As telemedicine hospitalists, one of the biggest challenges for Dr. Dana Giarrizzi and her staff is learning and staying updated on the many different state licensing rules.
Renewal time and dates vary, along with state requirements to become licensed and remain current, said Dr. Giarrizzi, national medical director for telehospitalist services at Eagle Hospital Physicians, based in Atlanta.
“One state renews on your birthday,” she said. Another “renews when you first activated your license. This one is every 2 years. This one requires CME. It’s hard to keep up with all the rules, and it’s costly.”
Dr. Giarrizzi believes a federal licensure process would be ideal, but she is also hopeful about state legislation in the form of the Interstate Medical Licensure Compact. The model legislation was developed by the Federation of State Medical Boards (FSMB) and aims to make it easier for telemedicine physicians to gain licenses in multiple states.
Under the legislation, physicians designate a member state as the state of principal licensure and select the other states they wish to gain licenses within. The state of principal licensure then verifies the physician’s eligibility and provides credential information to the interstate commission, which collects applicable fees and transmits the doctor’s information to the other states. Upon receipt in the additional states, the physician would be granted a license.
As of early October 2015, 11 states had enacted the compact legislation, and at least 19 states had introduced the legislation. In July, the Health Resources and Services Administration awarded the FSMB a grant to support establishment of the commission and aid with the compact’s infrastructure.
Ms. Lisa Robin
Broad support by medical associations, patients, and state leaders have quickly propelled the compact forward, said Lisa Robin, FSMB chief advocacy officer.
“I think the boards recognize the potential for telemedicine and what that can bring as far as access to health care,” Ms. Robin said. “As technologies are here – and it’s changing every day – this is a mechanism that will allow for much more efficiency and less administrative burden on the process for licensure for physicians who want to practice in multiple states.”
There have been several misconceptions tied to the compact law, Ms. Robin noted.
The compact does not change a state’s medical practice act, she stressed, nor does it create a national licensure system. In addition, the legislation does not require a physician to participate in maintenance of certification at any stage. Under the compact, approved physicians would be under the jurisdiction of the state medical board in which the patient is located at the time of the medical interaction. State boards of medicine would retain their individual authority for discipline and oversight.
Dr. Reed V. Tuckson
The compact hopefully will reduce physicians’ frustrations and lessen administrative hassles for doctors who wish to use telehealth technologies to bring their expertise to patients across multiple states, said Dr. Reed V. Tuckson, president of the American Telemedicine Association.
“There have been several models proposed to address both of these objectives, and it appears that the Federation of State Medical Boards’ licensure model compact has emerged as the most practical and implementable of the various approaches,” Dr. Tuckson explained. “We do hope that this compact model can function efficiently and cost effectively, so that physicians are not overburdened as well-meaning organizations attempt to ensure that the public’s interests are safeguarded.”
Dr. Giarrizzi of Eagle Hospital Physicians is also optimistic about the compact.
“I am hoping this helps streamline the information,” she said. “I know it will still take time, because it is not taking away the need to go through the process, but seems more like it is just sharing the information. It will make it easier for us to cross state lines if the states we want to work in agree with this process and participate.”
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