While the Interstate Medical Licensure Compact will make it easier for physicians to be licensed in other states for telemedicine, the Creating Opportunities Now for Necessary and Effective Care Technologies would use telemedicine appropriately for Medicare.
So far, the Compact (IMLC) has been approved by state legislatures in 19 states. It was launched by the Federation of State Medical Boards two years ago. The initiative is aimed at providing an expedited pathway to medical licensure in multiple states. At the present time, the IMLC is fully active in eight of the 19 states. These are Alabama, Idaho, Iowa, Kansas, Mississippi, West Virginia, Wisconsin and Wyoming.
The other ten states haven’t finished work necessary to accept applications and to verify the doctor’s education, training and practice credentials. A technical hangup has been licensee background checks. States want that information, including criminal history, to be shared with other member states. But the FBI takes issue with the laws in Arizona, Colorado, Illinois, Minnesota, Nebraska, New Hampshire, Nevada, Pennsylvania, South Dakota and Utah. And so, the IMLC is on hold in those states until something is worked out and acceptable to the feds.
Montana – the 19th state – recently approved a bill that would fix the criminal-background check issue. Washington will likely be the 20th state because its compact legislation has passed the legislature and is awaiting the signature of Governor Jay Inslee.
The compact is seen as a way of lowering the licensure barrier to doctors wishing to use telemedicine to expand into other states.
A group of U.S. senators is trying to change the Medicare law to allow doctors to receive reimbursements for telemedicine visits with beneficiaries, no matter where the patients are located. Senators Brian Schatz (D-Hawaii), Roger Wicker (R-Mississippi), Thad Cochran (R-Mississippi), Ben Cardin (D-Maryland), John Thune (R-South Dakota), and Matt Warner (D-Virginia) have introduced the Creating Opportunities Now for Necessary and Effective Care Technologies, or CONNECT for Health Act of 2017.
Ever since the original Medicare bill was passed in 2001 permitting doctors to be reimbursed for telemedicine visits, the legislation only allowed payments for those patients who were in rural and medically underserved areas. There are two consequences to this somewhat arbitrary geographical restriction. First, Medicare patients in urban areas don’t qualify for reimbursable telemedicine visits, even if they live miles from their physicians. And second, physicians in cities had no incentive to add a telemedicine service line to their practices to see their patients remotely.
The CONNECT for Health Act would remove the geographic restriction and it would also allow reimbursements for remote patient monitoring for patients with chronic diseases. Additionally, the bill would expand the covered services to include telemental health.
This could be the telemedicine bill that Congress approves because it has lawmakers on both sides of the aisle supporting it and because the American Medical Association has thrown its support behind it. Together with the interstate compact, the delivery of healthcare will change, and I believe for the better. And GlobalMed is ready to provide the systems that will bring doctors and patients together.