CMS plan could take a bite out of teleradiology night reads

Proposed new credentialing requirements could make it more difficult for hospitals to contract with teleradiologists to provide night and weekend call, a legal analysis concludes.

The proposal by CMS would require all Medicare-participating hospitals to separately credential and privilege teleradiologists, according to a July 29 memorandum from the ReedSmith law firm to radiology clients and friends of the firm. The rule would eliminate a process known as “proxy credentialing,” whereby a hospital accredited by the Joint Commission could accept the credentialing and privileging decisions of a Joint Commission-accredited teleradiology company.

While the proposed rule could raise a barrier to teleradiology companies looking to poach hospital business from local radiology groups, the analysis speculates it would also probably work to the detriment of community-based radiologists by making it more difficult for them to obtain night and weekend call service.

Hospitals and teleradiology companies intent on entering an agreement could probably invest the time and resources needed to meet the tougher credentialing standards, but in other circumstances, hospitals and radiology groups may simply avoid bringing in a teleradiology service or enter negotiations on how to absorb the added cost.

The new rule would go into effect in March 2011 and could be modified before then, according to ReedSmith.

Although proxy credentialing through the Joint Commission would be prohibited, hospitals could rely on a “distant site” process that could reduce some of the credentialing burden for those wishing to employ a teleradiology service. But this approach will probably work only when both hospitals are part of the same system and have an incentive to share information, according to the analysis.

“While organized radiology appears happy with the obstacles created by the potential elimination of proxy credentialing, my opinion is that radiologists will face hospitals that will be less receptive to their supplemental teleradiology coverage,” said Thomas Greeson, an attorney with ReedSmith who co-authored the analysis. “I believe efficient credentialing would be a better approach to keeping hospitals happy with outside teleradiology backup coverage.”