Arizona Association of

Medical Staff

Services Newsletter

APRIL 2008

Did You Know…

THANK YOU TO OUR SPONSORS

Gold Level Sponsor:
Morrissey Associates

MESSAGE FROM THE PRESIDENT

Networking:

On March … Lisa Rojo conducted our first networking session at 7^th Heaven in downtown Phoenix.  The food, fun and atmosphere were great and the evening provided many networking opportunities.  AAMSS will be conducting additional networking session throughout 2008.

Education:

The Basic Credentialing Workshop was held on March 21^st with a record attendance of 42 attendees.  Thank you Candy Williams for conducting this workshop for AAMSS members.  The feedback was positive as always and we hope Candy will agree to conduct other sessions going forward.

The April conference brochures are out.  The conference is scheduled for April 25^th.  If you have not received a brochure please email me at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it – the lineup of speakers is very exciting and I look forward to additional networking opportunities.

The Education Committee will be meeting shortly to determine additional workshops and educational opportunities for the remainder of 2008.  We hope to announce some of these at the April workshop.

Newsletter:

Your first addition of an electronic newsletter!  We hope you enjoy it and have Mary Heller to thank for all the hard work and dedication she has put into this project.  Give us some feedback on how you like the project or if you have news to share. This e-mail address is being protected from spam bots, you need JavaScript enabled to view it   

Membership:

Renewal applications are being processed.  Membership remains strong.  If you have not sent in your renewal notice please do so ASAP.   If you need a new application please let us know.

Leilani Wilson has been working night and day on our new website design and construction.  She will provide a brief presentation on the new project at the April conference.

-     Karen Salas, CPCS, CPMSM

      AAMSS President

MEET YOUR AAMSS BOARD OF DIRECTORS

Karen Salas, CPCS, CPMSM – President - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Leilani Wilson, CPCS - President Elect - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Patti Hull, CPCS - Past President - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Margie Arend, CPCS - Secretary - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Carol Garrison, CPCS, CPMSM – Treasurer - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Mary Lou Erwin, CPMSM - Member at Large - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Sharon Giles, CPCS, CPMSM, CPHQ - Member at Large - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Christi Irwin, CPCS, CPMSM - Member at Large - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Lisa Rojo, CPCS, CPMSM - Member at Large - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Mary Heller, CPMSM - Member at Large - This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Who does what?

Budget/Finance – Carol Garrison This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Certification – Sharon Giles This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Education  – Patti Hull, Lisa Rojo This e-mail address is being protected from spam bots, you need JavaScript enabled to view it    This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Membership – Christi Irwin This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Newsletter – Mary Heller This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Secretarial – Margie Arend  This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Social Networking – Lisa Rojo This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Staff Affiliation Workout – Karen Salas This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Website – Leilani Wilson This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

CREDENTIALING AND PEER REVIEW

The July, 2007 Phoenix Edition of the M.D. News contained an article by attorney Calvin  Raup of Raup & Hergenroether, PLLC. (read the full article here) Mr. Raup discusses the issues involved in credentialing and peer review. Credentialing is a requirement of the Joint Commission as well as the Center for Medicare and Medicaid Services (CMS) and the State of Arizona. Negligent credentialing is a hot topic in the legal circles. Arizona hospitals are not held liable for the negligence of their medical staff members, however, the hospitals can be held liable for credentialing a physician if it did so while consciously disregarding a substantial risk or significant harm, or if it consciously pursued a course of conduct knowing it created a substantial risk of significant harm.

Arizona understands and protects the importance of peer review and confidentiality. We have all heard that peer review is strictly confidential. There are, however, two exceptions to this statute: The Arizona Medical Board and the Arizona Osteopathic Board may request, and are entitled to receive and consider confidential peer review materials because investigations by these two Boards are confidential.

Hospitals are immune to civil suits seeking monetary damages. This state statute is reinforced by the Health Care Quality and Improvement Act (HCQIA). HCQIA presumes its Fair Standards have been followed, however, may be challenged by a preponderance of evidence to the contrary. Individual physicians involved in the peer review process are also protected and, therefore, have no exposure.

It is often a misconception that physicians have a right to medical staff privileges – this simply is not the case. The burden of proof is on the applicant, including the proof that the applicant meets the criteria set by the medical staff. Denial of membership is not necessarily reportable to the National Practitioner Data Bank (NPDB) unless denial is based on professional conduct or competence.

Anytime a practitioner’s privileges are suspended, revoked or limited, the hospital must comply with its own bylaws – including the fair hearing process. Any deviation from the bylaws opens the facility up to liability. Although the Medical Staff has taken the action of suspending, revoking or limiting a physician’s privileges, the burden of proof remains with the physician to prove that the action was not justified, was arbitrary or capricious.

While peer review is a necessary part of quality health care, it is never pleasant. Fortunately, the state and federal governments have put into place safeguards that maintain confidentiality and immunity for those involved in the peer review and credentialing process.

