Telemedicine in CMS and TJC Standards

Introduction

• Presenter: Darling Evans, RN, CPAQ
• Experience: 25 years in healthcare industry, specialized in clinical and regulatory operations, management, and accreditation readiness.

Overview

• Focus: Telemedicine, CMS (Centers for Medicare & Medicaid Services), and TJC (The Joint Commission) standards
• Context of telemedicine highlighted during COVID-19

Key Points

1135 Waiver

• Implemented during COVID-19 to facilitate telehealth services.
• Allowed services via various means, including Medicare patients and service provision.
• Operational Aspect: Allowed two-way real-time interactions (synchronous).

Contract with Entity for Telemedicine

• Need for contractual agreements for telemedicine services.
• Advantages: Acute response for patients, other care delivery means.

CMS Document: Medicare Learning Network

• Details billing and service aspects for telemedicine and telehealth.
• Reimbursements: Included under the waiver; financial viability for the service.

Standards and Guidelines

• Addressed for mental health services, rehab, eICU-type video conferencing, etc.
• Evolution spurred by COVID-19; numerous available resources.

American Medical Association Telemedicine Resources

• Long-standing resources, continued evolution since the 90s.
• 2014 guidelines, including model policies and contractual agreements.

Roles and Responsibilities

• Primary Site & Distance Site: Hospitals, clinics, individuals, groups.
• Oversight: Monitoring care delivery, satisfaction, annual reviews.
• Medical Staff and Leadership: Responsible for the care delivery process.

Specific Standards

• Credentialing and Privileging Process: Ensuring providers work within their licensed scopes.
• Joint Commission Accreditation: Regulations around telemedicine services.

Documentation and Compliance

• Review of contracts and clinical service evaluations during audits.
• Importance of understanding roles and responsibilities for all involved entities.

Types of Services and Involvement

• Examples: Podiatry, Dermatology assessments, COVID follow-ups, monitoring, care delivery.
• Scope of Practice: Legal and regulatory support for service providers.

Conclusion

• Extensive coverage of telemedicine in context of regulatory standards.
• Resources and support available post-session.

Q&A

• Session concluded with thanks and a Q&A opportunity.