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  • Credentialing & Privileging

  • Credentialing & Privileging

    Federal Tort Claims Act - protected Health Centers are required to initially credential, and periodically privilege, all clinicians who are required by their state to be licensed or certified. Individual states establish the requirements for which professionals must be licensed or certified. You should ensure that a thorough credentialing process has been undertaken for each clinician involved with your Health Center, and that those clinicians regularly undergo a Health Center privileging process.


    This Health Center FTCA requirement is identified in both the Federally Supported Health Centers Assistance Act of 1992, and PIN 2001-16. These documents require that each deemed Health Center that participates in the FTCA must credential all its physicians and all other licensed or certified health care practitioners. Specifically "A Health Center must verify that its licensed or certified health care practitioners possess the requisite skills and expertise to manage and treat patients and to perform the medical procedures that are required to provide the authorized services. It is incumbent on the Health Centers to assure their users that Health Center practitioners have met standards of practice and training that enable them to manage and treat patients and/or perform procedures and practices with a level of proficiency that minimizes the risk of causing harm. The organization must adopt its own policy that outlines specific privileging requirements and the periodicity of the review of privileges for all licensed or certified health care practitioners."


    All Health Centers participating in FTCA malpractice claims protection are required to periodically privilege their providers. You should develop and adhere to formal privileging policies, procedures and timetables that encompass each Health Center related clinician.

    The privileging process could, for a physician, involve a combination of the following: 1) Primary source verification of a course of study from a recognized and certifying educational institution showing that the clinician met or passed a level of training required to perform a defined procedure or management protocol. 2) Direct first hand one-on-one documentation by a supervising clinician who possesses the privilege of the particular procedure or management protocol. 3) Direct proctoring by a qualified clinician possessing a degree of expertise in the particular procedure or protocol beyond the level of expertise of most primary care providers. Whatever verification procedures used should be appropriate to the specialty of each practitioner, the breadth of clinical services offered by the Health Center and the particular circumstances of the clinic's accessibility to ancillary and tertiary medical practitioners.

    This information came from an
    HRSA online article.

    *** Any law, statute, regulation or other precedent is subject to change at any time ***

    **Any laws cited may not apply in your jurisdiction - Consult a local lawyer.**

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