/her Medicare enrollment application (CMS-855I or Internet-based PECOS) that he/she was born in a foreign country, the contractor shall verify that the physician or non-physician practitioner is: (1) a United States citizen; (2) a legal resident of the United States, or (3) otherwise legally authorized to work in the United States. The purpose of this change request is to help ensure that all enrolling physicians and non-physician practitioners are legally authorized to perform Medicare services.”
The regulation will become effective on March 29, 2010.
The full transmittal describing the new regulation can be found here.
December 18, 2009
The Joint Commission Standard MS01.01.01
Beginning December 17, 2009, The Joint Commission has posted MS.01.01.01 (formerly MS.1.20) for field review. The field review will last six weeks, and the proposed standard is identical to the standard drafted in March 2009 with the help of the AHA, AMA and others. To view the standard and other related TJC information, click here.
December 3, 2009
CMS Grants Continued Deeming Authority for The Joint Commission
The Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) has approved the continuation of deeming authority for The Joint Commission’s hospital accreditation program through July 15, 2014.
The CMS designation means that hospitals accredited by The Joint Commission may choose to be “deemed” as meeting Medicare and Medicaid certification requirements. For years, The Joint Commission had automatic deemed status to survey hospitals on behalf of CMS, but in 2008 CMS required The Joint Commission to reapply for this status. As a result, the commission needed to update some of its requirements to more closely align with the Medicare Conditions of Participation. (For example, see our recent article “Medical Staff Update: October 2009” for examples of changes affecting the medical staff.)
Accreditation by The Joint Commission is voluntary and seeking deemed status through accreditation is an option, not a requirement. Hospitals seeking Medicare approval may choose to be surveyed either by an accrediting body, such as The Joint Commission, or by state surveyors on behalf of CMS. All deemed status surveys are unannounced, a policy The Joint Commission instituted into its accreditation process in 2006.
October 19, 2009
von Briesen & Roper Law Bulletin Medical Staff Update: October 2009
As health care regulations and accreditation standards continuously evolve, so do medical staff requirements. This Update covers the following topics: The Joint Commission’s Telemedicine Standard; Board Certification Requirements; History & Physical Requirements for Medical Staff Documents; The Joint Commission’s Statement of Duties and Privileges Standard; and, Recent Development in Economic Credentialing. Read more…