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Product Strategy

Can you practice telemedicine across state lines?

Nisha Gopinath Menon
December 5, 2020

In response to COVID-19, the use of telehealth tools has expanded widely across the world, allowing healthcare professionals and physicians to continue providing health care to patients while minimizing the spread of the coronavirus. Traditionally, license portability across states has been one of the biggest hurdles to a multi-state telemedicine practice. Federal officials have made the announcement that they are making it possible for health tech providers to practice across state lines, a move which eliminates a key barrier to the sustained adoption of telemedicine and telehealth, at least temporarily. This is the latest in a historic set of moves aimed at reimbursing doctors for their services and expanding the use of connected health. The ruling gives providers the ability to treat patients in other states but won't eliminate interstate licensing entirely.

A lot of states had laws in place, allowing for broad coverage of telemedicine services & payment parity with in-person services even prior to the COVID-19 pandemic. With the need to quickly expand and scale the reach of telemedicine in response to the pandemic, regulators, governors, and legislators in many states have taken measures to modify or amend present telemedicine laws through agency directives, legislation, or executive orders. These measures have been key to letting more patients access telemedicine by expanding the types of modalities which can be made use of to provide telemedicine, eliminating all originating sites or other restrictions on coverage for telemedicine & making sure telemedicine is reimbursed at the same rate as in-person services.

To make sure more physicians have the ability to provide care to their patients through telemedicine and more patients have access to telemedicine, yet more needs to be done. For instance, you need to into account that many insurers have a different network for telehealth or select a telehealth provider who might not include contracted physicians who provide in-person services. Not only does this fragments continuity of care and the patient-physician relationship, both of which are a crucial part of the care provided to patients with chronic conditions & those seeking mental health services, it also gets incredibly confusing for patients.

Now providers can apply for full licenses from those states in which they wish to practice. State boards can issue a telemedicine license or certificate, a license to practice healthcare across state lines, or a special purpose license to make it possible to practice telemedicine. These kinds of special licenses make it possible to practice in specified conditions.  

In the past few months, several digital health and telehealth organizations to have the freedom to treat their patients wherever they live, have lobbied the government to relax restrictions on the interstate practice of medicine. Rules that state that a healthcare service has to be licensed in the state in which the patient is settled becomes a significant challenge to improving access to care as everybody works to combat COVID-19. Health systems, hospitals, and other practitioners, with interstate licensing restrictions put aside, will be able to care for patients in other states, allowing them to scale up mHealth and telehealth programs to reach more patients and improve access for patients in hard to reach areas. State medical boards do still have the authority to regulate healthcare services in their states.

Easing regulations at the state level to build a market at the national level has improved services in other industries and lowered prices. It can be expected to do as much for healthcare consumers. However, the health tech industry is moving slowly on state licensure even though they are slowly lifting the barriers to telehealth. In the meantime, Nova Telehealth will continue to serve our patients and innovate our service within the framework we're dealing with.

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Nisha Gopinath Menon