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Doctors Should Support Interstate Telemedicine

February 8, 2018 in Economics

By Shirley Svorny

Shirley Svorny

Should licensed physicians be allowed to practice telemedicine
across state borders? Lawmakers in Congress have been reluctant to
move this forward. An exception is the recent VETS Act of 2017,
versions of which just passed in both houses of Congress.

Department of Veterans Affairs’ health care professionals will
be allowed to practice via telemedicine in any state, no matter
where the clinician is licensed or the patient is located. Why not
make this type of access available to everyone?

Lawmakers have introduced bills that included language to
reduced barriers to interstate telemedicine, but ultimately
pushback from state medical boards and physician groups have doomed
these efforts. Reps. Devin Nunes, R-Tulare, and Sens. Mazie Hirono,
D-Hawaii, and Joni Ernst, R-Iowa, tried to expand cross-state
accessibility for Medicare recipients via the Telemedicine for
Medicare Act of 2015. Sen. John McCain, R-Arizona, addressed the
needs of TRICARE beneficiaries by including a similar provision in
an early version of the 2016 National Defense Authorization Act. In
both cases, the provision was stripped from the final legislation.
Rep. Mike Thompson, D-St. Helena, included a provision in the
Telehealth Promotion Act of 2012 that would have allowed physicians
to practice across states on the basis of their home-state licensed
and would have applied to all Americans: “For the purposes of
[telehealth service] … providers of such services are considered to
be furnishing such services at their location and not at the
originating site.”

A greater awareness of
the benefits of telemedicine is needed to counter special interest
groups that benefit financially from the status quo.

In each case, well-respected and politically powerful groups,
including the American Medical Association, and representatives of
state medical boards opposed the language. As always, when it comes
to proposals that would inject competition into the market for
physician services, physicians raise the patient safety flag.
However, there is no evidence to support this claim.

So the existing laws stand. Physicians who want to provide
services to residents in another state must be licensed in that
state. Initial license fees (about $430 a state – double that if
the physician uses a private company to assist in the process) and
renewal fees (about $220 a year per state) limit the number of
out-of-state licenses a physician is likely to acquire and
maintain. Another complication to interstate practice under
multiple state licenses is that state requirements for medical
practice, including patient informed consent and continuing medical
education, vary. So do rules regarding such things as fee-splitting
and referrals. As health care lawyer Erika L. Adler put it, “Every
state has its own rules for just about everything.”

Setting aside costly state licensing requirements would …read more

Source: OP-EDS

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