senate Bill S6970

Signed By Governor
2011-2012 Legislative Session

Provides for the credentialing of health care providers providing telemedicine services

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Archive: Last Bill Status Via A9834 - Signed by Governor


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Aug 17, 2012 signed chap.390
Aug 06, 2012 delivered to governor
May 30, 2012 returned to assembly
passed senate
3rd reading cal.817
substituted for s6970
May 30, 2012 substituted by a9834
May 21, 2012 advanced to third reading
May 16, 2012 2nd report cal.
May 15, 2012 1st report cal.817
Apr 18, 2012 referred to health

Votes

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Co-Sponsors

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S6970 - Bill Details

See Assembly Version of this Bill:
A9834
Law Section:
Public Health Law
Laws Affected:
Add ยง2805-u, Pub Health L

S6970 - Bill Texts

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Provides for the credentialing of health care providers providing telemedicine services. Legislative Commission on Rural Resources Bill.

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BILL NUMBER:S6970

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,
privileging 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 physician 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 hospital is required to conduct
periodic reviews in accordance with requirements 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 practitioners 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
practitioner'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
assessment of practitioner performance is known as "peer review. II
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 similar 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
telemedicine (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.
Unfortunately, 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 originating 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.

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                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

    S. 6970                                                  A. 9834

                      S E N A T E - A S S E M B L Y

                             April 18, 2012
                               ___________

IN  SENATE -- Introduced by Sens. YOUNG, BRESLIN, O'MARA, RITCHIE, VALE-
  SKY -- (at request of the Legislative Commission on  Rural  Resources)
  -- read twice and ordered printed, and when printed to be committed to
  the Committee on Health

IN  ASSEMBLY  -- Introduced by M. of A. GUNTHER -- Multi-Sponsored by --
  M. of A. BURLING, LIFTON, PALMESANO -- read once and referred  to  the
  Committee on Health

AN  ACT  to  amend the public health law, in relation to the granting of
  hospital privileges to providers of telemedicine services

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  The  public health law is amended by adding a new section
2805-u to read as follows:
  S 2805-U. CREDENTIALING AND PRIVILEGING OF HEALTH  CARE  PRACTITIONERS
PROVIDING TELEMEDICINE SERVICES. 1. FOR PURPOSES OF THIS SECTION:
  (A) "DISTANT SITE HOSPITAL" MEANS A HOSPITAL LICENSED PURSUANT TO THIS
ARTICLE  OR  A HOSPITAL LICENSED BY ANOTHER STATE, THAT HAS ENTERED INTO
AN AGREEMENT WITH AN ORIGINATING HOSPITAL TO MAKE AVAILABLE ONE OR  MORE
HEALTH  CARE PRACTITIONERS THAT ARE MEMBERS OF ITS CLINICAL STAFF TO THE
ORIGINATING  HOSPITAL  FOR  THE  PURPOSES  OF   PROVIDING   TELEMEDICINE
SERVICES.    TO  QUALIFY AS A DISTANT SITE HOSPITAL FOR PURPOSES OF THIS
ARTICLE, A HOSPITAL LICENSED BY  ANOTHER  STATE  MUST  COMPLY  WITH  THE
FEDERAL REGULATIONS GOVERNING PARTICIPATION BY HOSPITALS IN MEDICARE.
  (B)  "HEALTH  CARE PRACTITIONER" SHALL MEAN A PERSON LICENSED PURSUANT
TO ARTICLE ONE HUNDRED THIRTY-ONE, ONE HUNDRED THIRTY-ONE-B, ONE HUNDRED
THIRTY-THREE, ONE HUNDRED THIRTY-NINE, ONE HUNDRED  FORTY,  ONE  HUNDRED
FORTY-ONE,  ONE HUNDRED FORTY-THREE, ONE HUNDRED FORTY-FOUR, ONE HUNDRED
FIFTY-THREE, ONE HUNDRED FIFTY-FOUR OR ONE  HUNDRED  FIFTY-NINE  OF  THE
EDUCATION LAW, OR AS OTHERWISE AUTHORIZED BY THE COMMISSIONER.
  (C)  "ORIGINATING  HOSPITAL"  MEANS THE HOSPITAL AT WHICH A PATIENT IS
LOCATED AT THE TIME TELEMEDICINE SERVICES ARE PROVIDED TO HIM OR HER.
  (D) "TELEMEDICINE" MEANS THE DELIVERY OF CLINICAL HEALTH CARE SERVICES
BY MEANS OF REAL TIME  TWO-WAY  ELECTRONIC  AUDIO-VISUAL  COMMUNICATIONS

