[Federal Register Volume 85, Number 37 (Tuesday, February 25, 2020)]
[Pages 10705-10707]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-03659]



Indian Health Service

Request for Public Comment: 30-Day Information Collection: Indian 
Health Service Medical Staff Credentials

AGENCY: Indian Health Service, HHS.

ACTION: Notice and request for comments. Request for revision to a 


SUMMARY: In compliance with the Paperwork Reduction Act of 1995 (PRA), 
the Indian Health Service (IHS) invites the general public to comment 
on the information collection titled, ``Indian Health Service Medical 
Staff Credentials,'' OMB Control Number 0917-0009, that expires 
February 29, 2020. This proposed information collection project was 
previously published in the Federal Register (84 FR 70197) on December 
20, 2019, and allowed 60 days for public comment, as required by the 
PRA. The IHS received one comment regarding this collection. The 
purpose of this notice is to allow 30 days for public comment to be 
submitted directly to OMB.

DATES: Comment Due Date: March 26, 2020. Your comments regarding this 
information collection are best assured of having full effect if 
received within 30 days of the date of this publication.
    Direct Your Comments to OMB: Send your comments and suggestions 
regarding the proposed information collection contained in this notice, 
especially regarding the estimated public burden and associated 
response time to: Office of Management and Budget, Office of Regulatory 
Affairs, New Executive Office Building, Room 10235, Washington DC 
20503, Attention: Desk Officer for IHS.
    Summary of Comment: The IHS received one comment. The commenter 
asked: Any reason why PAs and NPs are not included as part of the 
requirement to be medical staff members? Non-physician providers are 
credentialed in the same manner to be able to provide high quality 
medical care to IHS beneficiaries.
    The IHS response to the comment:
    The Federal Register notice makes reference to IHS policy noting 
``IHS policy specifically requires physicians and dentists to be 
members of the health care facility medical staff where they 
practice.'' This notice is only making reference to existing IHS policy 
(not establishing policy in and of itself) as found in Indian Health 
Manual, Part 3, Chapter 1 which notes ``The medical staff shall include 
physicians (medical doctors and doctors of osteopathy) and dentists, 
and other categories of providers as determined by the local medical 
staff and its governing body, and defined in its policies and 
procedures manual and bylaws.''

SUPPLEMENTARY INFORMATION: This notice announces the IHS intent to 
revise the collection already approved by OMB, and to solicit comments 
on specific aspects of the information collection. The purpose of this 
notice is to allow 30 days for public comment to be submitted to OMB. A 
copy of the supporting statement is available at

[[Page 10706]]

