[Federal Register Volume 88, Number 91 (Thursday, May 11, 2023)]
[Notices]
[Pages 30317-30319]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-09998]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Request for Public Comment: 60-Day Information Collection: Indian 
Health Service Medical Staff Credentials Application

AGENCY: Indian Health Service, HHS.

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

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the 
Indian Health Service (IHS) invites the general public to comment on 
the information collection titled, ``Indian Health Service Medical 
Staff Credentials Application,'' OMB Control Number 0917-0009, which 
expires August 31, 2023.

DATES: Comment Due Date: July 10, 2023. Your comments regarding this 
information collection are best assured of having full effect if 
received within 60 days of the date of this publication.

[[Page 30318]]


ADDRESSES: Send your written comments, requests for more information on 
the collection, or requests to obtain a copy of the data collection 
instrument and instructions to Ms. Lisa Majewski, Associate Director, 
Quality Assurance and Patient Safety, by email: [email protected].

SUPPLEMENTARY INFORMATION: This notice announces our 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 60 days for public comment to be submitted to the 
IHS. A copy of the supporting statement is available at 
www.regulations.gov (see Docket ID IHS-2023-0001).
    Information Collection Title: ``Indian Health Service Medical Staff 
Credentials Application, 0917-0009.''
    Type of Information Collection Request: Revision of an approved 
information collection, and retitled to, ``Indian Health Service 
Medical Staff Credentials and Privileges Records, 0917-0009.''
    Form Numbers: 0917-0009.
    Need and Use of Information Collection: This collection of 
information is used to evaluate IHS medical and health care 
professionals to include: licensed practitioners (LP) applying for 
medical staff membership, credentialing and privileges at IHS health 
care facilities. Practitioner credentialing and privileging in the IHS 
has been identified as a priority area for quality improvement to 
support patient safety, demonstrate quality of care, and improve 
practitioner satisfaction.
    The IHS policy specifically requires all LP (i.e., Federal 
employees, contractors, and volunteers) who intend to provide health 
care services at IHS facilities to be credentialed and privileged PRIOR 
to providing such care. When a practitioner applies to provide health 
care services at an IHS clinic or hospital, that application contains 
two parts. The first is for membership in the medical staff. Criteria 
for such membership may include type of licensure, education, training, 
and experience. The second part is for privileges, which define the 
scope of clinical care that a practitioner can administer and matches 
the practitioner's current clinical competency. There are certain 
criteria that practitioners must meet in order to exercise particular 
privileges in the facilities. These criteria may overlap with criteria 
for membership on the medical staff, but those for privileges are more 
specific and must be facility specific to meet the facility's 
requirements.
    The IHS operates health care facilities that provide health care 
services to American Indians and Alaska Natives. To provide these 
services, the IHS employs (direct-hire and direct-contract) several 
categories of fully licensed, registered, or certified individuals 
permitted by law to independently provide patient care services within 
the scope of their license, registration, or certification, and in 
accordance with individually granted clinical privileges when the 
individual is a credentialed member of the IHS medical staff. Licensed 
Practitioners who are eligible may become medical staff members, 
depending on the local health care facility's capabilities and medical 
staff bylaws.
    All LP who provide care at IHS facilities must maintain full, 
active, unrestricted and current licensure and credentials, and be 
proficient in their granted privileges in accordance with the 
facility's medical staff bylaws, accreditation standards, privilege 
criteria, agency and local policies, and applicable law and guidelines.
    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 prime source verify credentials of medical staff 
applicants prior to granting medical staff privileges. Medical 
credentials specifically include the primary source verified and 
documented evidence of competence, character, judgment, education and 
training. In order to meet these standards, IHS health care facilities 
require all medical staff applicants to provide verifiable information 
concerning their education, training, licensure, work experience, 
health status, and current professional conduct and competence and any 
adverse disciplinary actions taken against them. This information is 
collected through the agency's current commercial off the shelf 
credentialing software to make the following application packets 
electronically available via the internet. The Application packets are: 
(1) Pre-Application; (2) Initial Application for Membership & 
Privileges; and (3) Reappointment Application for Membership and 
Privileges. All these application packets include a Statement of 
Understanding and Release and Health Attestation Statement for the LP 
to sign.
    Privileges vary across all IHS Areas and clinics, as services and 
procedures provided and equipment utilized varies across facilities and 
can change often. Privilege forms are required to be current and 
modified to reflect only services and procedures provided by that 
specific facility in order to be in compliance with accreditation 
standards. The electronic credentialing system allows tailoring the 
privileging needs to site specifications.
    Information collected in the application packets are prime source 
verified by IHS staff using standard IHS forms (Affiliation, Peer 
Reference, Insurance, and Education) with the original source of the 
credential. The credentials review includes, but is not limited to, 
verifying information from the state medical boards, the Drug 
Enforcement Administration, Excluded Parties List System/System for 
Awards Management, National Practitioner Data Bank, Office of Inspector 
General, colleges or universities, residency programs, peer references, 
insurance companies, etc.
    Once the LP application packet is approved, agency policy requires 
licensure, registration, and certification requirements and clinical 
competency be continuously verified on an ongoing basis until the time 
of the next reappointment. At the time of reappointment (every two to 
three years), the health care practitioner will go through a similar 
reappointment process to renew their membership and privilege status. 
This review evaluates the current competence of the health care 
providers and verifies whether they are maintaining the licensure or 
certification requirements of their specialty.
    The medical staff credentials and privileges records are stored in 
two ways: records stored in file folders are stored at the IHS 
facilities or the Federal Record Center, and computer-based or 
electronic records are located at the IHS Albuquerque Data Center in 
Albuquerque, New Mexico.
    The IHS is continuing to standardize, transform, and optimize the 
medical staff credentialing and privileging process into a centrally 
automated, standardized, electronic/digital, measurable, portable, 
accessible, and efficient business process to improve the effectiveness 
of application and re-application to medical staffs, movement of 
practitioners within the IHS system, and recruitment/retention of high-
quality LP.
    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 Responses per 
Respondent, Average Burden per Response, and Total Annual Burden Hours.

[[Page 30319]]



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                                                      Number of
                                      Estimated        annual        Average  burden hour  per     Total annual
  Data collection instrument(s)       number of     responses per           response *                burden
                                     respondents     respondent                                    (current) **
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Pre-Application Package to                    500               1  .50 (30 min)................              250
 Medical Staff.
Initial Application Package to                878               1  1 (60 min)..................              878
 Medical Staff and Privileges.
Reappointment Application Package           2,212               1  0.50 (30 min)...............            1,106
 to Medical Staff and Privileges.
Affiliation Verification.........           4,225               1  .25 (15 min)................            1,056
Education Verification...........           3,289               1  .25 (15 min)................              822
Malpractice Verification.........           2,535               1  .25 (15 min)................              634
Peer Reference Verification......           6,180               1  .25 (15 min)................            1,545
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    Total........................          19,819  ..............  ............................            6,291
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For ease of understanding:
* Average Burden Hour per Response are provided in actual minutes.
** Total Annual Burden (Current) are provided in hours.

    Annual number of respondents and average burden hour were factored 
based on total IHS providers credentialed and privileged Calendar Year 
(CY) 22, accreditation requirements with estimates of verification per 
applicant, and respondent estimate time of completion 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 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.

P. Benjamin Smith,
Deputy Director, Indian Health Service.
[FR Doc. 2023-09998 Filed 5-10-23; 8:45 am]
BILLING CODE 4165-16-P