have a history of licensure disciplinary actions, a criminal history, a history of controlled substance actions against their license, or a license currently under investigation. The Compact does not issue a single interstate medical license. Instead, participating states issue individual licenses. Physicians can select multiple Compact member states where they wish to be licensed but only need to complete one application. Member states include Alabama, Arizona, Colorado, Georgia, Idaho, Iowa, Illinois, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, North Dakota, South Dakota, Tennessee, Utah, Vermont, Washington, West Virginia, Wisconsin, and Wyoming. Between April 2017 and August 2021, the Compact licensed 23,321 physicians. Details about eligibility, participating states, application, renewal, and costs (an initial non-refundable fee for the Compact and then the individual cost of a license in each state) are available on the Compact ’s website. Under the Compact and state law, medical care is provided and received where the patient is physically located. Resources Many of the state public health emergency orders that temporarily waived telehealth licensing requirements have ended. Others are on the verge of expiring. As a result, physicians, advanced health care practitioners, and practices should consider their workflows and licenses before patients call for out-of-state care. For state-specific telehealth and licensing information, consult these resources from the Federation of State Medical Boards and Center for Connected Health Policy: • Telemedicine Licensure Policies – Board by Board Overview • State-by-State-Listing of Waivers and Other Modifications of Telehealth Requirements in Response to COVID-19 • COVID-19 Cross-state Licensing Page • Professional Requirements Cross-state Licensing Page In addition, call your medical professional liability carrier to confirm that your policy provides coverage when you render care to patients in other states. About MICA MICA risk management services are exclusively available to its members at no additional cost. Contact MICA today to learn more about the benefits of joining a physician-owned and physician-directed mutual insurance company. To request a quote, visit https://info.mica-insurance.com/ quote or call 800-681-1840. Risk Solutions The patient’s location Physicians, advanced health care practitioners, and practices should prepare now for patient requests for out-of-state medical care by considering the workflows for appointment scheduling, telephone triage, and telemedicine appointments. For telephone triage and telemedicine encounters: • Screen for the patient ’s anticipated geographic location during scheduling; • Before a clinician begins a telemedicine appointment or a telephone triage call, confirm the patient ’s physical and geographic location and document in the medical record; and • If the patient ’s physical location is inappropriate, e.g., driving or steering a car, and the patient cannot immediately relocate, e.g., pull over and park, staff should reschedule the appointment. As part of telemedicine appointment workflows, staff should also confirm: • The patient or representative provided their informed consent for the telemedicine appointment, and their consent is documented; • Intake forms or questionnaires are completed; • The practice provided instructions for connection problems; and • If appropriate, reasonable accommodations are in place for patients with disabilities. Interstate medical licensure Another consideration for workflows is the Interstate Medical Licensure Compact, in which member states have agreed to streamline and expedite licensure for out-ofstate physicians. Physicians must have a full, unrestricted medical license in a Compact member-state. Physicians may designate that state as their State of Principal License (SPL) if one of the following applies: • The physician’s primary residence is in the SPL; • At least 25% of the physician’s medical practice occurs in the SPL; • The physician is employed to practice medicine by a person, business, or organization located in the SPL; and • The physician uses the SPL as the state of residence for U.S. federal income taxes. In addition to meeting the SPL requirements, physicians applying for licensure through the Compact must not Located| Continued from page 33 UtahAFP.org | 34
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