NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A9834
SPONSOR: Gunther (MS) TITLE OF BILL: An act to amend the public health law, in relation to
the granting of hospital privileges to providers of telemedicine
services
PURPOSE: To provide 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, privi-
leging 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 physi-
cian 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 hospi-
tal is required to conduct periodic reviews in accordance with require-
ments 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 practitioner's 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 prac-
titioner'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 assess-
ment of practitioner performance is known as "peer review." 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 simi-
lar 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 tele-
medicine (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. Unfortu-
nately, 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 origi-
nating 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.
