Community hospitals in rural areas are likely to be the biggest beneficiaries of new legislation that Sen. Tom Udall (D-UT) is planning to introduce on Capitol Hill this spring. The bill, which is still being drafted, would allow physicians to practice telemedicine in more than one state without applying for a separate license in each state.
If passed, the legislation would make it easier for rural hospitals to arrange telehealth consults with specialists at academic medical centers in metropolitan areas, which are often located in different states.
And, according to InformationWeek Healthcare, it would also ease the barriers faced by health care systems and telemedicine companies that operate nationally or in multiple states. Finally, the legislation would pave the way for travelers or “snow birds” to consult with their own physicians if they have a medical emergency while away from home.
Current Telemedicine Barriers and Solutions
Currently, a physician who supplies treatment remotely must obtain a medical license in each of the states where patients receive his or her care via telemedicine. That’s not always an easy task. Fees for medical license applications vary across states, from a low of $110 to more than $1,300.
The time to obtain these licenses varies from 3 to 12 months, even though state licensing requirements vary little from one state to another. There is currently no state reciprocity for licenses unless physicians work within the Department of Veterans Affairs or the Indian Health Service.
The Udall bill would be the third major step in the past year to facilitate telemedicine by allowing physicians to practice simultaneously in different medical settings. Last year, Congress passed a bill that would allow providers in one state to use telemedicine to treat military personnel or veterans in another state.
Last summer, the Centers for Medicare and Medicaid Services made it easier for hospitals to grant privileges to physicians at other institutions who provide them with telemedicine services.
Licensing Portability
The new bill would create a national practitioner database that includes a set of standardized data on physician credentials. Physicians could include their claims history, hospital privileges and criminal background information in the database by completing a unified application.
According to a report by DrBicuspid, a dental industry website, the draft bill also gives states a variety of options for carrying out license portability, such as allowing a physician who is unlicensed in one state to practice medicine in that state if consulting on a case for a licensed physician.
States could also enter into reciprocity agreements to recognize certain medical privileges, could voluntarily accept a physician’s home-state licensure, or could accept the license of an out-of-state physician provided certain conditions are met.
The bill would also authorize a tandem license that would enable a licensed health care professional to provide telehealth services in any state recognizing that license. Incentives would be provided for states to accept tandem licenses.