To: Chief Executive Officers, Chief Medical Officers, Government Affairs staff
Please share with staff involved with training or credentialing telehealth providers
From: Shirley S. Prasad, JD, Policy Director, Government Affairs
ShirleyP@wsha.org | (206) 216-2550
Subject: Telemedicine Training Standards and Credentialing
Purpose
This bulletin is to inform hospitals and health systems about Senate Bill 5386, relating to telemedicine training and Senate Bill 5387, relating to telemedicine credentialing. WSHA worked to ensure that these new laws provided appropriate flexibility for providers while recognizing the desire by the Legislature to continue to advance telemedicine in Washington State.
- Senate Bill 5386, Telemedicine Training: Beginning January 1, 2020, health care professionals who provide services through telemedicine may complete telemedicine training prior to providing those services. The training may be incorporated into existing telemedicine training.
- Senate Bill 5387, Telemedicine Credentialing: Effective July 28, 2019, when granting or renewing credentials of any physician providing telemedicine or store and forward services, an originating site hospital (the location of the patient at the time of the telemedicine visit) may rely on a distant site hospital’s (the location of the provider at the time of the telemedicine visit) decision to grant or renew credentials.
Applicability / Scope
The telemedicine training legislation applies to any person who is licensed, registered or certified to provide health services and provides those services through telemedicine.
The telemedicine credentialing legislation applies to any originating site hospital that seeks to grant or renew credentials of a physician who will provide telemedicine services.
Recommendation / Next Steps
Review bulletin and share with staff, as appropriate.
Overview
Telemedicine Training
Beginning January 1, 2020, health care professionals who provide services through telemedicine may complete telemedicine training prior to providing services through telemedicine to patients in the state. If a health care professional completes training, they must sign and retain an attestation.
The training:
- Must include information on current state and federal law, liability, informed consent and other criteria established by the Collaborative for the Advancement of Telemedicine (referred to as the “Collaborative”), in conjunction with the Department of Health and the Medical Commission;
- Must use a question and answer format; and
- May be made available electronically and completed online.
Existing telemedicine training programs may be used, provided they meet the above requirements.
Telemedicine Credentialing
An originating site hospital is able to rely on a distant site hospital’s decision to grant or review clinical privileges when the physician is providing telemedicine or store and forward services, provided certain provisions are met. Senate Bill 5387 extends this provision to granting or renewing credentials.
As such, RCW 70.41.230(3) is amended to allow an originating site hospital that is granting or renewing credentials, as well as privileges to rely on a distant site hospital’s decision, provided that it obtains written assurances that:
- The distance site hospital providing the telemedicine or store and forward services is a Medicare participating hospital;
- Any physician providing telemedicine or store and forward services at the distance site hospital will be fully privileged to provide such services at the distant site hospital;
- Any physician providing telemedicine or store and forward services will hold and maintain a valid license to perform such services issued or recognized in Washington State; and
- The originating site hospital has evidence of the distant site hospital’s internal review of the distant site physician’s performance and sends the distant site hospital performance information to be used for the periodic review of the distant site physician. At a minimum, this information must include:
- All adverse events, as defined in RCW 70.56.010, that results from the telemedicine or store and forward services being provided by the distant site physician to the originating site patient, and all complaints the originating site hospital has received about the distant site physician.
See RCW 70.41.230(3)(a)-(d).
Background and References
In 2016, the Collaborative was established to develop recommendations on improving reimbursement and access to services. In 2018, the Legislature tasked the Collaborative to design a training program to teach health care professionals about telemedicine and proper billing. They were also tasked with developing recommendations on reimbursing for telemedicine at the same rate as if the provider provided the service in person, for the treatment of certain conditions.
As a result of this request, the Collaborative recommended to the Legislature a series of bills, which included Senate Bills 5386 and 5387, which both passed unanimously in the House and Senate this session. Senate Bill 5385, Telemedicine Payment Parity, was introduced this year but did not pass.
WSHA’s 2019 New Law Implementation Guide
Please visit WSHA’s 2019 implementation guide online, where you will find a list of the high priority laws that WSHA is preparing resources and information on to help members implement the new laws, as well as links to resources such as this bulletin. In addition, you will find the Government Affairs team’s schedule for release of upcoming resources on other laws and additional resources for implementation.
