State Medical Boards Revamp Licensure Laws to Make Room For Telehealth

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The Federation of State Medical Boards has announced sweeping changes to  medical licensing requirements, representing the largest legislative change to the laws in decades. The law is controlled through a compact which will need to be adopted by each state’s legislative body. These interstate compacts provide a way for states to agree upon legislative changes that will have a national effect without having to work through the federal layers of the government. For medical licensure, these compacts are drafted by the Federation of State Medical Boards.

For the past year, delegates have been collaborating on a new compact with the goal of making state medical licenses more portable. The team set out to clear the way for innovative telehealth programs that have the potential to reduce national ER visits, and thus drive down health care spending. A secondary hope is that telehealth visits could supplement traditional practices to help alleviate the physician shortage, a problem that is only expected to intensify as the Affordable Care Act expands insurance coverage to millions of additional Americans.

The final compact achieves these goals by establishing that “the practice of medicine occurs where the patient is located at the time of the physician-patient encounter,” essentially mandating that physicians will need to have state licenses from multiple, or possibly many states to provide care. By establishing this framework, states are able to maintain their own specific physician credentialing laws, something that state medical boards were reluctant to give up.

To alleviate the logistical headache of maintaining multiple state licenses, the compact establishes what it is calling an “expedited license” process that will allow physicians to apply for licensure to multiple states with minimal cost or paperwork. To be qualified, physicians must meet certain conditions:

  • Certified in a medical specialty from at least one state
  • No history of being disciplined, penalized, or punished by a court, medical licensing agency, or the DEA.
  • Cannot be “under active investigation by a licensing agency or law enforcement agency.

As the compact is written, about three-quarters of the total US physician population would qualify for multi-state licensure. In addition to streamlining licensure requirements, the law also establishes that states will implement data sharing processes to ensure that information about physicians that have had their licenses revoked, or that are under investigation for crimes such as overprescribing or Medicare fraud, are identified early. This has been a problem area for state’s in the past.

Sixteen senators from both parties wrote a letter in response to the new compact supporting the effort to usher in an era of expanded telehealth availability. The compact will spend the rest of 2014 being finalized, and then will be ready for state-level adoption sometime in 2015.


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