www.regulations.gov (see Docket ID IHS-2019-01).
    Information Collection Title: ``Indian Health Service Medical Staff 
Credentials and Privileges Files, 0917-0009.'' Type of Information 
Collection Request: Extension of an approved information collection, 
and revised to, ``Indian Health Service Medical Staff Credentials, 
0917-0009.'' Form Numbers: 0917-0009. Need and Use of Information 
Collection: This collection of information is used to evaluate 
individual health care providers applying for medical staff privileges 
at IHS health care facilities. The IHS operates health care facilities 
that provide health care services to American Indians and Alaska 
Natives. To provide these services, the IHS employs (directly and under 
contract) several categories of health care providers including: 
Physicians (M.D. and D.O.), dentists, psychologists, optometrists, 
podiatrists, audiologists, physician assistants, certified registered 
nurse anesthetists, nurse practitioners, and certified nurse midwives. 
IHS policy specifically requires physicians and dentists to be members 
of the health care facility medical staff where they practice. Health 
care providers become medical staff members depending on the local 
health care facility's capabilities and medical staff bylaws. There are 
three types of IHS medical staff applicants: (1) Health care providers 
applying for direct employment with IHS; (2) contractors who will not 
seek to become IHS employees; and (3) employed IHS health care 
providers who seek to transfer between IHS health care facilities.
    National health care standards developed by the Centers for 
Medicare and Medicaid Services, the Joint Commission, and other 
accrediting organizations require health care facilities to review, 
evaluate, and verify the credentials, training and experience of 
medical staff applicants prior to granting medical staff privileges. In 
order to meet these standards, IHS health care facilities require all 
medical staff applicants to provide information concerning their 
education, training, licensure, and work experience and any adverse 
disciplinary actions taken against them. This information is then 
verified with references supplied by the applicant and may include: 
Former employers, educational institutions, licensure and certification 
boards, the American Medical Association, the Federation of State 
Medical Boards, the National Practitioner Data Bank, and the applicants 
    In addition to the initial granting of medical staff membership and 
clinical privileges, Joint Commission standards require that a review 
of the medical staff be conducted not less than every two years. This 
review evaluates the current competence of the medical staff and 
verifies whether each is maintaining the licensure or certification 
requirements of one's specialty.
    The medical staff credentials and privileges records are maintained 
at the health care facility where the health care provider is a medical 
staff member. The establishment of these records at IHS health care 
facilities is a Joint Commission requirement. Prior to the 
establishment of this Joint Commission requirement, the degree to which 
medical staff applications were maintained at all health care 
facilities in the United States that are verified for completeness and 
accuracy varied greatly across the Nation.
    The application process has been streamlined and is using 
information technology to make the application electronically available 
via the internet. The IHS is transforming credentialing, which includes 
granting privileges into a centrally installed, automated, 
standardized, electronic/digital, measurable, portable, accessible, and 
efficient business process to improve the effectiveness of application 
and reapplication to medical staffs, movement of practitioners within 
the IHS system, and recruitment/retention of high-quality 
practitioners. The credentialing process no longer requires paper/pdf 
forms for granting privileges. The electronic credentialing system 
incorporates privileges as part of the overall process for 
credentialing, eliminating the need for paper, and allows tailoring the 
needs to site specifications. Privileges will differ across IHS Areas 
and clinics in compliance with accreditation standards.
    The adoption of a central-source IT system for medical practitioner 
staff credentialing/privileging data will enhance the quality, 
accuracy, and efficiency of the IHS credentialing/privileging process, 
which is expected to improve the recruitment and retention rates of 
medical practitioner staff at IHS. Cost savings will be obtained 
through the termination of disparate business processes, reduction of 
paperwork duplication, and eliminating systems that do not provide IHS 
enterprise access to credentialing/privileging information. 
Additionally, communicating information electronically can reduce costs 
and errors, promote collaboration, ensure accreditation/privileging 
requirements are met, and help bring practitioners on board more 
quickly, which will improve recruitment and retention.
    Affected Public: Individuals and households. Type of Respondents: 
    The table below provides: Types of data collection instruments, 
Estimated number of respondents, Number of annual number of responses, 
Average burden per response, and Total annual burden hours.

                                      Estimated                                                    Total annual
  Data collection instrument(s)       number of     Responses per    Average  burden hour  per        burden
                                     respondents     respondent              response *              (current)
Initial Application to Medical                600               1  0.583 (35 min)...............             350
Application Packet/Signature                1,300               1  0.167 (10 min)...............             217
Reappointment Application to                  700               1  0.333 (20 min)...............             233
 Medical Staff.
    Total........................           2,600  ..............  .............................             800
* For ease of understanding, burden hours are provided in actual minutes.

    Annual number of respondents were factored based on total IHS 
providers credentialed and privileged on the indicated cycles in the 
paragraphs above. There are no capital costs, operating costs and/or 
maintenance costs to respondents.
    Requests for Comments: Your written comments and/or suggestions are 
invited on one or more of the following points: (a) Whether the 
information collection activity is necessary to carry out an agency 
function; (b) whether the agency processes the information collected in 
a useful and timely fashion; (c) the accuracy of the public burden 
estimate (the estimated amount of time needed for individual 
respondents to

[[Page 10707]]

provide the requested information); (d) whether the methodology and 
assumptions used to determine the estimates are logical; (e) ways to 
enhance the quality, utility, and clarity of the information being 
collected; and (f) ways to minimize the public burden through the use 
of automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology.

 Michael D. Weahkee,
Assistant Surgeon General, U.S. Public Health Service, Principal Deputy 
Director, Indian Health Service.
[FR Doc. 2020-03659 Filed 2-24-20; 8:45 am]