Medical Licensing Compact

Several medical professions have been working with CSG’s National Center on Interstate Compacts to explore the use of compacts to promote license portability to ensure access to high quality health care. These efforts have the potential to help facilitate telemedicine and widen access to a variety of medical services. Licensing compacts also provide a mechanism to ensure state regulatory agencies maintain their licensing and disciplinary authority. This session featured a discussion about the proposed compacts and their potential to enhance access to medical care across the states.

Several medical professions have been working with CSG’s National Center on Interstate Compacts to explore the use of compacts to promote license portability to ensure access to high quality health care. These efforts have the potential to help facilitate telemedicine and widen access to a variety of medical services. Licensing compacts also provide a mechanism to ensure state regulatory agencies maintain their licensing and disciplinary authority. This session featured a discussion about the proposed compacts and their potential to enhance access to medical care across the states.

Policymakers attending The Council of State Governments’ National and CSG West 2014 Annual Conference in Anchorage, Alaska, will have an opportunity hear about a new distance learning compact being developed by CSG’s National Center for Interstate Compacts....

A piece in Monday’s NY Times highlighted the Medical Licensing Compact.  CSG, through its National Center for Interstate Compacts, is consulting with the Federation of State Medical Boards and a drafting team of subject matter experts to develop the compact.  The goal of the compact is to better utilize telehealth and improve access to health care by more easily allowing doctors to practice in multiple states.  The compact would allow doctors who meet certain criteria to more easily obtain a license to practice in member states, while preserving the authority of each state to regulate the practice of medicine within its borders.  Compact language is expected to be ready for state legislative consideration as soon as the 2015 legislative session.

Population growth, aging baby boomers and a dramatic rise in the number of insured Americans resulting from the Patient Protection and Affordable Care Act are stressing America’s health care system like never before. Demand for care is increasing dramatically, but access to a variety of health professionals has remained largely static. One possible solution may be an increased emphasis on license portability through a series of medical licensing compacts.

A blog written by Robert Kocher that appeared in Health Affairs earlier this week endorses the idea of interstate physician licensing agreements as a way to improve access to health care.  Kocher currently serves on the advisory board of the Harvard Medical School Health Care Policy Department and previously worked in the Obama Administration as Special Assistant to the President for Healthcare and Economic Policy.   In his posting he notes that the current physician licensing system limits a physician’s ability to practice across state lines, which in turn has stifled the growth of telemedicine and has also resulted in problems such as specialist shortages in rural and underserved areas. 

Florida Senate Bill 7028, entitled an act relating to telemedicine, would allow the state licensing board and the Florida Department of Health to explore a telemedicine compact for the purposes of increasing access to health care.  The bill was introduced this session and will first be considered by the Committee on Health Policy. 

A letter dated January 9, 2014 and signed by 16 US Senators commended efforts to develop an Interstate Medical Licensing Compact.  The bi-partisan group of Senators, which was led by Senator John Thune (R-S.D.) and Senator Mike Enzi (R-Wyo.), applauded the Federation of State Medical Boards and the Interstate Medical Licensure Compact Taskforce for beginning work on a medical licensing compact.  CSG, through the National Center for Interstate Compacts, is providing technical assistance to the Taskforce. 

Crady deGolian, Director of CSG's National Center for Interstate Compacts, outlines the top 5 compacts to watch in 2014, including those dealing with the siting of electricity transmission lines,  interstate reciprocity regarding online education, and several compacts related to licensing, including EMS licensing, medical licensing, and physical therapy and telepsychology licensing compacts. 

The cost of health care in the United States has grown an average of 2.4 percent faster than the gross domestic product since 1970; it now represents 18 percent of the total GDP, according to the Kaiser Family Foundation. One challenge contributing significantly to these costs is access to health care in hard-to-serve locations. Problems accessing care is especially common in rural areas. According to the American Academy of Family Physicians, 21 percent of the U.S. population lives in rural areas, but only 11 percent of medical specialists practice in those areas. This results in a significant segment of the population that is frequently underserved. One possible solution is a series of medical licensing compacts intended to reduce existing barriers to the process of gaining licensure in multiple states.

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