Connected Care Alliance Seeks Support for New Telehealth Licensure Rules

The Alliance for Connected Care wants to make it easier for health systems and hospitals to use telehealth to treat patients no matter where they live.

The organization is seeking support for Consensus Principles on Telehealth Across State Lines, a document aimed at urging federal and state lawmakers to support licensure recognition in multiple states.

“Patients have long traveled across state lines for specialty care, but the COVID-19 pandemic has demonstrated that this care, particularly delivered through telehealth, can also help alleviate access issues in many other areas of health care,” the alliance says in a draft letter. “Looking beyond the public health emergency, one important way policymakers and health care regulators can permanently facilitate access to care is by allowing providers and patients to connect with each other regardless of their physical location.”

The effort targets a long-standing barrier to telehealth and mHealth expansion: federal and state policies that limit providers to practicing medicine in the state in which they’ve been granted a license. This forces providers to either acquire licenses from multiple states – a costly and time-consuming process – or restrict their patient base to specific states.

Several licensure compacts have sprung up in recent years that aim to promote interstate licensure by providing a streamlined path for providers to apply for licenses in multiple states, but critics note this still forces providers to seek multiple licenses. Others have suggested compacts that recognize one license in multiple states, or even one license that’s good across the entire country.

In its recent recommendations for federal policy changes to support post-COVID-19 telehealth expansion, the eHealth Initiative offered support for licensure portability through a compact that enables care providers licensed in one compact state to practice in any other compact state – much like the Nurse Licensure Compact (NLC). It noted the Interstate Medical Licensure Compact (IMLC), which is in effect in 29 states and Washington DC and has cost the HRSA some $7 million, focuses on expedited licensure, which still forces physicians to get a license in each state.

“Policymakers should ensure that all financial and policy incentives – including existing and new HRSA grants – encourage states to adopt a similar mutual recognition compact for physicians,” the report recommends. “This path forward recognizes the rights of states to regulate the practice of medicine within their borders, protects patients, and at the same time facilitates access to care across state lines.”

That strategy was also endorsed by the Taskforce on Telehealth Policy, launched this past June by the American Telemedicine Association, Alliance for Connected Care and National Committee for Quality Assurance. In its report to lawmakers issued in September, the group called for “allowing telehealth across state lines by considering strategies to expedite licensure reciprocity between states, while maintaining important patient protections and disciplinary tools for bad actors.”

In its missive to lawmakers, the Alliance for Connected Care recommends “state leadership with federal support.” The alliance says it supports “efforts to simplify and accelerate health professional licensure recognition across state lines,” which could come through compacts that allow states to recognize licenses from other states in that compact.

The alliance plans to send the document to federal and state policy makers this month, once it has secured signature from a wide range of organizations.