A measure drafted by the Federation of State Medical Boards that enables physicians to practice across state lines is expected to take effect shortly, with seven states on board to honor the agreement and several more waiting in the wings.
The FSMB's Interstate Licensure Compact was adopted this past week by legislators in Alabama, passing the threshold of seven states needed to enact the compact. Idaho, Montana, Utah, South Dakota, Wyoming and West Virginia have ratified the compact so far.
Telehealth advocates – among them American Well CEO Roy Schoenberg, the Mayo Clinic, the American Medical Association and the American Academy of Pediatrics – have thrown their support behind the compact, which expedites the licensure process for doctors who want to practice in multiple states. The FSMB, a national non-profit representing the 70 medical and osteopathic boards of the U.S. and its territories, unveiled the compact in September 2014.
West Virginia is among the early adopters.
"The idea behind the compact is that simplifying the licensing procedure will enable more doctors to treat people in more states through the use of telemedicine, which involves doctors diagnosing and treating patients in another location through the use of telecommunications technology such as live video connections," an editorial in the May 4 edition of the Huntington Herald-Dispatch reported. "Such simplification also can be useful for physicians who work in various locations as temporary staff at hospitals, clinics and doctor's offices across the country. The hoped-for end result is that more physicians, even though they are not located within West Virginia, will be eligible to serve the state's residents so long as they meet the licensing requirements."
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In drafting the compact, FSMB officials pointed out that it wouldn’t change the medical standards of any state, but would create a voluntary path by which physicians could apply to practice medicine in other states. Each state's medical board would retain regulatory oversight.
"The interstate compact is expected to significantly reduce barriers to the process of gaining licensure in multiple states, helping facilitate licensure portability and telemedicine while expanding access to healthcare by physicians, particularly in underserved areas of the nation," the organization said in launching the compact last year.
"The interstate medical licensure compact model legislation creates a new process for faster licensing for physicians interested in practicing in multiple states and establishes the location of a patient as the jurisdiction for oversight and patient protections," the FSMB added. "The compact is a dynamic system of expedited licensure over which the member states can maintain control through a coordinated legislative and administrative process. Participation in an interstate compact would be voluntary, for both states and physicians.
Eleven states – Nevada, Minnesota, Iowa, Nebraska, Michigan, Illinois, Oklahoma, Texas, Vermont, Rhode Island and Maryland – have legislation pending to approve the compact.
“We applaud the progress being made to ensure that Iowans have access to quality healthcare services,” said Mark Bowden, executive director of the Iowa Board of Medicine, said in a January press release issued by the FSMB. “This legislation would expand access to telemedicine, making it easier for physicians to see patients. Everything about this legislation is a win-win for our state, our physicians, and most importantly, our patients.”
“The growing number of introductions in state legislatures represents the desire for a dynamic system of expedited licensure that simultaneously respects the inherent role of state regulatory agencies in protecting the public,” Humayun J. Chaudhry, the FSMB's president and CEO, added in the release. “At a time when some within the telemedicine industry seek to implement licensing frameworks that undermine and circumvent state licensing rules and practice requirements, the compact is a key element to ensuring state sovereignty while providing the license portability necessary to enhance the delivery of healthcare.”
Alabama's House of Representatives last week approved the compact, which awaits Gov. Robert Bentley's signature.
“This compact opens the door for more doctors to practice medicine in Alabama, which will improve medical care in under-served and rural areas,” Sen. Greg Reed, a co-sponsor of the bill, said in a story published in CorridorMessenger.com. “I’m glad to sponsor legislation that will give patients increased access to healthcare. Our state and country’s population is rapidly aging, and the compact will help address the dire physician shortage we face.”
“The Alabama Hospital Association supports this compact because it will speed up the process of issuing licenses for physicians who wish to practice in more than one state, while ensuring quality of care is a priority in approving those who seek licensure through the compact,” added Mike Horsley, president of the Alabama Hospital Association, in the story. “It will improve licensure portability and enhance the state’s ability to recruit physicians to rural Alabama.”
With Alabama's approval, the seven states on board would next create an Interstate Medical Licensure Compact Commission, which would include two commissioners from each participating state. That board would have up to 12 months to develop its bylaws for governing the compact.