by Audrey Kinsella
Imagine being issued a driver's license that is only recognized in the issuing state. Before you may drive across a state line, you would have to obtain a separate license in that state. It might not matter much if you live in Hawaii, or even in Anchorage, Anaheim or Austin. In the Northeast states, however, it would present a bit of a problem.
In this era of telemedicine, where the physical location of patients and caregivers no longer limits care, people in leadership positions have begun to ask why medical licenses cannot be treated like driver's licenses and be honored in every state. Federal law currently requires every practitioner to obtain a unique license to practice medical care, including telemedicine, in each state in which they want to deliver care services. Care location is defined as the patient's location, preventing specialists from remotely treating a person in need without one of them jumping on an airplane.
This limitation has been in contention for some years. (See "Lawmaker Proposes Government Health Insurance Cover Telehealth Services" in HCTR, 1/16/2013.) Jon Linkous, CEO of the American Telemedicine Association stated then, "I draw the equivalence to, say, driving. You're located in California, you can drive anywhere in the country as long as you have a valid California license. Why can't we do something similar for healthcare?"
A few exceptions apply
According to Gary Capistrant, the ATA's Senior Director of Public Policy, nurses who reside in states that are part of the "Nurse Licensure Compact" – an agreement that allows mutual recognition of a RN or LPN nursing license between member states – may practice nursing physically or electronically in any other member state without obtaining additional licensure in those states. A listing of the 24 participating states can be found on the web site of the National Council of State Boards of Nursing.
The ATA has been rallying telemedicine advocates to urge legislators to support two pending bipartisan bills stalled in Congress – H.R. 3077 and H.R. 2001 – which were referred to committee 11 and 14 months ago, respectively. Each would mitigate the per-state licensure requirement for healthcare professionals by creating a comprehensive, federal interstate telehealth license. More details about these bills are available at:
Though GovTrack.us gives these bills a 1% and 2% chance of being enacted, the ATA web site asserts that, if they are, a health care professional would need only one state license to serve certain patients, those covered under a specific federal health program, anywhere in the U.S. Passage of these bills would help health care practitioners bring care to less accessible populations in both urban and rural areas for whom telemedicine may be the only way to provide care.
Audrey Kinsella, MA, MS, is HCTR's telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at audreyk3@charter.net or 828-348-5308.
©2014 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com