CPCS Telemedicine Credentialing and Privileging Standards 2 — Questions and Answers
Question 1: Under CMS Conditions of Participation, a distant-site hospital providing telemedicine services must have a written agreement with the originating-site hospital that addresses which key element?
- Reimbursement rates for telemedicine visits
- The distant-site medical staff's credentialing and privileging process (Correct answer)
- Marketing and branding requirements for telemedicine services
- Equipment maintenance schedules for telemedicine technology
Correct answer: The distant-site medical staff's credentialing and privileging process
CMS requires the written telemedicine agreement to specify how the distant-site hospital's credentialing and privileging of practitioners will be relied upon by the originating site.
Question 2: When a telemedicine provider's privileges at a distant site are revoked for cause, what action must the originating-site hospital take?
- Notify the state medical board within 30 days
- Immediately suspend or revoke the provider's telemedicine privileges at the originating site (Correct answer)
- Allow the provider to continue until the peer review process is complete
- Transfer responsibility for the provider to the distant-site hospital
Correct answer: Immediately suspend or revoke the provider's telemedicine privileges at the originating site
The originating site must immediately act on adverse credentialing actions taken by the distant site to protect patient safety.
Question 3: What does the term 'privileging by proxy' mean in telemedicine credentialing?
- A practitioner credentialing another practitioner on their behalf
- An originating site relying on a distant site's credentialing decisions to grant telemedicine privileges (Correct answer)
- A temporary privilege granted while full credentialing is pending
- Delegating credentialing authority to a third-party organization
Correct answer: An originating site relying on a distant site's credentialing decisions to grant telemedicine privileges
Privileging by proxy allows the originating site to grant privileges based on the distant site's credentialing process rather than conducting a separate full review.
Question 4: Which accreditation standard specifically addresses telemedicine credentialing and privileging for hospitals?
- The Joint Commission's MS.13.01.01 (Correct answer)
- NCQA's CR 7
- URAC's Health Plan Accreditation Standard UM 9
- AAAHC's Chapter 5
Correct answer: The Joint Commission's MS.13.01.01
The Joint Commission's MS.13.01.01 outlines the standards for credentialing and privileging practitioners who provide services via telemedicine.
Question 5: A hospital wants to credential a telestroke neurologist using the proxy credentialing option. What is the minimum requirement for the distant site to qualify?
- The distant site must be a URAC-accredited telemedicine organization
- The distant site must be a Medicare-participating hospital with an approved medical staff process (Correct answer)
- The distant site must be located in the same state as the originating site
- The distant site must have Joint Commission Gold Seal of Approval
Correct answer: The distant site must be a Medicare-participating hospital with an approved medical staff process
CMS requires that for proxy credentialing, the distant-site organization must be a Medicare-participating hospital or a Medicare-approved telemedicine entity.
Question 6: How frequently must a telemedicine provider's performance be evaluated at the originating site when using the proxy credentialing option?
- Every 90 days
- Annually, consistent with the medical staff bylaws reappointment cycle (Correct answer)
- Every two years, aligned with FPPE completion
- Only at initial privileging, with no ongoing evaluation required
Correct answer: Annually, consistent with the medical staff bylaws reappointment cycle
Performance must be evaluated at least every two years at reappointment, consistent with the originating site's medical staff bylaws and ongoing professional practice evaluation.
Question 7: Which scenario would DISQUALIFY a telemedicine arrangement from using CMS's streamlined proxy credentialing option?
- The telemedicine provider holds privileges at multiple distant-site hospitals
- The originating site is a critical access hospital
- The distant-site organization is a physician group practice, not a hospital (Correct answer)
- The telemedicine services involve mental health rather than acute care
Correct answer: The distant-site organization is a physician group practice, not a hospital
The CMS proxy credentialing option is only available when the distant site is a Medicare-participating hospital or telemedicine entity, not a physician group practice.
CPCS Telemedicine Credentialing and Privileging Standards 2
Under CMS Conditions of Participation, a distant-site hospital providing telemedicine services must have a written agreement with the originating-site hospital that addresses which key element?