Interstate licensure compacts are an example of another policy that is helping propel the telehealth movement. These regulations make it so that telemedicine providers can receive multiple state licenses simultaneously in order to provide virtual care. Since a main hallmark of telehealth is that providers can treat patients anywhere in the country, it is coming at a good time that the Centers for Medicare and Medicaid Services opted to determine their stance on these interstate licensure pacts.

The licenses a provider obtains as part of the agreement process are considered equally as valid as standard licenses. The premise behind the compact is that all states involved agree to accept a provider’s credentials from other states. The standard licensing requirements and timelines vary slightly from state to state, but it can take upwards of 6 to 8 weeks for a provider to complete the process and receive their license. These wait times are even slower in some places due to staffing shortages and departmental closures as a result of COVID.

Therefore, an expedited process not only gets patients off wait lists to be seen more quickly, but it also prevents health care providers from being out of work while waiting for their licenses. This process can quickly become more complicated and lengthy if a provider offers only telehealth across several states, since they need multiple licenses in order to be assigned patients. This is why having a finalized compact in place is of great benefit to the entire health care system.

The policy being reviewed is the 2017 version of the Interstate Medical Licensure Compact (IMLC), which was initially developed to help expedite the process of doctors treating patients in other states. This is a completely different legislation from what is in place for nurses and other allied health providers such as physical therapists, occupational therapists, and speech-language pathologists. With so many disciplines expanding their reach via telehealth, it has become even more essential for CMS to determine what they deem acceptable in terms of licensure and how this impacts their reimbursement for telehealth services.

CMS has settled on alternatives for organizations that wish to double-verify the providers they collaborate with. They can either take the compact verification as-is or ask the provider for more information before accepting it as valid. CMS is also providing added layers of security around this process by reopening previous enrollment applications to check them against valid licenses.

As a result, the best option for insurance companies is to get on board with medical license compacts, since this will help insurers more readily expand their provider networks and also get patients connected with providers more quickly. Building a robust provider network is one of the best ways insurers can support themselves and the members they serve. If you want a comprehensive network analysis to protect your business, contact TOG today.