The Joint Commission recently announced it has changed its accreditation rules to enable more hospitals and telemedicine companies to use the streamlined “credentialing by proxy” process. Under the change, the distant site telemedicine entity must be accredited with The Joint Commission or enrolled in the Medicare program. Previously, the rules required both the originating site hospital and the distant site entity to be accredited with The Joint Commission. That requirement of dual-accreditation was exclusively created by The Joint Commission, and was not mandated by the CMS Medicare regulations.

This is a welcome change that will enable more hospitals and more distant site telemedicine entities to avail themselves of the more efficient and less expensive proxy credentialing process in their hospital B2B telemedicine service agreements. Both rural and originating site hospitals, as well as telemedicine companies offering professional services to those hospitals, will benefit from this change.

The rule change is found in Standard MS.13.01.01, EP 1. It is effective immediately and will be included in the spring 2021 update to The Joint Commission’s Comprehensive Accreditation Manual for Critical Access Hospitals (CAMCAH) and Comprehensive Accreditation Manual for Hospitals (CAMH).

What is Credentialing by Proxy?

The Medicare Conditions of Participation require hospitals and certain other accredited health care facilities and providers to have a credentialing and privileging process for physicians and practitioners providing services to their patients. This includes practitioners who provide services via telemedicine. Recognizing the inherent differences between in-person care and virtual care (including, for smaller and rural hospitals, the potential complexities associated with credentialing multiple specialist and sub-specialist applicants), the Conditions of Participation allow a process for streamlined credentialing of telemedicine-based practitioners, allowing hospitals to more efficiently harness the benefits of telemedicine and comply with the Conditions of Participation without incurring the full administrative burden associated with the traditional credentialing process.

This streamlined process is commonly referred to as “credentialing by proxy.” It permits the hospital receiving the telemedicine services (known as the “Originating Site” hospital) to rely on the privileging and credentialing decisions made by the hospital or a non-hospital entity providing the telemedicine services (known as the “Distant Site” hospital or “Distant Site Telemedicine Entity,” respectively), provided certain requirements are met.

Credentialing by proxy is one of many regulatory features that, while complex, can be a great opportunity for hospitals and telemedicine companies to deliver their services faster and at lower administrative cost. Telemedicine companies and hospitals that understand and implement these processes will be better positioned in the marketplace to more nimbly deliver services to patients across locations and geographies.