Arkansas State Medical Board and CCVS Information Update 4/29/16

During 2015, the Arkansas State Medical Board was approached by legislators, hospital administrators, managed care administrators, physicians and other interested individuals regarding the length of time for a physician to go through the initial licensure process. November 2015 – the ASMB was asked to address this issue before the Legislative Joint Performance Review Committee. It was their intent that steps should be taken to create a more efficient process to allow physicians into the workforce at a much quicker rate. December 2015 – the ASMB voted to move forward with implementation of the following changes, some of which will be implemented in May 2016 and others will be implemented later as they are developed:

1)Licensure applicants may voluntarily utilize the Federation of State Medical Board’s CVO, (FCVS) for some of their primary source verifications.

What this means to CCVS customers. CCVS customers will see a difference on the CCVS Profile where the Verification Source would previously list Direct, Verbal Direct and Roster Direct. The Verification Source will state, “FCVS PSV” for those entries. This means the primary source verification was obtained from the Federation of State Medical Board’s Credentials Verification Service.

NCQA and The Joint Commission. The ASMB/CCVS staff have had several conference calls with both NCQA and the Federation regarding this change. Documentation has been received allowing the use of the FCVS. These changes should have no negative repercussions with The Joint Commission or any other certification or accreditation organization for the CCVS or for customers.

2)Licensure applicants may soon be able toutilize the Federation of State Medical Board’s Uniform Application. This would be voluntary and not mandated. The Board’s IT Department is working tirelessly to automate the FSMB Uniform Application data.

What this means to CCVS customers. There is no impact to CCVS customers. The application will be reconfigured by the ASMB and FSMB’s IT staff to meet the ASMB and CCVS requirements. The attestation will still be scanned and available for CCVS customers to view with their orders.

3)Verify the licensure applicant’s last 10 years of work history as opposed to collecting verifications from the date of graduation from Medical School. Exception would be made if the file contained any derogatory information in their education, work history or by other state boards.

What this means to CCVS customers. For the CCVS customer, this would mean that once these applicants are granted a license, their CCVS profile would contain the work history prior to the 10 years except if there is disciplinary action. The work history prior to the 10 years will be listed but not verified. Any licensee that was licensed before this change will already have the information prior to 10 years already on the profile. Any organization requiring the work history verifications prior to the 10 years may obtain it if it is notprovided on the new licensees’ CCVS profiles.

4)The work roster from Locum Tenens and Telemedicine contract companies will be allowed to serve as verification for the last 10 years of work history for licensure and CCVS purposes. A chronological list of activities will be included on the profile but not verified.

What this means to CCVS customers. The CCVS profile should now contain information and verifications that may not have been obtained previously or were listed as “Cannot verify, no response,” “Cannot verify, no records,” or “Cannot verify within PSV.”

5) Create a Graduate Registered physician license for those applicants waiting to match for postgraduate programs.

What this means to CCVS customers. CCVS profiles on these licensees will be available to order at the same price and turn-around-time as regular profiles but will only contain verification of medical school.

ELECTRONIC SIGNATURES The ASMB has made the decision to allow physicians to utilize electronic signatures in completing their paperwork for the ASMB and CCVS with the use of a disclaimer on the Organization Authorization and Release. Wet or dynamic signatures tend to slow processes down due to the exchange of paperwork. There are three types of physician electronic signatures that may fit this criteria.

According to the U.S. Federal ESIGN Act passed in 2000, an electronic signature is an "electronic sound, symbol, or process, attached to or logically associated with a contract or other record and executed or adopted by a person with the intent to sign the record.“ An electronic signature, or e-signature, is any electronic means that indicates either that a person adopts the contents of an electronic message, or more broadly that the person who claims to have written a message is the one who wrote it (and that the message received is the one that was sent by this person). By comparison, a signature is a stylized script associated with a person. In commerce and the law, a signature on a document is an indication that the person adopts the intentions recorded in the document. Both are comparable to a seal. In many instances, digital seals are also required for another layer of validation and security. Digital seals and signatures are equivalent to handwritten signatures and stamped seals.

Types of e-Signatures Signature that matches “wet” signature – usually signed on a device of some type with a special pen or your finger; Signature that appears just as a typed signature; There is an electronic digital signature symbol of some type where the signature normally would be.

The ASMB currently already uses an electronic signature that appears as a typed signature where the script or “wet” signature would normally be on a document. In using this “signature,” the ASMB maintains a secure processing on our end. In allowing the use by other organizations, that security for the physician has to be present at the source that is providing the document with the e-signature. A process to prevent a cut/paste signature from being applied to the document should be strictly enforced by the organization.

Digital Signatures A digital signature is a type of electronic signature, an electronic “fingerprint” in the form of a coded message, that offers more security than a traditional electronic signature because it links the signature to the signer’s identity by different methods. The signature contains the date/time it was signed and the public key (number). If the document changes after signing, it is invalidated.

Electronic signatures are easy to use. Documents can be “signed” with the click of a mouse or by using their fingers to trace a handwritten signature onto a device that will copy onto a document. An organization providing the electronic signature makes their own standards regarding the security of the signatures. Electronic signatures are an image placed on the document, but they cannot show whether someone tampered with the signature.

CCVS’S Organization-Specific A&R 1.In order to be able to utilize an electronic signature on the Organization Authorization and Release, the Board’s attorney has advised that a disclaimer would need to be added to that document to protect the ASMB. 2.Determining which type of e- Signature will be accepted, or whether all types will be accepted.

What has been completed… A draft Organization-specific Authorization and Release has been approved by the Board attorney. Current policies are being revised prior to posting and implementing. Website Posting of new form and policy change with effective date will be completed.

The following enhancements are in process and no implementation date has been assigned at this time. The ASMB will allow the use of American Express (in addition to those already in use) credit cards for payment of license renewals and CCVS orders once the new ordering system is implemented. The ASMB will move payment transactions from the ACH/Bank Draft system to Credit Card transactions only.

ASMB IT department is working on a checklist system that will allow CCVS customers to view the progress or status of their orders and see what is verified and what is pending verification. They will eventually be able to decide if they want to go ahead and obtain the order before completion or wait for completion. Also coming in future months, online A&R where the physician will check off the organizations he/she wants to have access to their credentials. Organizations can be added. A paper Organization A&R will no longer be needed.

Allied Healthcare and the CCVS Information Technology department is still working on rewriting the CCVS program to accommodate creating the availability of selling these profiles through the CCVS system. The data entry process to get the information in our system so a profile can be created is well underway.

CCVS User’s Manual Currently being updated for the current system but will be revised once the new processes are ready. What do customers want in the Guide, what can we add or change to make it more usable?

QUESTIONS?