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Oregon Bulletin

February 1, 2014

Oregon Health Authority, Office for Oregon Health Policy and Research, Chapter 409

Rule Caption: Credentialing Requirements for Telemedicine Providers

Adm. Order No.: OHP 10-2013(Temp)

Filed with Sec. of State: 12-31-2013

Certified to be Effective: 1-1-14 thru 6-30-14

Notice Publication Date:

Rules Adopted: 409-045-0105, 409-045-0110, 409-045-0115, 409-045-0120, 409-045-0125, 409-045-0130, 409-045-0135

Subject: The Oregon Health Authority, Office for Oregon Health Policy and Research is adopting temporary administrative rules to comply with the mandates in ORS 441.056, adopted by the 77th Legislative Assembly in section OL 2013, chapter 414 (Enrolled Senate Bill 569) and amendments to ORS 441.223 and 442.015. These temporary rules will apply uniform telemedicine credentialing standards in Oregon to aid distant-site and originating-site hospitals in Oregon to better serve patients requiring telemedicine.

Rules Coordinator: Zarie Haverkate—(503) 373-1574

409-045-0105

Purpose

These rules, OAR 409-045-0105 to 409-045-0135, establish credentialing requirements for telemedicine health care practitioners providing telemedicine services from distant-site hospitals in Oregon to patients in originating-site hospitals in Oregon.

Stat. Auth.: ORS 441.056

Stats. Implemented: ORS 441.056, 441.223 & 442.015

Hist.: OHP 10-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14

409-045-0110

Definitions

The following definitions apply to OAR 409-045-0105 to 409-045-0135:

(1) “Authority” means the Oregon Health Authority.

(2) “Delegated credentialing agreement” means a written agreement between an originating-site hospital and a distant-site hospital that provides that the medical staff of the originating-site hospital will rely upon the credentialing and privileging decisions of the distant-site hospital in making recommendations to the governing body of the originating-site hospital as to whether to credential a telemedicine provider, practicing at the distant-site hospital either as an employee or under contract, to provide telemedicine services to patients in the originating-site hospital.

(3) “Distant-site hospital” means the hospital where a telemedicine provider, at the time the telemedicine provider is providing telemedicine services, is practicing as an employee or under contract.

(4) “Health services” means clinically related diagnostic, treatment or rehabilitative services, and includes alcohol, drug or controlled substance abuse and mental health services that may be provided either directly or indirectly on an inpatient or ambulatory patient basis.

(5) “Hospital” means a facility with an organized medical staff and a permanent building that is capable of providing 24-hour inpatient care to two or more individuals who have an illness or injury and that provide at least the following health services:

(a) Medical;

(b) Nursing;

(c) Laboratory;

(d) Pharmacy; and

(e) Dietary.

(6) “Originating-site hospital” means a hospital in which a patient is located while receiving telemedicine services.

(7) “Telemedicine” means the provision of health services to patients by physicians and health care practitioners from a distance using electronic communications.

Stat. Auth.: ORS 441.056

Stats. Implemented: ORS 441.056, 441.223 & 442.015

Hist.: OHP 10-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14

409-045-0115

General Applicability

(1) These rules apply to all:

(a) Telemedicine health care practitioners who provide telemedicine services from any distant-site hospital in Oregon to patients in originating-site hospitals in Oregon.

(b) Originating-site hospitals located in Oregon that credential telemedicine health care practitioners located at distant-site hospitals in Oregon.

(2) Completion of credentialing requirements does not require a governing body of a hospital to grant privileges to a telemedicine health care practitioner and does not affect the responsibilities of a governing body under ORS 441.055.

Stat. Auth.: ORS 441.056

Stats. Implemented: ORS 441.056, 441.223 & 442.015

Hist.: OHP 10-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14

409-045-0120

Standard List of Credentialing Documents

(1) To become credentialed by an originating-site hospital, a telemedicine healthcare practitioner or the distant-site hospital must provide the following information and documentation to the originating-site hospital:

(a) A completed current (within the past 6 months) Oregon Practitioner Credentialing Application (OPCA) and the following accompanying documents:

(A) A copy of state medical license;

(B) Drug Enforcement Agency certificate;

(C) Educational Commission for Foreign Medical Graduates certificate, if applicable; and

(D) Certification of professional liability insurance.

(b) Attestation by medical staff at the distant-site hospital that they have conducted primary source verification of all materials of the OPCA except for:

(A) Hospital affiliations other than to the distant-site hospital;

(B) Work history beyond 5 years previous.

(2) Originating-site hospitals may request documentation of all the verifications above from the distant-site hospital or the telemedicine health practitioner. Verifications that are not provided may be obtained separately by the originating-site hospital.

(3) Originating-site hospitals must not require either the telemedicine healthcare practitioner or the distant-site hospital to provide the following documentation for the purposes of credentialing or privileging a telemedicine provider:

(a) Proof of Tuberculosis Screening;

(b) Proof of vaccination or immunity to communicable diseases;

(c) HIPAA training verification;

(4) Originating-site hospitals shall not require a telemedicine provider to attend physician/staff meetings at the originating-site hospital.

(5) Originating-site hospitals must not request credentialing information if the credentialing information was made available under OAR 409-045-0120(1) and is not subject to change.

(6) To become recredentialed by an originating-site hospital, a telemedicine healthcare practitioner or the distant-site hospital must, every two years, provide a completed current Oregon Practitioner Recredentialing Application and all other information required in OAR 409-045-0120(1).

Stat. Auth.: ORS 441.056

Stats. Implemented: ORS 441.056, 441.223 & 442.015

Hist.: OHP 10-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14

409-045-0125

Distant-Site Hospital Agreements

In lieu of the requirements in OAR 409-045-0120, hospitals may use delegated credentialing agreements to provide that the governing body of a hospital accepts the recommendation of the medical staff at another hospital to credential telemedicine providers. If a delegated credentialing agreement is in place the originating-site hospital is not limited to the information and documents prescribed by the Authority in 409-045-0120.

Stat. Auth.: ORS 441.056

Stats. Implemented: ORS 441.056, 441.223 & 442.015

Hist.: OHP 10-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14

409-045-0130

Hold Harmless Clause

Originating-site hospitals that use credentialing information provided by distant-site hospitals are immune from civil liability that might otherwise be incurred or imposed with respect to the use of that credentialing information.

Stat. Auth.: ORS 441.056

Stats. Implemented: ORS 441.056, 441.223 & 442.015

Hist.: OHP 10-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14

409-045-0135

Information Sharing or Use of Data

(1) Telemedicine healthcare practitioners must provide written, signed permission that explicitly allows the sharing of required documents and necessary evidence by a distant-site hospital with originating-site hospitals, including but not limited to any release required under HIPAA or other applicable laws.

(2) Dissemination of information received under these rules shall only be made to individuals with a demonstrated and legitimate need to know the information.

Stat. Auth.: ORS 441.056

Stats. Implemented: ORS 441.056, 441.223, 442.015

Hist.: OHP 10-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14

Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2013.

2.) Copyright Oregon Secretary of State: Terms and Conditions of Use

Oregon Secretary of State • 136 State Capitol • Salem, OR 97310-0722
Phone: (503) 986-1523 • Fax: (503) 986-1616 • oregon.sos@state.or.us

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