Ask an Advisor: Licensing physicians for out-of-state phone consultations

Telehealth services continue to grow across the nation, as well as the number of payers and programs reimbursing for those services. This means that ensuring your physicians are properly licensed for the services your practice offers is of increasing importance.

One MGMA member recently sent the following inquiry to MGMA Ask an Advisor:
Could you please provide guidance on the physician licensing requirements for conducting out-of-state phone consultations?

Per MGMA’s subject-matter experts, the primary distinction for determining those licensing requirements is whether the physician is providing health education versus actually practicing medicine in another state without a license.

Per the Office of the National Coordinator (ONC) for Health Information Technology, most states will require that the physician be licensed in the originating site’s state and the state where the patient is located. However, there may be some exceptions for certain types of services depending on the state medical board, as noted by Rachel Dixon, president and executive director, Prime Health.

One of the best places for healthcare administrators to stay up to date on telehealth policy updates is the Center for Connected Health Policy, a nonprofit, nonpartisan organization that tracks of legislation and regulation regarding telehealth, and interprets current state laws and policies.

More resources are available through the HRSA-funded National Consortium of Telehealth Resource Centers, including the following:

• A checklist for initiating telehealth services (via Great Plains Telehealth Resource & Assistance Center)
• A remote patient monitoring toolkit (via the Mid-Atlantic Telehealth Resource Center)
• A telehealth etiquette checklist (via Heartland Telehealth Resource Center).

MGMA offers a range of content and education regarding telehealth services:

• “Starting a telehealth program in your practice: Know the steps” (Member tool)
• “Would telehealth work for your practice?” (MGMA Connection magazine)
• “Educating patients about telehealth starts with face-to-face conversations” (MGMA Connection magazine)
• “Leveraging direct-to-consumer telehealth to improve provider productivity” (MGMA Connection magazine)

MGMA also recommends the following resources for telehealth service provided across state lines:

• “Practicing medicine across state lines: telephone health advice” (CAM LAW)
• “Policies on legality of telemedicine across state lines” (BehaveNet)
• “Telemedicine laws and developments: A state-by-state analysis” (Becker’s Health IT & CIO Report)

What’s your question?

Do you have a critical question or need help with a complicated medical practice management issue? With MGMA’s Ask an Advisor program, you can depend on our team of experts to provide answers, recommendations and the tools you need to be successful.