State-by-State Licensing: Navigating the Complexities of Medical Licensure in a Post-Pandemic World

In this article, we’ll look at the difficulties of state-by-state licensing in the post-pandemic environment. Let’s explore the future of healthcare licensure and credentialing, including the growing adoption of telehealth and the need for greater flexibility in licensing requirements.

The Impact of the Pandemic on State-by-State Licensing

Changes to Licensing Requirements

The Department of Health and Human Services (HHS) has made several changes to the licensing standards for healthcare workers in response to the public health catastrophe caused by the COVID-19 pandemic. These changes were intended to increase the accessibility and availability of medical care to people in need while simultaneously ensuring treatment safety and quality.

One of the changes was the temporary waiver of certain licensing fees and renewal requirements for healthcare professionals whose licenses are set to expire during the state of emergency. Such an approach allowed providers to continue to practice without paying any fees or submitting any documents until the end of the state of emergency.

Another change was the emergency licensing of out-of-state providers, who hold a valid license in another state or territory. It could be received within 24 hours after submitting the application. The emergency license allowed doctors to practice for up to 90 days or until the end of the state of emergency. This applied to all licensed healthcare professionals, except for those who had been disciplined or had pending complaints against them in another jurisdiction.

A third change was expedited licensure. Out-of-state providers, who planned permanent practice could apply for an expedited license online and receive it within 10 business days. It allowed practicing without any restrictions or limitations.

However, these measures were not uniform or comprehensive across the US, and not all states have adopted emergency waivers or declarations for telehealth during the pandemic.

Learn more about the Post-Pandemic Policy Changes.

Telehealth Growth

The pandemic forced many healthcare providers to shift to telehealth services to continue providing care while minimizing the risk of transmission. In the early days of the pandemic, telehealth use surged as in-person visits were limited or suspended. The Centers for Disease Control and Prevention (CDC) reported that telehealth visits grew by 154% during March 2020 in comparison to March 2019.

The Telehealth Modernization Act, introduced in Congress in February 2021, addressed this issue by allowing healthcare providers to offer telehealth services across state lines without obtaining additional licenses. This law might enable patients to receive care from clinicians outside of the state, potentially expanding access to medicine for underserved populations.

The Uniform Law Commission (ULC) also put forward a solution to the difficulties that healthcare practitioners encounter in negotiating the state-by-state norms and standards of medical licensing. The ULC, a non-profit organization made up of state commissioners, is working to establish uniformity across state legislation for certain circumstances. They suggested a “reciprocal license” that would allow licensed physicians to practice in other states.

The Uniform Telehealth Act outlines the full details and parameters of this proposal.

One particularly exciting aspect is the potential for protected exemptions from registration for certain types of consults. For example, the Act could allow for physician-to-physician consults, continuing care for previously established practitioner-patient relationships, and services specific to a specialty assessment, diagnosis, or recommendation of treatment. This would create a safe harbor for specialty physicians to consult directly with patients in any state that has adopted the Act. While this has not yet been implemented, it is a potential remedy to the issues connected with state-by-state medical licensing.

Read more about Navigating the Regulatory Landscape: Key Considerations for Telehealth Compliance and Reimbursement.

The Complexities of State-by-State Medical Licensing

In addition to the time and expense, providers must also stay up-to-date with the changing licensing requirements and regulations in each state of practice.

Variations in State Regulations and Requirements

• Application submission channels: Kentucky, Louisiana, Maine (MD), Massachusetts, New Hampshire, New York (IMG), Nevada (OD), North Carolina (IMG), Ohio, Rhode Island, South Carolina, Utah (OD), U.S.Virgin Islands, and Wyoming require applicants to submit their applications through the Federation Credentials Verification Service (FCVS).

• Application fees: The cost can vary significantly. For instance, the application fee in Delaware is $425, while in Rhode Island, it is $1090.

• License duration: The length of time a medical license is valid generally varies from 1 to 3 years.

• Verification process: The process for verifying credentials can also differ, with some states requiring primary source verification of educational credentials and others accepting verified copies.

In addition to these application and verification differences, there are also a variety of variations in continuing education requirements from state to state. Each state has its own requirements for continuing medical education (CME) to maintain licensure, with some requiring more hours than others. For instance, California requires physicians to complete 50 hours of CME every two years, while New York mandates 100 hours every four years. 

Additionally, states may have specific subject matter requirements for CME courses, such as Florida’s requirement for two hours of CME on the prevention of medical errors or Texas’ mandate for two hours of ethics-related CME. Reporting periods for CME credits can also vary, with some states requiring annual reporting and others requiring biennial or longer reporting periods.

