CMS Clarification on Hospital
Privileging:
What Does It Mean for Your Privileging System?
Recorded December
17, 2004
Faculty: Paul
Verardi & Susan Lapenta
On
November 12, the Centers for Medicare and Medicaid
Services ("CMS") sent a memo to State
Survey Agency Directors regarding CMS Requirements
for Hospital Medical Staff Privileging. The
memo directed state survey agency surveyors "to
determine whether the hospital's privileging
process and its implementation of that process
comply with the hospital Conditions of Participation
("CoPs").
The
memo never uses the term "core privileges." But
the elements that it describes as required
for a hospital's privileging process to meet
the CoPs mirror what has commonly become known
as "core" privileging.
Topics covered include:
- CMS
Memo: What is Required?
- Evolution
of Privileging: From Laundry List to "Block" to "Core"
- "Core" Privileging
Process
- Advantages:
- Improves
quality and efficiency of process
- Satisfies
current JCAHO Standards
- Helps
with "call" issues
- Step-by-step
process for defining "core" and "special" privileges
- The
key: developing good threshold criteria
- Examples
of "core" and "special" privileges
and criteria in a particular
specialty
- Top
Tips and Issues with Core/Special Privileges
- Credibility
comes from research — what resources
are available to you
- Board
certification issues
- Should
you use numbers? Advantages and pitfalls
of volume requirements
- "Turf" Battles
and New Procedures
- Establish
criteria for privileges that cross
specialty lines
- Role
of department; role of Credentials
Committee/Interdisciplinary Committee
- Credentialing
criteria are just the start!
- Establish
criteria for new procedures
- What's "new" vs.
extension of existing privileges?
- Good
bylaws language is critical
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