CTiBS Blog

January 20, 2019

Interstate Licensing Compact and Telehealth Reimbursement: Recommendations of the U.S. Departments of Health and Human Services, Treasury, and Labor to the U.S. President

In December of 2018, a number of recommendations were outlined in a government report sent by the U.S. Departments of Health and Human Services, Treasury, and Labor to the U.S. President. Titled the, Reforming Americans Healthcare System Through Choice and Competition, the 115-page report included specific recommendations of relevance to advocating for telehealth regarding the passage of interstate licensing compacts and telehealth legislation and regulation to promote workforce mobility and improve patient access through expanded reimbursement.

Below are the telehealth-related excerpts from page 108-109 of Reforming Americans Healthcare System Through Choice and Competition:

Recommendations: Improve Workforce Mobility

States should consider adopting interstate compacts and model laws that improve license portability, either by granting practitioners licensed in one state a privilege to practice elsewhere or by expediting the process for obtaining licensure in multiple states.

The federal government should consider legislative and administrative proposals to encourage the formation of interstate compacts or model laws that would allow practitioners to more easily move across state lines, thereby encouraging greater mobility of healthcare service providers.

Recommendations: Facilitate Telehealth to Improve Patient Access

States should consider adopting licensure compacts or model laws that improve license portability by allowing healthcare providers to more easily practice in multiple states, thereby creating additional opportunities for telehealth practice. Interstate licensure compacts and model laws should foster the harmonization of state licensure standards and approaches to telehealth.

States and the federal government should explore legislative and administrative proposals modifying reimbursement policies that prohibit or impede alternatives to in-person services, including covering telehealth services when they are an appropriate form of care delivery. In particular, Congress should consider proposals modifying the geographic location and originating site requirements in Medicare fee-for-service that restrict the availability of telehealth services to Medicare beneficiaries in their homes and in most geographic areas

States generally should consider allowing individual healthcare providers and payers to mutually determine whether and when it is safe and appropriate to provide telehealth services, including when there has not been a prior in-person visit.

Congress and other policymakers should increase opportunities for license portability through policies that maintain accountability and disciplinary mechanisms, including permitting licensed professionals to provide telehealth service to out-of-state patients.

What are your thoughts regarding these telehealth-related recommendations made by the U.S. Departments of Health and Human Services, Treasury, and Labor in this Reforming Americans Healthcare System Through Choice and Competition report at this point in time?