COVID: Interstate Medical License Compact

Interstate Medical License Compact

Not a new effort, but offers a pathway for establishing a multi-state practice

Written by Luke Schmitt, Flaherty Sensabaugh Bonasso PLLC

Even before the COVID-19 pandemic, efforts were made within the United States to facilitate the borderless practice of medicine in our country.  However, now more than ever, these measures are necessary even if temporarily.  To effectively combat this public health crisis, we need to be able to mobilize resources efficiently and effectively.

The Interstate Medical License Compact (the “Compact”) offers a voluntary, expedited pathway to licensure for qualified physicians who wish to practice in multiple states.  The mission of the Compact is to increase access to health care for patients in underserved or rural areas and to allow them to connect with medical experts through telemedicine technologies more efficiently.  In addition to making it easier for physicians to obtain licenses to practice in multiple states, the Compact also seeks to strengthen public policy by enhancing the ability of states to share investigative and disciplinary information.

The Compact is not a federal program or administered by a federal agency.  Nor was it a product of Congressional action or the result of executive or administrative order.  Rather, it is an agreement among states with the Commission functioning as an independent organization.  The Commission is based in Littleton, Colorado, and is governed by the terms of the Compact, which empowers the Commission to create bylaws, rules, and policies.

In West Virginia, in 2015, the Legislature passed House Bill 2496, adopting the Interstate Medical Licensure Compact.  West Virginia Code 30-1C-1 codifies the Interstate Medical Licensure Compact Act. West Virginia Code 30-1C-3 outlines eligibility requirements, West Virginia Code 30-1C-5 governs applications and the issuance of expedited licenses, and West Virginia Code 30-1C-6 sets forth the application fees.

The efficacy of the Compact may not move the needle much in our current situation, but its goals and purposes are something to keep in mind for the future.

More information about who may qualify to participate in the Compact and how to apply is available at the Interstate Medical Licensure Compact website at: https://imlcc.org/.

In addition, to directly combat COVID-19, on Wednesday, March 18, 2020, the Trump Administration announced that the Department of Health and Human Services (“HHS”) would allow all physicians and other medical personnel to practice in states other than those in which they are currently licensed to practice. The HHS regulation is designed to mobilize doctors across state lines to meet the needs of hospitals as they arise during this public health crisis.

However, it is crucial to recognize that the federal medical licensure waivers by HHS are limited in scope to conditions of participation and payment for federal health care programs such as Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).  HHS and CMS accomplished these waivers according to Section 1135 of the Social Security Act, which authorizes the Secretary of HHS to waive certain Medicare, Medicaid, and CHIP program requirements and conditions of participation once the President declares a public health emergency (“PHE”). HHS Secretary Alex M. Azar issued a PHE on January 31,2020, and President Trump declared an emergency on March 13, 2020.

These waivers do not waive the requirement for physicians and other healthcare providers to maintain licensure in states where they are practicing a licensed profession, including via telehealth.  State laws continue to govern whether a provider is authorized to provide professional services in that state without holding an active license from that state’s medical board.  However, some states are working to ease these restrictions.

Congress is currently considering additional Legislation that would apply to covered health services by private payors.  We are continuing to monitor these developments.