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Cross-State Licensing Compact Gains Momentum

The voluntary effort to streamline licensing for doctors wanting to practice in other states now includes a dozen states, with eight more considering legislation. It's especially attractive to telemedicine advocates.

By Eric Wicklund

- Twelve states have now signed an agreement to streamline the licensing process for clinicians wanting to practice medicine across state lines.

Wisconsin became the latest state to join the Interstate Medical Licensure Compact, with Gov. Scott Walker singing the legislation into law on Dec. 14. The compact became official this past May, upon its adoption by a seventh state.

Billed as “an expedited licensure process for eligible physicians that improves license portability and increases patient access to care,” the compact offers an appealing platform for health systems that are using telemedicine or want to expand their reach across state lines. It’s overseen by the Washington, D.C.-based Federation of State Medical Boards, a non-profit representing more than 70 medical and osteopathic boards in the United States and its territories.

Advocates point out the compact doesn’t change licensing standards in any state or deprive any state of its right to regulate doctors. It creates a voluntary path by which physicians can apply to practice medicine in other states.

"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 unveiling the compact in 2013.

"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.”

Other states in the compact are Illinois, Iowa, Minnesota, South Dakota, Wyoming, Montana, Idaho, Utah, Nevada, Alabama and West Virginia. Another eight states – Vermont, Rhode Island, Maryland, Pennsylvania, Michigan, Nebraska, Oklahoma and Texas, have legislation pending.

Wisconsin’s bill had the support of the Wisconsin Medical Examining Board, Wisconsin Medical Society, Wisconsin Hospital Association, Mayo Clinic Health System and Gunderson Health System, among others.

"We are proud that Wisconsin has joined the Interstate Medical Licensure Compact to ensure that all its patients have access to quality health care, while maintaining the highest level of patient protections," Dr. Kenneth B. Simons, the WMEB’s Chairperson, said in a prepared statement. "By facilitating medical license portability, the compact will benefit both physicians and patients in Wisconsin and across the nation."

Nationally, the compact is supported by the American Medical Association, American Osteopathic Association, American Academy of Pediatrics and American College of Physicians. More than a dozen senators - Sens. John Barrasso (R-Wyo.), John Thune (R-S.D.), Shelley Moore Capito (R-W.Va.), Thad Cochran (R-Miss.), Steve Daines (R-Mont.), Mike Enzi (R-Wyo.), James Inhofe (R-Okla.), James Lankford (R-Okla.), Mike Lee (R-Utah), Joe Manchin (D-W.Va.), Jon Tester (D-Mont.), Mark Warner (D-Va.) and Roger Wicker (R-Miss.) - have also announced their support.

In a position paper issued in November, the ACP announced that it “supports a streamlined process to obtaining several medical licenses that would facilitate the ability of physicians and other clinicians to provide telemedicine services across state lines while allowing states to retain individual licensing and regulatory authority.”

West Virginia was one of the first adoptees.

"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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