in

Telehealth licensing and credentialing

Telehealth licensing and credentailing

As we see more and more physicians turn to telemedicine to help their patients gain access to healthcare services, there are still quite a few obstacles such as telehealth licensing and credentialing that must be navigated by healthcare providers when it comes to telemedicine. When a provider fails to follow the laws they can find their licensure in jeopardy or be hit with high fines and penalties all while increasing the potential that they are exposed to medical malpractice claims. That is why it is extremely critical that medical providers abide by the state’s licensure and credentialing rules while practicing telemedicine. 

Licensure

Licensure presents a pretty big obstacle to the growth of telemedicine. That’s because the state laws that govern telemedicine differ widely from state-to-state. Generally speaking, healthcare providers are required to be licensed by the state where the patient is located. There are certain states, however, like Texas, that offer a special license for those healthcare providers that practice telemedicine. In other states, like California, there is a limited about of consultations allowed by out-of-state practitioners without a state license. If you are a healthcare provider considering the licensure requirements in any state to practice telemedicine, it’s important that you take into consideration the nature and frequency of the services you plan to provide via telemedicine. If you are planning to offer telemedicine in multiple states, keep in mind the process can be arduous and expensive.

Getting licensure for multiple states is just a piece of the puzzle, however. Healthcare providers that are planning to practice telemedicine in multiple states must also follow the standards of medical practice in each state. This is a big challenge because the standards of practice vary considerably by state, so you will be required to memorize and adhere to many different laws and regulations. Adding to the challenge, there is not one location of resources for providers to find the rules by state. In certain states, the rules can be found in statutes and regulations. In others, they are found in the rules, policies and procedures of the state licensing boards. So, even finding the applicable regulations can be a feat in itself.

Other laws to take into account

In addition to licensure laws, healthcare providers also need to know about federal and state laws that govern the privacy and security of medical information and make sure that the technology they are using for their telehealth services complies with the laws. Reimbursement for telehealth services is another factor that varies from state-to-state and can be a lot harder to get in certain states.

Credentialing versus licensure

As we mentioned, telehealth licensing and credentialing poses challenges to expanding services, especially in rural communities. 

  • Licensing: Licensing refers to the process of getting the authority to practice medicine in a specific state.
  • Credentialing: Credentialing refers to the process of verifying the provider’s information like license, insurance, education and other information needed to verify that the provider meets the standards of practice required by the hospital or other healthcare facility. It’s important to note that practically all states require physicians that provide telehealth services be licensed in the state that the patient is receiving care in. Furthermore, every site that delivers telehealth services must fully credential the provider. Credentialing tends to be done by the organization that will bill for the healthcare provider’s services.

What’s the purpose of licensing and credentialing?

Licensing and credentialing are meant to protect patients by ensuring telehealth providers are following state regulations. The challenge of licensing and credentialing, as we mentioned, is that they are time-consuming administrative processes. These processes affect rural telehealth programs the most because they may be limited with resources and can easily become burdened by having to renew licenses and check provider’s qualifications. 

Streamlined licensing and crentialing

As we see a rise in telemedicine services as well as the need for telemedicine especially in rural communities and during COVID-19, some states are working on increasing the portability of licenses. For example, the Federation of State Medical Boards offers the Federation Credentials Verification Service and the Uniform Application for Licensure, these help streamline the process of applying for licenses and credentials. There are also several states that participate in interstate compacts for healthcare providers, these programs help facilitate multi-state licensing. It’s important to note that interstate licensure compacts do not cover every type of telehealth provider, however.

Other states, including Alabama, Louisiana, Maine, Minnesota, New Mexico, Ohio, Oregon and Texas have developed special out-of-state telehealth licenses. This helps streamline the process of telehealth providers looking to practice on patients outside of their state.

The Interstate Medical Licensure Compact (IMLC)

This is a quick-expanding physical compact that helps expedite the licensure process for qualified physicians looking to practice telemedicine across state lines. Participation in IMLC is voluntary and interested physicians must meet criteria in order to be eligible.  As of April 2020, the IMLC includes 29 states, the District of Columbia and Guam and several more states are expected to join in the near future as telemedicine continues to expand. The states that are expected to join include Missouri, South Carolina, New York, New Jersey and Rhode Island, which recently introduced IMLC legislation.

For rural communities

Rural communities that are looking to streamline the telehealth credentialing process need to be aware of the credentialing by proxy method. Credentialing by proxy can help rural programs expand their telehealth services by allowing Critical Access and Community Hospitals to rely on the credentialing processes that happen at distant telehealth sites.

If you would like more information about the benefits of telehealth, we would love to have you sign up for our fundamentals course by clicking here. The course goes over everything you need to know about telehealth, from the history, to the benefits to the licensing and credentialing.

What are the benefits of telehealth for providers?

Telehealth risks and challenges