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD15253-02-2

S. 6970                             2                            A. 9834

WHICH  FACILITATE  THE  ASSESSMENT,  DIAGNOSIS, CONSULTATION, TREATMENT,
EDUCATION, CARE MANAGEMENT AND SELF MANAGEMENT  OF  A  PATIENT'S  HEALTH
CARE  WHILE  SUCH PATIENT IS AT THE ORIGINATING SITE AND THE HEALTH CARE
PROVIDER IS AT A DISTANT SITE.
  2.  WHEN  TELEMEDICINE  SERVICES ARE PROVIDED TO AN ORIGINATING HOSPI-
TAL'S PATIENTS PURSUANT TO AN AGREEMENT WITH A  DISTANT  SITE  HOSPITAL,
THE ORIGINATING HOSPITAL MAY, IN LIEU OF SATISFYING THE REQUIREMENTS SET
FORTH  IN  SECTION  TWENTY-EIGHT HUNDRED FIVE-K OF THIS ARTICLE, RELY ON
THE CREDENTIALING AND PRIVILEGING DECISIONS MADE  BY  THE  DISTANT  SITE
HOSPITAL IN GRANTING OR RENEWING PRIVILEGES TO A HEALTH CARE PRACTITION-
ER  WHO  IS A MEMBER OF THE CLINICAL STAFF OF THE DISTANT SITE HOSPITAL,
PROVIDED THAT:
  (A) THE DISTANT SITE HOSPITAL PARTICIPATES IN MEDICARE AND MEDICAID;
  (B) EACH HEALTH CARE PRACTITIONER PROVIDING TELEMEDICINE  IS  LICENSED
TO PRACTICE IN THIS STATE;
  (C)  THE DISTANT SITE HOSPITAL, IN ACCORDANCE WITH REQUIREMENTS OTHER-
WISE APPLICABLE TO THAT HOSPITAL, COLLECTS AND EVALUATES ALL CREDENTIAL-
ING INFORMATION CONCERNING EACH HEALTH CARE PRACTITIONER PROVIDING TELE-
MEDICINE SERVICES, PERFORMS ALL REQUIRED  VERIFICATION  ACTIVITIES,  AND
ACTS  ON  BEHALF OF THE ORIGINATING SITE HOSPITAL FOR SUCH CREDENTIALING
PURPOSES;
  (D) THE DISTANT SITE HOSPITAL REVIEWS PERIODICALLY, AT LEAST EVERY TWO
YEARS, AND AS OTHERWISE WARRANTED BASED ON OUTCOMES, COMPLAINTS OR OTHER
CIRCUMSTANCES, THE CREDENTIALS, PRIVILEGES, PHYSICAL AND MENTAL  CAPACI-
TY,  AND  COMPETENCE  IN  DELIVERING HEALTH CARE SERVICES OF EACH HEALTH
CARE  PRACTITIONER  PROVIDING  TELEMEDICINE  SERVICES,  CONSISTENT  WITH
REQUIREMENTS  OTHERWISE APPLICABLE TO THAT HOSPITAL; REPORTS THE RESULTS
OF SUCH REVIEW TO THE ORIGINATING HOSPITAL; AND NOTIFIES THE ORIGINATING
HOSPITAL IMMEDIATELY UPON ANY SUSPENSION, REVOCATION, OR  LIMITATION  OF
SUCH PRIVILEGES;
  (E)  WITH  RESPECT  TO  EACH DISTANT SITE HEALTH CARE PRACTITIONER WHO
HOLDS PRIVILEGES AT THE ORIGINATING HOSPITAL, THE  ORIGINATING  HOSPITAL
CONDUCTS  A  PERIODIC  INTERNAL REVIEW, AT LEAST EVERY TWO YEARS, OF THE
DISTANT SITE PRACTITIONER'S PERFORMANCE OF THESE PRIVILEGES AND PROVIDES
THE DISTANT SITE HOSPITAL WITH SUCH PERFORMANCE INFORMATION FOR  USE  IN
THE  DISTANT HOSPITAL'S PERIODIC APPRAISAL OF THE DISTANT SITE PHYSICIAN
OR HEALTH CARE PRACTITIONER. SUCH INFORMATION SHALL INCLUDE, AT A  MINI-
MUM,  ALL  ADVERSE  EVENTS  THAT  RESULT  FROM THE TELEMEDICINE SERVICES
PROVIDED BY THE DISTANT SITE HEALTH CARE PRACTITIONER TO THE ORIGINATING
HOSPITAL'S  PATIENTS,  ALL  COMPLAINTS  THE  ORIGINATING  HOSPITAL   HAS
RECEIVED  ABOUT  THE  DISTANT  SITE  PRACTITIONER,  AND  ANY REVOCATION,
SUSPENSION OR LIMITATION OF THE DISTANT SITE  PRACTITIONER'S  PRIVILEGES
BY THE ORIGINATING HOSPITAL; AND
  (F)  THE  AGREEMENT ENTERED INTO BETWEEN THE ORIGINATING SITE HOSPITAL
AND DISTANT SITE HOSPITAL SHALL BE IN WRITING AND SHALL, AT A MINIMUM:
  (I) PROVIDE THE CATEGORIES  OF  HEALTH  CARE  PRACTITIONERS  THAT  ARE
ELIGIBLE  CANDIDATES FOR APPOINTMENT TO THE ORIGINATING HOSPITAL'S CLIN-
ICAL STAFF,
  (II) REQUIRE THE GOVERNING BODY OF THE DISTANT SITE HOSPITAL TO COMPLY
WITH THE MEDICARE CONDITIONS OF PARTICIPATION GOVERNING THE  APPOINTMENT
OF  MEDICAL STAFF WITH REGARD TO THE HEALTH CARE PRACTITIONERS PROVIDING
TELEMEDICINE SERVICES,
  (III) ITEMIZE THE CREDENTIALING INFORMATION TO BE  COLLECTED  AND  THE
REQUIRED  VERIFICATION  ACTIVITIES  TO  BE PERFORMED BY THE DISTANT SITE
HOSPITAL AND RELIED UPON BY THE ORIGINATING HOSPITAL IN  CONSIDERING THE
RECOMMENDATIONS OF THE DISTANT SITE HOSPITAL,

