One of the major barriers to telemedicine is about to get thrown into the ring by Sen. Tom Udall (D-Utah), who is drafting a bill to streamline medical licensure portability across states. He plans to introduce the bill this spring.
Currently, physicians looking to practice telemedicine must be licensed in the state where the patient receiving services resides. Applying for state medical licensure costs time and money. Fees for medical license applications vary across states, from $110 to more than $1300, said Fern Goodhart, Udall’s legislative assistant, in an interview with Dr.Bicuspid.com. “And the time to obtain these licenses varies from three to 12 months, although the actual state requirements for these licenses varies little, if at all,” she added.
Udall’s proposed bill would streamline licensure with a unified set of standardized data in a comprehensive and interoperable database of primary source verified credentials, Goodhart told GovernmentHealthIT.com at a Capitol Hill briefing in January. Information including claims history, hospital privileges and criminal background check would only have to be entered once, creating a “national practitioner database” of sorts.
The easing of state licensure requirements would certainly be a good thing for telemedicine, but it would only be a baby step toward adoption. If we want telemedicine to become a reality, we need to put our money where our mouth is. The lack of reimbursement for telemedicine services remains one of the biggest barriers to adoption.
Practicing telemedicine across state lines can also be a hassle due to the Centers for Medicare and Medicaid Services’ carrier jurisdiction rule, said Tom Greeson, a partner at law firm Reed Smith, who specializes in radiology-related regulatory matters in an interview with Dr. Bicuspid.com. This rule, he said, requires groups that bill for physician services to enroll and submit claims to the Medicare administrative contractor for the state in which the interpreting physician is located.
“For example,” said Greeson, “the hypothetical group in State A that has a contract with a teleradiology group with radiologists providing services via teleradiology in States B, C, D, and E must enroll and submit claims to each of those Medicare carriers depending on where the interpreting physician happened to be sitting when the service was performed.” Greeson believes this is the barrier that needs to be knocked down, before state licensure.
At least the barriers are getting some attention. Telemedicine technology is coming of age, and advocates are eager to get all the roadblocks removed so physicians can begin using it. During a panel discussion at last year’s Federation of State Medical Boards’ telemedicine symposium, Dale Alverson, M.D., immediate past president of the American Telemedicine Association, said eventually “the borders of states and countries will be blurred by advanced technologies such as live holograms, which will make telemedicine a truly global phenomenon.”
I don’t think he’s talking about the advent of the Emergency Medical Hologram, though that would be pretty cool. Udall’s bill is an example of the borders being blurred to help bridge the gap between policy and telemedicine technology. From there, we are just a hop, skip and a jump away from stating the nature of our medical emergencies to an EMH.