To treat COVID-19, administration expected to relax physician licensing. But no regulation yet

Healthcare innovation
Doctors and other medical professionals are awaiting a government regulation that would allow them to work across state lines amid the coronavirus outbreak. (Getty/LightFieldStudios)

Doctors and other medical professionals are awaiting a new government regulation that would allow them to work across state lines amid the coronavirus outbreak.

If a new regulation is released, physicians and other medical professionals would no longer need a new state license to care for patients living in another state and would be able to treat more coronavirus patients.

Wednesday, U.S. Vice President Mike Pence announced the Department of Health and Human Services (HHS) would issue a regulation at President Donald Trump’s direction that will allow doctors and other medical professionals to practice across state lines, even if they are not licensed to practice in a particular state.

Pence announced the new regulation during a White House press briefing and said it was being implemented "to meet the need of hospitals that may arise in adjoining areas." But so far, HHS has not taken action.

As the coronavirus spreads across the U.S., there are a number of “hot spots” where the need for doctors and nurses is more acute. Eliminating the requirement that doctors and nurses have a license in a particular state would allow medical professionals to work in hospitals where more hands are needed to treat patients.

Given the fast-moving coronavirus picture, HHS has not released a regulation yet on allowing clinicians to practice across state lines without getting an additional license in that state.

“The Trump Administration is continuing to take quick and decisive action to combat COVID-19 and protect Americans. We will keep you updated on this front,” the agency said.

Currently, healthcare professionals must hold a license in whatever state or states in which they want to practice.

At a press conference Thursday morning, Janis Orlowski, M.D., chief healthcare officer at the Association of American Medical Colleges, said the licensure guidelines “are evolving as we speak.”

The Centers for Medicare & Medicaid Services (CMS) has approved payment for services rendered by a licensed physician via telehealth across state lines, she said in an email to FierceHealthcare, and is looking at whether there are ways under federal rules to extend licensing nationally. 

Many states are taking action to make licensing easier given the urgency of the pandemic, she added. For instance, Mississippi has shortened its application and accelerated the approval process. And in New York, the governor also made temporary emergency changes for the practice of medicine in that state. The Federation of State Medical Boards has assembled the changes to state law on a special COVID-19 webpage. 

The American College of Physicians (ACP), which represents internal medicine physicians, said it supports the government recommendations that medical licensing restrictions be eased and that elective medical procedures be suspended.

“These are important steps in ensuring that physicians and other healthcare professionals are able to devote their time and resources to dealing with the rapidly spreading emergency created by COVID-19,” said Robert McLean, M.D., president of the ACP. “Additionally, keeping patients who would have been in healthcare facilities for elective procedures home, and away from potential exposures to the virus, can help us to slow the spread.”

The physicians’ group also urged additional steps be taken to help slow the spread of COVID-19 and ensure that internal medicine physicians and others on the front lines can continue caring for patients.

The group said it is concerned that physicians are unable to maintain the financial viability of their practices.

“ACP has heard from many of its members, in large and small practices alike, that the economic viability of their practices is at risk because of increased expenses associated with COVID-19 and reduced revenue from cancellation of office visits and replacing them with virtual visits that often are not reimbursed by payers, or reimbursed at lower levels than face-to-face visits,” wrote McLean in a letter (PDF) to congressional leaders.

“Payment for all medically necessary telephone and video consults will allow physicians to convert face-to-face visits to virtual telephone consultations with patients, thereby freeing up capacity to see patients in the office who require immediate attention for testing, diagnosis, treatment and counseling related to COVID-19,” he said.

The administration has taken steps to relax regulations to create access to care as the coronavirus spreads, including expanding access to telehealth for Medicare beneficiaries.

HHS announced Tuesday it is waiving certain Medicare telehealth payment requirements to enable telehealth services to be provided in all settings, including a patient's home.

The waiver enables Medicare beneficiaries to use telehealth services even if they aren’t in a rural community. Clinicians can bill immediately for dates of service starting March 6. Telehealth services are paid under the Physician Fee Schedule at the same amount as in-person services, according to CMS.

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