[Federal Register Volume 85, Number 37 (Tuesday, February 25, 2020)]
[Notices]
[Pages 10705-10707]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-03659]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
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
collection.
-----------------------------------------------------------------------
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
themselves.
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:
Individuals.
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
Staff.
Application Packet/Signature 1,300 1 0.167 (10 min)............... 217
Documents.
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]
BILLING CODE 4165-16-P