Highlights from the National Credentialing Forum

Highlights from the National Credentialing Forum

Feb 24, 2021

Author: Cheryl Cisneros, RN, BSN, CPMSM, CPCS; Consulting Services; VerityStream


On February 4-5, 2021 Vicki Searcy and I attended (virtually of course) the National Credentialing Forum. This year again there was a full house of attendees representing major organizations (American Board of Medical Specialties, American Health Lawyer’s Association, American Medical Association, American Osteopathic Association, Council for Affordable Quality Healthcare, Inc (CAQH), Det Norske Veritas (DNV), Educational Commission for Foreign Medical Graduates (ECFMG), Federation of State Medical Boards, National Committee for Quality Assurance (NCQA), National Association Medical Staff Services (NAMSS), National Practitioner Data Bank (NPDB), and the Joint Commission) as well as organizations and individuals who are deep into credentialing – either because they work in this area and/or provide services to the credentialing industry.


As usual, the meeting was excellent with much information shared and discussions on subjects of interest to those of us who work in this industry. Kudos to this year’s organizers and facilitators: Maggie Palmer, Cris Mobley and Chris Giles!


The following are notes on issues of interest during the meeting that are beneficial for those in the payer enrollment space.

 

CAQH (Council for Affordable Quality Healthcare)

  • CAQH has added Telehealth Information to ProView. Providers can now add if they offer telehealth services at their practice location. The benefit is that patients who are members of CAQH participating organizations will be able to identify providers offering telehealth services which the organizations can add to their online directories.
  • CAQH in 2020 made the decision to allow electronic signatures for the Standard Authorization. Until 2020, providers were required to upload a one-time pen signed Authorization to Release document. Refer to CAQH website for specific details.

DNV- GL

  • DNV is experiencing an uptick in new applications for accreditation.
  • Organizations have achieved DNV accreditation in 47 states
  • Effective March 1, 2021, DNV GL will become DNV

FSMB (Federation of State Medical Boards)

  • The FSMB has made available a comprehensive list of US State and Territory requirements for Telehealth in response to COVID-19.
  • The FSMB is the source for state medical and osteopathic boards that use the Uniform Application for Physician State Licensure. Read more about FSMB's list of UA Participating Boards

NCCPA (National Commission on Certification of Physician Assistants)

In 2020, 47 states and District of Columbia have made changes to relax or modify regulatory body requirements for Physician Assistants


NCQA

Stressed the importance of paying attention to the newly added CR 1C Factors 1-5: Credentialing System Controls effective 7/01/2020 as a “Must Pass” Element. This standard is currently being surveyed. (See recent or 11/23,2020 NCQA Clarification below):


  • CR 1, Element C.
    • Factor 4: Securing information
      • Revise the third and fourth sub-bullets of the third bullet under Factor 4: Securing information to read:
        – User IDs and passwords unique to each user.
        – Change passwords when requested by staff or if passwords are compromised.
        Note: If the organization’s policies and procedures state that it follows the National Institute of Standards and Technology guidelines, this is acceptable to describe the process for password-protecting electronic systems.

The Joint Commission (TJC)

  • Surveys were on hold March – May 2020
  • Surveys started back up May 2020. Documents are required to be uploaded to a SharePoint site, with all documents to be uploaded one day prior to the survey.
  • Surveys conducted using Zoom with each surveyor scheduling their own Zoom call
  • 60 days after HHS releases the health emergency, when possible, the same virtual survey group that conducted the initial survey will complete an accreditation onsite survey for the components that could not be completed virtually (could include pharmacy and sterile assessment, among other areas). This was an agreement with CMS so that TJC accreditation survey process could continue during the declared national health emergency.

Legal Update – Brian C. Betner, Attorney (Representing the American Health Law Association)

  • Introduced conversation on HIPPA changes in 2021.

(Note: Check out this article I found when doing some research to learn more about this topic.)

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