Page 12 Unlocking The Potential of Physician to Patient Telehealth Services The Information Technology & Innovation Foundation

reciprocal licensing agreements with other states, and are actively exploring this policy, but
40
this practice has not yet been adopted by states.
Finally, mutual recognition of licensing occurs when states jointly develop an agreement to
recognize one another’s licenses. Typically, this requires states to harmonize their licensing
requirements. This model has been successfully applied in nursing. In 1994, the National
Council of State Boards of Nursing began developing the Nurse Licensure Compact, a
model nurse licensure policy that allows a nurse licensed in one state to practice in others
that are part of the agreement. To date, twenty four states have adopted the multistate
41
license.

Figure 3: State licensing requirements for telehealth
42
Unfortunately, states have made little progress addressing these barriers. The Federation of
State Medical Boards (FSMB), a non-profit organization representing the different state
medical boards, has made multiple attempts over the past decade at increasing portability
of licensing and streamlining the application process for physicians who wish to practice in
multiple states. However, to date, it has had only limited success. As shown in Figure 3,
only twelve states so far—Alabama, Louisiana, Minnesota, Montana, Nevada, New
Mexico, North Dakota, Ohio, Oregon, Tennessee, Texas, and Washington—have put in
place at least one type of policy to reduce the licensure barriers to telehealth. An
43
additional nine states have adopted some limited accommodations for telehealth providers,
but these accommodations generally do not make it feasible for providers to offer telehealth
services to a large number of patients. For example, Arizona, Mississippi and Kentucky
allow telehealth providers licensed in another state to treat patients without a license if they
are doing so in consultation with an in-state provider, and Utah allows out-of-state

THE INFORMATION TECHNOLOGY & INNOVATION FOUNDATION | MAY 2014 PAGE 12