[Federal Register Volume 88, Number 144 (Friday, July 28, 2023)]
[Notices]
[Pages 48896-48898]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-16011]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Request for Public Comment: 30-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: August 28, 2023. 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.

FOR FURTHER INFORMATION CONTACT: To request additional information, 
please contact Evonne Bennett, Information Collection Clearance Officer 
by email at: [email protected] or telephone at 240-472-1996.

SUPPLEMENTARY INFORMATION: This previously approved information 
collection project was last published in the Federal Register on May 
11, 2023 (88 FR 30317), and allowed 60 days for public comment. There 
was one public comment received in response to the notice. This notice 
announces our intent to submit this collection, which expires August 
31, 2023, to OMB for approval of an extension with revisions, and to 
solicit comments on specific aspects for the proposed information 
collection.
    A copy of the supporting statement is available at 
www.regulations.gov (see Docket ID IHS-2023-0001).
    Comment: Commenter requested the IHS review the medical staff 
credentials application and revise or remove any invasive or 
stigmatizing language around mental health.
    Response to Comment: The IHS does not believe there are any 
stigmatizing language around mental health in the application. Should 
specific stigmatizing language be presented to IHS, IHS will review the 
language and then determine whether remedial action needs to be taken.
    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

[[Page 48897]]

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.
    Indian Health Service policy specifically requires all LP (i.e., 
Federal employees, contractors, and/or 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 Indian and Alaska Native patients. 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 the individual's 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; (3) Reappointment Application for Membership and 
Privileges; and (4) Credentialing by Proxy (CBP) Intake Form. The first 
three application packets include an IHS Conditions of Application and 
Release and Health Attestation Statement for the LP to sign; Item 4, 
the CBP Intake Form, only includes an IHS Conditions of Application and 
Release.
    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 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 staff, 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.

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                                        Estimated                                                  Total annual
   Data collection instrument(s)        number of     Responses per   Average  burden hour  per       burden
                                       respondents     respondent             response *           (current) **
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Pre-Application Package to Medical              500               1  .50 (30 min)...............             250
 Staff.
Initial Application Package to                  878               1  1 (60 min).................             878
 Medical Staff and/or Privileges.
Reappointment Application Package             2,212               1  0.50 (30 min)..............           1,106
 to Medical Staff and/or Privileges.

[[Page 48898]]

 
Credentialing by Proxy Intake Form.             250               1  .25 (15 min)...............              63
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..........................          20,069  ..............  ...........................           6,354
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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 
2022, 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. 2023-16011 Filed 7-27-23; 8:45 am]
BILLING CODE 4165-16-P