S. 6970                             3                            A. 9834

  (IV) REQUIRE EACH DISTANT  SITE  HEALTH  CARE  PRACTITIONER  PROVIDING
TELEMEDICINE SERVICES TO BE LICENSED TO PRACTICE IN THIS STATE AND PRIV-
ILEGED AT THE DISTANT SITE HOSPITAL,
  (V)  REQUIRE  THE  DISTANT SITE HOSPITAL TO PROVIDE TO THE ORIGINATING
HOSPITAL A CURRENT LIST OF EACH DISTANT SITE HEALTH CARE  PRACTITIONER'S
PRIVILEGES AT THE DISTANT SITE HOSPITAL, AND
  (VI)  REQUIRE  THE  DISTANT SITE HOSPITAL TO CONDUCT A PERIODIC REVIEW
CONSISTENT WITH REQUIREMENTS OTHERWISE APPLICABLE TO THAT  HOSPITAL,  AT
LEAST  EVERY  TWO  YEARS,  AND AS OTHERWISE WARRANTED BASED ON OUTCOMES,
COMPLAINTS OR OTHER CIRCUMSTANCES, THE CREDENTIALS, PRIVILEGES, PHYSICAL
AND MENTAL CAPACITY, AND COMPETENCE IN DELIVERING HEALTH  CARE  SERVICES
OF  EACH  HEALTH  CARE  PRACTITIONER PROVIDING TELEMEDICINE SERVICES; TO
PROVIDE THE ORIGINATING HOSPITAL WITH THE RESULTS OF SUCH REVIEW; AND TO
NOTIFY THE ORIGINATING HOSPITAL IMMEDIATELY UPON ANY SUSPENSION, REVOCA-
TION, OR LIMITATION OF SUCH PRIVILEGES.
  3. NOTHING IN THIS SECTION SHALL BE CONSTRUED AS ALLOWING AN ORIGINAT-
ING HOSPITAL TO DELEGATE ITS AUTHORITY OVER AND RESPONSIBILITY FOR DECI-
SIONS CONCERNING THE CREDENTIALING  AND  GRANTING  STAFF  MEMBERSHIP  OR
PROFESSIONAL PRIVILEGES TO HEALTH CARE PRACTITIONERS PROVIDING TELEMEDI-
CINE SERVICES.
  4.  NOTWITHSTANDING  ANY  CONTRARY  PROVISION  OF  LAW, AN ORIGINATING
HOSPITAL SHALL NOT BE REQUIRED TO PROVIDE A PHYSICAL EXAMINATION  OR  TO
MAINTAIN  RECORDED  MEDICAL HISTORY INCLUDING IMMUNIZATIONS FOR A HEALTH
CARE PROVIDER PROVIDING CONSULTATIONS SOLELY THROUGH TELEMEDICINE FROM A
DISTANT SITE HOSPITAL.
  S 2. This act shall take effect immediately.

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