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Updated: 2 hours 52 min ago

Developing Issue: CMS and Temporary Privileges

Wed, 08/12/2015 - 19:58
Recently, during a NAMSS hosted webinar, CMS officials specified that in compliance with CMS’ Conditions of Participation, only the hospital governing body can grant privileges and that the process for granting temporary privileges must be the same as the process for credentialing and granting of full hospital privileges. This is in contrast to standards put forth by The Joint Commission (TJC), Healthcare Facilities Accreditation Program (HFAP), and other accrediting bodies.

NAMSS is working to attain clarification on this significant change in CMS’ interpretation of the Conditions of Participation and will be working with our industry partners to address this change. As NAMSS obtains additional information, we will update our members via the NAMSS Blog so please stay tuned.

Health Care Consolidation Continues as Anthem Looks to Merge with Cigna

Mon, 08/03/2015 - 19:40
Following the merger of Aetna and Humana earlier in the month, Anthem announced in late July that it would acquire Cigna. This constitutes one of the largest health insurance mergers and will have ramifications across the health care industry. As reported by the New York Times, "Together, Anthem, which runs Blue Cross plans in 14 states, and Cigna, which offers insurance plans through employers, would have around $115 billion in revenue. Cigna also has 24 million behavioral health customers, nearly 14 million dental care members, eight million pharmacy benefit plan members and 1.5 million Medicare Part D pharmacy customers." (Click here for the full New York Times article)

Insurance companies have cited the need to cut costs and increase access to broad networks as the reasons behind such mergers. However, the Anthem-Cigna merger, coming so close on the heels of other major health insurance industry mergers, faces potential regulatory challenges. For a full description of these potential hurdles, please click here for another helpful article from the New York Times.

Iowa Joins 9 Other States in Enacting the FSMB Interstate Medical Licensure Compact

Wed, 07/08/2015 - 19:44
Following Alabama, Idaho, Minnesota, Montana, Nevada, South Dakota, Utah, West Virginia, and Wyoming, Iowa enacted the Interstate Medical Licensure Compact earlier this month. The legislation was signed into law by Governor Terry Branstad and received endorsements from the Iowa Board of Medicine, the Iowa Academy of Family Physicians, the Iowa Hospital Association, the Iowa Medical Society, and others.

According to a press release by the FSMB, "The final model Interstate Medical Licensure Compact legislation was released in September 2014. Since then, 19 state legislatures have introduced the Compact legislation and nearly 30 state medical and osteopathic boards have publicly expressed support for the Compact. The Compact has been endorsed by a broad coalition of health care stakeholders, including the American Medical Association (AMA)."

For the full release, please click here.

Doctors Coming Back after a Break from Practice

Tue, 06/16/2015 - 21:17
From a Report by Anna Gorman in Kaiser Health News:"Like many professionals, physicians take time off to raise children, care for sick family members or to recover from their own illnesses. Some want to return from retirement or switch from non-clinical jobs back to seeing patients. But picking up where they left off is more difficult in medicine than in most careers.In medicine, change occurs quickly. Drugs, devices and surgical techniques that were standard a decade ago may now be obsolete. Or a returning doctor’s skills may simply be rusty...After extended leaves, doctors must convince medical boards to reissue their licenses, hospitals to grant admitting privileges and malpractice insurers to provide coverage. Only a handful of programs around the country are set up to help physicians brush up on their skills, and they can cost doctors thousands of dollars."For the full story, click here.

Register Today for NAMSS' 39th Educational Conference and Exhibition

Fri, 05/29/2015 - 21:36
Join NAMSS in Seattle, Washington for the 39th Educational Conference and Exhibition, October 3 to 7, 2015. This year’s educational conference will feature more than 30 sessions, giving you the freedom to choose your own educational pathway.

This year, we are excited to offer four unique tracks centered around Embracing Change: A Journey of Leadership, allowing you to pick sessions that are most important to you! This year’s tracks include:
  • Professional Development
  • Credentialing and Privileging
  • Executive Leadership
  • Legal
Arriving to Seattle before the official start to the conference? Attend one of our Pre-Conference Workshops and take advantage of this great way to help you prepare for your upcoming CPCS or CPMSM exam. Along with the educational offerings, network with your peers and create new relationships with other members in the industry. While interacting with your peers, be sure to meet with innovative and leading exhibitors who will showcase the latest technology and services within the field.

Registeron or before Friday, July 24 for early bird savings on your conference registration! Not a NAMSS member? Join now to receive additional savings of up to $150!

The Sheraton Seattle Hotel is the headquarters hotel for the NAMSS 39th Educational Conference & Exhibition. NAMSS has secured a discounted rate of $199 per night for a single or double room. Both the Washington State Convention Center (where all conference events will be convening) and the Sheraton Seattle Hotel are a short walk away from a variety of shops as well as the famous Pike Place Market. The hotel reservation cut-off date is September 10, 2015.

NAMSS 2015 Payer Credentialing Standards Roundtable A Success

Mon, 05/11/2015 - 19:30
On May 7, 2015, the National Association Medical Staff Services (NAMSS) held the 2015 Payer Credentialing Standards Roundtable at the Gaylord National Resort in National Harbor, MD. NAMSS brought together thought leaders from across the health care industry to discuss essential common practices for practitioner credentialing with payer organizations. These practices can be utilized to improve both credentialing efficiency and patient safety.

Credentialing is the gateway to patient safety. Preventable adverse events in healthcare kill 200,000 to 400,000 Americans annually, making them the third leading cause of death in the United States. Some of these deaths could be avoided if the healthcare system could better identify unqualified healthcare practitioners through the credentialing process. Industry collaboration is essential to realize a credentialing system that reduces costs, streamlines the process, and – ultimately – protects patients. That is why NAMSS convened this important Roundtable discussion.

In May 2014, NAMSS also assembled the Ideal Credentialing Standards (ICS) Roundtable to discuss essential common practices for provider credentialing at medical facilities. By working collaboratively with participants from both the 2014 and 2015 Roundtables, NAMSS hopes to create a better, more efficient credentialing system that best serves patients.