Credentialing and privileging of health care practitioners providing telemedicine services

§ 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
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
hospital'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 practitioner 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
otherwise applicable to that hospital, collects and evaluates all
credentialing information concerning each health care practitioner
providing telemedicine 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
capacity, 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
minimum, 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
clinical 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,

(iv) require each distant site health care practitioner providing
telemedicine services to be licensed to practice in this state and
privileged 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,
revocation, or limitation of such privileges.

3. Nothing in this section shall be construed as allowing an
originating hospital to delegate its authority over and responsibility
for decisions concerning the credentialing and granting staff membership
or professional privileges to health care practitioners providing
telemedicine 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.