State Medical Boards Develop Interstate Compact to Help Ease Practice Across State Lines
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Home health agencies, private duty agencies, hospices and home medical equipment (HME) suppliers have wrestled with the issue of orders from physicians licensed in states other than the states in which patients live. Can home care providers accept these orders? Although this problem may be most common in areas close to state borders and rural areas, it is becoming more common in urban areas as patients travel out-of-state to seek specialized care. The problem also arises with regard to telehealth services.
Now the Federation of State Medical Boards, which is composed of state licensure boards in each state that license and discipline doctors, has drafted legislation in the form of an interstate compact (i.e., a legally binding agreement among states). The purpose of the interstate compact is to speed licensure of physicians who practice in multiple states. The compact permits doctors who meet certain requirements to apply for licenses in multiple states.
The proposed interstate compact will, however, preserve the authority of individual states to regulate the practice of medicine within their borders. Physicians must still comply with the laws and regulations of each state in which they are licensed to practice. To be effective in particular states, each state must approve and adopt it as a statute in its state. Once enacted by some or all of the states, the compact will be administered and enforced by an interstate commission. Working through this commission, doctors licensed in one state may seek expedited licensure from one or more additional states.
Specifically, the compact adopts the prevailing standard that the practice of medicine occurs where patients are located at the time of physician-patient encounters. Physicians are, therefore, required to be under the jurisdiction of the state medical board where patients are located. The compact creates another pathway for licensure that does not affect this prevailing standard. A physician who wants to be licensed in more than one state through the compact will file an application with the licensure board of the state that he/she chooses as his/her state of principal licensure. If the physician meets all applicable requirements, the state licensure board will issue a letter of qualification verifying the physician's eligibility.
Eligible physicians will then be required to complete a registration process established by the Interstate Commission described above to receive a license in another state that has adopted the compact. Licensure boards in any state that has adopted the compact will then be required to issue expedited licenses to physicians that permit them to practice in that state. Expedited licenses may be renewed.
The usefulness of the interstate compact for homecare providers will surely depend largely on how many states adopt the compact, so that physicians may seek expedited licensure from multiple states. Effectiveness will also depend upon physicians' willingness to be subject to multiple state licensure boards and to meet requirements of various states. It's a start toward addressing an issue that has periodically been problematic for many post-acute providers.
©2014 Elizabeth E. Hogue, Esq. All rights reserved.
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