AAMSS ANNUAL CONFERENCE

CERTIFICATION

The Certified Professional Credentialing Specialist (CPCS) and Certified Professional Medical Services Management (CPMSM) examinations are the standard in the medical services profession and are a symbol of excellence within the industry. Earning the credential signifies that an individual has demonstrated the knowledge and skills required to perform competently in today's complex medical credentialing environment. AAMSS would like to acknowledge and extend our congratulations to the following 2007 NAMSS certificants:

CPCS:

Cheryl Bohucki

Louise Jackson

Mary Varjabedian

Mary Heller

Guadalupe Mendoza**

Melinda Ogden**

** dual certification

The certification cycle begins at the time of notification of successful completion of the certification examination and continues through October 31, three years later, and every three years thereafter. The certification cycle for those holding dual certification begins at the time of notification of successful completion of the first certification exam and continues through October 31, three years later, and every three years thereafter. Subsequent certifications are rolled into the initial certification cycle.

Certification Study Group

Scholarships are offered to AAMSS members in order to provide professional and financial support to promote the profession. The Carol Scott Memorial Scholarship provides one person the opportunity to attend the National Association of Medical Staff Services (NAMSS) conference. The winner of the Carol Scott Memorial Scholarship will be announced at the April AAMSS conference.

Additionally, in an effort to encourage AAMSS members to achieve the CPCS and/or the CPMSM certification, AAMSS offers Certification Scholarship opportunities to its members.   The Certification Scholarship provides financial assistance for two people to become certified.  The awarding of the certification scholarships will be conducted in May. Please contact Sharon Giles at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it if you are interested in applying for any of  the scholarships.

The Continuing Education (CE) requirements for dual certificants have changed beginning with recertification in 2010.  The two certifications (CPMSM and CPCS) were created because there are distinct differences in the level of skill, knowledge and expertise needed to perform the specific job functions and to pass each exam. Therefore, since such differences exist at initial certification, those same differences will exist at recertification.   Therefore, beginning with the 2010 recertification cycle, all dual certificants will be required to obtain 45 CE credits for recertification, of which 25 must be NAMSS approved. This requirement becomes effective with the first recertification cycle in which you hold dual certification for the entire three-year period.  For example, if you were, or are due for:

• Recertification in 2007, 45 credits will be due in the next recertification cycle of 2010.
• Recertification due in 2008, 45 credits will be due in the next recertification cycle of 2011.
• Recertification due in 2009, 45 credits will be due in the next recertification cycle of 2012.

NPI UPDATE

The National Provider Identifier (NPI) database is now up and running. The NPI is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses will use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-digit, intelligence-free numeric identifier. This means that the numbers do not carry any other information about healthcare providers, such as the state in which they live or their medical specialty.

NPI usage for all covered providers and organizations became effective May 23, 2007. The next stage is quickly approaching. Effective May 23, 2008 all small health plans must also use NPIs. This means, the NPI will be required for all HIPAA Standard Transactions on May 23^rd, 2008.

The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.

All individual HIPAA covered healthcare providers or organizations (hospitals, home health care agencies, nursing homes, residential treatment centers, group practices, laboratories, pharmacies, medical equipment companies, etc.) must obtain an NPI for use in all HIPAA standard transactions, even if a billing agency prepares the transaction. Once assigned, a provider's NPI is permanent and remains with the provider regardless or job or location changes.

AAMSS ANNUAL BYLAWS REVIEW

MINUTES 101

At one time or another, if you work in a medical staff office, you will most likely be asked to take minutes at a meeting. Once you get past the initial panic stage, relax, breath and realize you can do it. Minutes don’t have to be as imposing as they seem. All it takes is a little practice and a lot of organization.

Whenever possible, prepare ahead of time and understand the purpose of the meeting. This will give you a head start on what to expect during the course of the meeting - making note taking that much easier.

Most facilities use Roberts Rules of Order (http://www.robertsrules.com/ ) for their parliamentary procedures which also makes meetings more organized and, again, easier to take notes.

Minutes do not need to be very long, they must however contain:

●     What decisions were made;

●     Who proposed and supported items for decision;

●     The result of any votes (the numbers in favor, against and any abstentions);

●     What action was agreed;

●     Who was given responsibility to carry out the action and by when.

A few more helpful hints:

●     Don’t write everything down, just the main points of a discussion, decisions and actions.

●     Produce rough notes shortly after the meeting and check them with the Chairperson.

●     Give each item a separate heading, ensuring the minutes follow the same order as the agenda.

●     Write the minutes in a consistent style.

●     Retain copies of the minutes in a file for future reference.

PHYSICIAN ASSISTANTS UPDATE

Since Arizona established the Physician Assistant Practice Act (the Act) in 1973, the physician assistant practice in the community has evolved extensively. The notion of a PA working alongside a single physician in a private office has given way to PAs working with multiple physicians in large group practices, in busy emergency departments, or alone in an office separate from the physician’s primary office. Interpreting and applying the Act in this ever-evolving environment requires balancing the need for the evolution of safe healthcare practices with the requirement to maintain proper oversight of the profession. In analyzing the Act and the evolving community practices, the Arizona Medical Board (AMB) and the Arizona Regulatory Board of Physician Assistants (ARBOPA) identified seven areas of common misconceptions and concerns:

I.    The legal requirements for physician assistants to perform healthcare tasks;

II.   The meaning of the physician assistant’s dependent relationship with a supervising physician;

III.  The role of the Notice of Supervision in establishing the physician assistant’s practice parameters;

IV. The supervising physician’s responsibility for physician assistant supervision;

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