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OIG asks for feedback on economic credentialing

Credentialing Resource Center Connection, January 10, 2003

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Dear Credentialing Colleague:

Late last year, the December 9th edition of the Federal Register (Vol.67, No.236) contained a section from the Office of Inspector General pertaining to "Safe Harbors and Special Fraud Alerts." This edition may be of interest to hospital credentialing professionals because it solicits public comment on so-called "economic credentialing" practices.

The American Medical Association has asked the OIG to issue guidance regarding the legality of certain privileging practices under the federal anti-kickback statute. The notice indicates that an increasing number of hospitals refuse to grant medical staff membership and clinical privileges to physicians who

• own or have other financial interests in, or leadership positions with competing health care entities
• refer to competing entities
• fail to admit some specified percentage of their patients to the hospital

I encourage medical staff services professionals to obtain a copy of this Federal Register and consider submitting their own responses ( go to http://oig.hhs.gov ). Clearly, this OIG notice has little to do with day-to-day credentialing tasks (i.e., processes for verifying a person's professional qualifications) and everything to do with a hospital's medical staff strategic planning. Not long ago, I wrote a letter about the increased use of the "intended practice plan" as a tool to encourage more significant commitment between physicians and their hospitals. To access this letter, click here.

As hospitals and their medical staff leaders continue to react to major changes in the health care landscape, carefully drafted strategic plans will become more important. But medical staff leaders and governing boards must realize that decisions to open or restrict medical staff membership must be made in the best interest of patients, the hospital, and the community it serves.

I am sure we will hear more about this issue in the near future.

That's all for this week.

All the best,

Hugh Greeley
www.greeley.com/seminars

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