Learn more about The Crucial Role of CMEs in Healthcare 

Legal and Regulatory Challenges

The complexity and variation of rules among states can make it challenging for healthcare professionals to keep current and in compliance. This can lead to potential legal and regulatory challenges that can affect their ability to practice and provide care to patients:

• Licensure denials: One such challenge is facing licensure denials due to previous disciplinary actions, malpractice claims, or criminal convictions. These issues can be complicated and may require legal representation to navigate the legal and regulatory landscape of medical licensing

• Disciplinary actions: Failure to comply can result in fines, probation, suspension, or even license revocation.

• Telemedicine regulations: A physician licensed in multiple states may face differing telemedicine regulations in each state. In such cases, the practitioner must adhere to the more restrictive regulation to ensure compliance.

• Prescription authority: States may have varying regulations regarding a healthcare professional’s authority to prescribe controlled substances. For example, nurse practitioners in California can independently prescribe Schedule II controlled substances, while in Georgia they don’t have such authority, and in Florida, NPs can only do so in collaboration with a physician.

Strategies for Navigating State-by-State Licensing

Researching state regulations and requirements is crucial to understanding the unique licensure requirements and processes of each state. Keeping up-to-date with changes is critical. 

Subscribing to newsletters and updates from state licensing boards, professional organizations, and licensing services and joining online communities and discussion groups can help you stay informed about the latest developments.

Another critical step is to prepare for the application procedure. Gathering and organizing all necessary documentation well in advance can ensure a smooth application process. 

Knowing each state’s application forms and procedures will help you prevent mistakes or delays in your application.

Building and maintaining a strong professional network can be invaluable in navigating the complexities of state-by-state licensing. Utilizing telemedicine and telehealth platforms can help you connect with other healthcare professionals who are experienced in providing telehealth services across state lines. 

Participating in online telehealth and telemedicine webinars, courses, and training programs may also help you remain up to date on the newest trends and best practices.

Leveraging technology to support collaboration is also essential. Project management and collaboration tools, such as Asana or Trello, can facilitate communication and collaboration with your network of colleagues and partners. Adopting secure messaging platforms and video conferencing tools can also enable seamless communication with your peers and licensing board contacts.

Leveraging Technology for Licensing and Credentialing: A Digital Transformation

Utilizing online platforms for licensure and credentialing processes can save you time and minimize errors. Credentialing software like Credsy collects, verifies, and tracks your professional documents and information, making the process more efficient. Additionally, submitting license applications and renewals through online portals provided by state licensing boards can simplify the process even further.

Adopting technologies that support telehealth and remote work is another way to streamline the licensing and credentialing processes. With secure telehealth platforms, healthcare professionals can provide virtual care to patients across state lines while complying with privacy and security regulations. Remote collaboration tools like Zoom, Microsoft Teams, and Slack can also be useful in staying connected with colleagues and licensing board contacts, particularly in a world where remote work has become the norm.

Seeking Legal and Regulatory Expertise: Expert Guidance for Compliance

Navigating the complexities of state-by-state licensing can be challenging. Seeking expert advice can help ensure compliance and minimize risks:

• Consult with attorneys and compliance consultants who specialize in healthcare licensing. They can provide guidance on navigating the complexities of multi-state licensure and advise on potential legal and regulatory issues, such as the scope of practice limitations, telehealth regulations, and interstate licensure compacts.

• Access online resources, checklists, and templates provided by professional organizations and licensing boards to help ensure compliance with all relevant regulations. These resources can be especially helpful when completing licensure applications or renewals.

• Stay informed about changes in telehealth reimbursement policies and other regulatory matters by subscribing to industry newsletters and alerts. This might assist you in staying current with the newest advances and adjusting your methods accordingly.
  
• Benefit from utilizing licensing services. MedicalLicensing.com can help streamline the licensing process by handling tasks such as credential verification and application submission. We will also establish a process for managing and tracking credentials across multiple states.

Medical licensing services can also provide guidance on navigating the complexities of multi-state licensure and advise on potential legal and regulatory issues, such as the scope of practice limitations, telehealth regulations, and interstate licensure compacts. Our team of experts will guide you through every step of the licensing process whatever the state or practice, ensuring compliance and eliminating redundant, time-consuming tasks

In conclusion, the post-pandemic world presents new challenges and complexities for healthcare providers seeking state-by-state licensing. However, by proactively monitoring regulatory changes, utilizing technology, seeking expert guidance, and collaborating with policymakers, healthcare providers can successfully navigate this evolving landscape.

The future of healthcare licensure and credentialing will require increased telehealth adoption, interstate collaboration, and greater flexibility in licensing requirements. By working together to shape policies and practices, healthcare providers, organizations, and policymakers can ensure continued growth and success in the healthcare industry.