How is hospital credentialing being handled during the COVID-19 crisis?

For reappointments, the Joint Commission issued guidelines the week of March 23rd which allow hospitals to extend current/existing medical staff membership and clinical privileges until this national emergency ends, plus 60 days after that, while reappointments are completed. You can read more here.

Can a physician treat patients while they are being credentialed and bill the insurer?

A physician at a group practice in Virginia should be able to treat right away while they get credentialed, then bill the plan for claims thereafter (HB 139 from the 2018 session).

Is there any regulatory malpractice relief available during COVID-19?

See the liability statues below. Please consult your lawyer with concerns or questions.

 § 8.01-225.02. Certain liability protection for health care providers during disasters.

A. In the absence of gross negligence or willful misconduct, any health care provider who responds to a disaster shall not be liable for any injury or wrongful death of any person arising from the delivery or withholding of health care when (i) a state or local emergency has been or is subsequently declared in response to such disaster, and (ii) the emergency and subsequent conditions caused a lack of resources, attributable to the disaster, rendering the health care provider unable to provide the level or manner of care that otherwise would have been required in the absence of the emergency and which resulted in the injury or wrongful death at issue.

B. For purposes of this section:

“Disaster” means any “disaster,” “emergency,” or “major disaster” as those terms are used and defined in § 44-146.16; and

“Health care provider” has the same definition as provided in § 8.01-581.1.

§ 8.01-225.01. Certain immunity for health care providers during disasters under specific circumstances.

A. In the absence of gross negligence or willful misconduct, any health care provider who responds to a disaster by delivering health care to persons injured in such disaster shall be immune from civil liability for any injury or wrongful death arising from abandonment by such health care provider of any person to whom such health care provider owes a duty to provide health care when (i) a state or local emergency has been or is subsequently declared; and (ii) the provider was unable to provide the requisite health care to the person to whom he owed such duty of care as a result of the provider’s voluntary or mandatory response to the relevant disaster.

B. In the absence of gross negligence or willful misconduct, any hospital or other entity credentialing health care providers to deliver health care in response to a disaster shall be immune from civil liability for any cause of action arising out of such credentialing or granting of practice privileges if (i) a state or local emergency has been or is subsequently declared; and (ii) the hospital has followed procedures for such credentialing and granting of practice privileges that are consistent with the Joint Commission on Accreditation of Healthcare Organizations’ standards for granting emergency practice privileges.

C. For the purposes of this section:

“Disaster” means any “disaster,” “emergency,” or “major disaster” as those terms are used and defined in § 44-146.16; and

“Health care provider” means those professions defined as such in § 8.01-581.1.

D. The immunity provided by this section shall be in addition to, and shall not be in lieu of, any immunities provided in other state or federal law, including, but not limited to, §§ 8.01-225 and 44-146.23.

(2003, c. 507; 2008, cc. 121, 157.)