WASHINGTON--Sen. Tom Udall (D-Utah) anticipates introducing a bill this spring to make it easier for physicians to practice telemedicine in many states instead of applying for a separate license for each state.
The bill, which is still being drafted, would streamline licensure portability across state lines, according to Fern Goodhart, Udall's legislative assistant.
"Telemedicine is medicine, just practiced virtually," she said at a Jan. 31 Capitol Hill briefing sponsored by the American Telemedicine Association (ATA), which advocates for use of remote medical technologies. Legislation may be needed because the private sector market has not generated medical license portability, even with the increasing adoption of health IT and networking capabilities, she said.
Physician licensure has been a barrier to telemedicine because digital health care does not stop at state borders. A physician, who may supply treatment remotely, must obtain a medical license in each of the states where patients receive care via telemedicine, said Jonathan Linkous, ATA CEO.
"It's time we explore nationwide licensure reform that will help to increase consumer choice, improve safety and cut costs," he said. States have the same basic licensure requirements.
Telemedicine is critical for access to quality care in rural areas, said Deanna Larson, vice president for quality and e-care initiatives for South Dakota-based Avera Health, which offers services across seven states in a primarily rural region of the country. The isolation also means that there is not a large enough population to support specialists in the area.
"These services are vital," she said. Tele-health has enabled the health plan to avoid $4 million in unnecessary transfer charges and admissions to hospitals. Larsen has assigned two employees just to do the lengthy paperwork for licensure.
"I'd rather have them working with patients," she said. Federal agencies that provide health care, such as the Veterans Affairs and Defense Departments, offer license portability for their physicians. In addition, the Fiscal Year 2012 National Defense Authorization Act, which President Barack Obama signed into law, incorporated the Servicemembers' Telemedicine and E-Health Portability (STEP) Act.
It overcomes some barriers to state licensure for telemedicine so service members can expand the private healthcare professionals available to them in a different state from where they are residing or posted, such as for mental health care, according to Darrell Owens, legislative assistant for Rep. Glenn Thompson (R-Pa.), who introduced the legislation.
"We will be collecting data to show that this model works," he said. The bill that Udall is developing would streamline licensure with a unified set of standardized data in a comprehensive and interoperable database of primary source verified credentials, Goodhart said. It could include claims history, hospital privileges, criminal background check with a unified application. The information would only have to be entered once.
"You can think of it as a national practitioner database or unified provider database or a federation-based credential verification source on steroids with improvements," she said. Ultimately, telemedicine could have nationwide or federal licensure, state reciprocity or mutual recognition and registration, Goodhart said.