Select a state regulation from a state of your choice on one of the below topics. Prepare an annotated copy of the regulation, including the sections you reviewed to answer the questions in the following format:
Prepare a four (4) to five (5) page written response addressing all information in the following table. Text must be double spaced. Also include a cover page and a reference page in APA Format (these do not count toward the page limit).Review the bolded formatting requirements in the Class Guidelines section of the Syllabus. Highlight five (5) notable parts of the regulation. For each of the parts, describe how the patient, provider, product developer, health care organization and/or payer may be impacted. Remember to write in narrative format except for titles. Use citations and attach the notated regulation. You must submit your topic in Week Five. Note a maximum of three (3) students may select the same topic. The topics are as follows:
Expert Solution Preview
Introduction:
State regulations have a significant impact on healthcare practices within a state. It is essential for medical college students to understand the regulations in their respective states to provide appropriate care to patients. In this answer, I will discuss the state regulation on the topic of “Physician Credentialing” in the state of New York. I have reviewed and annotated the regulation to provide a comprehensive understanding of its contents.
State Regulation on “Physician Credentialing” in New York:
The regulation on “Physician Credentialing” in New York is provided in the New York Codes, Rules, and Regulations (NYCRR) Title 10, Section 405.4. The regulation outlines the requirements for credentialing and recredentialing of physicians and other healthcare providers in the state of New York. The following are the notable parts of the regulation:
Part 1: Definitions
The section provides definitions for the terms used in the regulation, such as credentialing, recredentialing, healthcare organization, and practitioner, among others. This part impacts the provider, healthcare organization, and patient, as it establishes the criteria for credentialing and outlines the roles of each entity.
Part 2: Credentialing Requirements
This section outlines the requirements for credentialing of a practitioner, such as medical education, licensure, and malpractice insurance. It also requires healthcare organizations to verify the practitioner’s credentials before appointing them. This part impacts the provider, healthcare organization, and patient.
Part 3: Recredentialing Requirements
This section outlines the requirements for recredentialing of a practitioner, such as continuing education and evidence of clinical competency. It also requires healthcare organizations to conduct a periodic review of the practitioner’s performance. This part impacts the provider, healthcare organization, and patient.
Part 4: Privileging Process
This section outlines the process for granting privileges to a practitioner, such as delineation of privileges and peer review. It also requires healthcare organizations to ensure that the practitioner is qualified and competent to perform the privileges granted. This part impacts the provider, healthcare organization, and patient.
Part 5: Provisional Appointment
This section outlines the requirements for a provisional appointment of a practitioner, such as medical education and licensure. It also requires healthcare organizations to verify the practitioner’s credentials before granting provisional appointment. This part impacts the provider, healthcare organization, and patient.
Overall, the regulation on “Physician Credentialing” in New York impacts the provider, healthcare organization, and patient by establishing the criteria for credentialing and recredentialing of practitioners, outlining the process for granting privileges, and requiring healthcare organizations to verify the practitioner’s credentials and conduct a periodic review of their performance. The regulation ensures that the practitioners are qualified and competent to provide appropriate care to patients in the state of New York.
