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Archive for the ‘Electronic Health Information’ Category

Telemedicine Credentialing By Proxy

Tuesday, February 12th, 2013

Telemedicine Credentialing By Proxy and Hospital Policies

telemedicine policies credentialing telehealthProvider Credentialing requirements raise important considerations in any telemedicine arrangement. The facility where care is received, renders a diagnosis, or otherwise provides clinical treatment to a patient, must assure that a telemedicine practitioner is appropriately credentialed and privileged in compliance with their credentialing process, CMS rules, and the requirements of applicable accreditation organizations.  The process for credentialing telemedicine providers should be addressed by the governing body and reflected in medical staff bylaws and formal credentialing policies.

Credentialing standards have been somewhat streamlined since CMS adopted new regulations that were effective in June of 2011.  CMS rules now permit “credentialing by proxy” provided that several conditions are met.  It remains the responsibility of the board to determine when or if it wishes to rely on “credentialing by proxy” or whether it should apply full credentialing requirements on remote providers of telemedicine services.  Even though the process has been simplified, credentialing of providers who perform telemedicine services to patients of a hospital is still an extremely important responsibility of the hospital board.

Electronic Medical Record Licensing and Contracting for EHR

Friday, April 20th, 2012

EHR Licensing and Contracting Comes Center Stage

As Meaningful Use Deadlines Approach

As the meaningful use deadline approaches, many providers are scrambling to implement electronic health records.  The agreements surrounding licensing, implementation, and support of EHR systems are some of the most important agreements that a health care provider will enter.  Unfortunately, many smaller providers put little effort into negotiating terms that help assure that the product functions like it is supposed to and that the implementation takes place in a timely and efficient manner.

             We routinely become involved in the negotiation of EHR agreements.  Some of the important issues that we address include:

  •  Creating an appropriate project milestone system to assure timely project flow.
  • Coordination between vendors in multi-application systems.
  • Requiring that functional specifications are well-defined.
  • Assuring compliance with HIPAA and state laws, particularly with respect to data conversion.
  • Negotiating warranties, including meaningful use warranties.
  • Protecting against “runaway” implementation and support costs.

             The agreements relative to EHR implementation can be very complex.  Each vendor has their own license form and it can be overwhelming to work through the issues to determine how to best protect the interest of the provider.  Our experience in these issues will be a valuable resource to any provider addressing EHR implementation issues.

Anti-kickback Statutes Safe Harbor Regulations

Thursday, December 8th, 2011

Anti-kickback Statutes and Safe Harbor Regulations

Medicare Antikickback Statute Safe HarborsOverview: On the books since 1972, the federal anti-kickback law’s main purpose is to protect patients and the federal health care programs from fraud and abuse by curtailing the corrupting influence of money on health care decisions. Straightforward but broad, the law states that anyone who knowingly and willfully receives or pays anything of value to influence the referral of federal health care program business, including Medicare and Medicaid, can be held accountable for a felony. Violations of the law are punishable by up to five years in prison, criminal fines up to $25,000, administrative civil money penalties up to $50,000, and exclusion from participation in federal health care programs.

Because the law is broad on its face, concerns arose among health care providers that some relatively innocuous — and in some cases even beneficial — commercial arrangements are prohibited by the anti-kickback law. Responding to these concerns, Congress in 1987 authorized the Department to issue regulations designating specific “safe harbors” for various payment and business practices that, while potentially prohibited by the law, would not be prosecuted.

John H. Fisher

Health Care Counsel
Ruder Ware, L.L.S.C.
500 First Street, Suite 8000
P.O. Box 8050
Wausau, WI 54402-8050

Tel 715.845.4336
Fax 715.845.2718

Ruder Ware is a member of Meritas Law Firms Worldwide

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