Because the Centers for Medicare and Medicaid Services (CMS) has not yet published final regulations on telemedicine, it has allowed The Joint Commission (TJC) to delay changes to its telemedicine standards until July 1, 2011. The TJC's current telemedicine standards are in conflict with the Medicare Conditions of Participation, which do not allow for credentialing by proxy. The proposed rule issued by CMS last year would permit credentialing by proxy between CMS-accredited hospitals.
TJC issued the following statement:
The Centers for Medicare & Medicaid Services (CMS) has not yet published its new telehealth regulations, which it had expected to do by March 1, 2011. Therefore, CMS has now notified The Joint Commission that it has an extension to July 1, 2011 before The Joint Commission will need to alter its telehealth standards to comply with CMS telehealth regulations. Our hope is that the new regulation will modify existing CMS standards in this area to be more in keeping with Joint Commission requirements. CMS expects to publish its telehealth regulations shortly and when it does, The Joint Commission will make changes to its standards in accordance with the regulation and will notify its accredited hospitals and critical access hospitals of the timeframe expected for implementation of the new CMS regulations.
As background on this issue, since September 2009, The Joint Commission has engaged CMS and members of Congress regarding the issue of credentialing and privileging by proxy as it relates to telemedicine providers and users. The Joint Commission took the position that there would be an adverse affect on the access to some telehealth services if organizations were not allowed to comply with Joint Commission requirements addressing credentialing and privileging by proxy. The Joint Commission’s position has been that the CMS requirements place an undue burden on many organizations without improving the quality of services, provider accountability and the effectiveness of the credentialing and privileging processes.