Proposed legislation to ease telemedicine licensing, credentialing

Amidst calls to fix what some see as an unnecessarily restrictive technicality, proposed legislation for an integrated, universal credentialing database and simplified license applications seek to ease the way for remote health.

Despite the growing popularity--and potential--of telehealth programs, regulatory roadblocks remain. Chief among them: the problem of physicians who treat patients across state lines. Telehealth, by definition, brings clinical expertise to remote patients who might otherwise have difficulty accessing healthcare services. But that solution is also a problem if the specialist in question isn't licensed to practice in the same state as the patient.

In one of the latest efforts, Sen. Tom Udall (D-Utah) said he'll introduce a bill this spring to make it easier for physicians to practice telemedicine in many states instead of applying for a separate license for each state, according to a Government Health IT article.  

The bill would streamline licensure with a unified set of standardized data in a comprehensive and interoperable database of primary source verified credentials, Fern Goodhart, Udall's legislative assistant said at a briefing. Physicians only would have to enter information, such as claims history, hospital privileges and a criminal background check, in one application.

"You can think of it as a national practitioner database or unified provider database or a federation-based credential verification source on steroids with improvements," she said at the meeting.

Physicians, themselves, overwhelmingly say licensing and credentialing issues are a barrier to using telehealth technology--not to mention malpractice, cost, billing and reimbursement as additional challenges to telehealth.

One recent survey, published in the journal Telemedicine and e-Health, found 61 percent agreed or strongly agreed that out-of-state licensing was a barrier to implementation. The same number said the inability bill for services rendered was a barrier, while 73 percent cited government reimbursement as a barrier.

The Department of Health & Human Services has also taken steps to remedy some of these problems. For example, it introduced a change to hospitals' Conditions of Participation so that smaller hospitals no longer will have to double check each telehealth physician's credentials before granting them privileges at their own site. Instead, they can rely on the information provided by the telehealth practitioner's home facility.

To learn more:
- read the Government Health IT article
- learn more about the Telemedicine and e-Health study
- see an HHS progress report on telehealth and other regulations

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