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Medical Licensing Compacts Backgrounder

CAPITOL RESEARCH

INTERSTATE COMPACTS

THE COUNCIL OF STATE GOVER NMEN TS

The cost o health care in the United States has grown an

average o 2.4 percent aster than the gross domestic prod-

uct since 1970 and now represents 18 percent o the total

GDP, according to the Kaiser Family Foundation. One

challenge contributing signifcantly to these costs is access

to health care in hard-to-serve locations.

Problems accessing care is especially common in rural

areas. According to the American Academy o Family Physi-

cians, 21 percent o the U.S. population lives in rural areas,

but only 11 percent o medical specialists practice in those

areas. The group notes that because o this disparity, patients

in these areas are requently dramatically undeserved. These

patients oten do not have access to the latest research, scien-

tiic breakthroughs and medicine because o where they live.

Missed appointments and incomplete care can contribute to

escalating health care costs.

Experts expect this problem to worsen as the popula-

tion grows and ages and the number o insured Americansseeking health services increases as a result o the Patient

Protection and Aordable Care Act. Research published

by the Annals o Family Medicine estimate the United

States will need an additional 52,000 primary care physi-

cians by 2025 to keep up with growing demands on the

health care system.

One possible solution is a series o medical licens-

ing compacts intended to reduce existing barriers to the

process o gaining licensure in multiple states. This has

the potential to help acilitate telemedicinethe use o

technology to aid in the delivery o medical services across

long distancesand widen access to a variety o medical

services in underserved areas o the nation as the Aord-

able Care Act is implemented. Licensing compacts alsoprovide a mechanism to ensure state regulatory agencies

maintain their licensing and disciplinary authority, while si-

multaneously providing a ramework to share inormation

and processes essential to licensing and regulation across a

variety o medical proessions.

Interstate Compacts as a SolutionInterstate compacts oer one approach to achieve these

goals, and in turn, improve access to health care through

telehealth. Compacts are unique tools reserved or states

that encourage multistate cooperation and innovative

policy solutions while asserting and preserving state

sovereignty.

Compacts, which are governed by the tenets o contract

law, give states an enorceable, sustainable and durable

tool capable o ensuring permanent change without ed-

eral intervention. With more than 215 interstate compacts

in existence today and each state belonging to an average

o 25 compacts, there is considerable legal and historical

precedence or the development and use o the tool.

Several existing compacts deal specifcally with licensing

issues. Compacts such as the Drivers License Compact

and the Nurse Licensure Compact provide precedence or

member states to honor licenses issued in another member

state. For these reasons, a variety o medical proessions

are considering interstate compacts as a tool to breakdown existing barriers to multi-state practice.

Ongoing Medical Licensing Compact Work

EMS Licensure CompactCSG, through its National Center or Interstate

Compacts, has been working with the National Associa-

tion o State EMS Ofcials to explore a multi-state EMS

licensure compact. It is becoming more common or EMS

personnel to cross state lines to provide services in a state

in which they are not technically licensed and do not enjoy

legal recognition. Drating or this is well underway. Com-

http://www.aamva.org/uploadedFiles/MainSite/Content/DriverLicensingIdentification/DL_ID_Compacts/Compact%20Member%20Joinder%20Dates.pdfhttps://www.ncsbn.org/nlc.htmhttps://www.ncsbn.org/nlc.htmhttp://www.aamva.org/uploadedFiles/MainSite/Content/DriverLicensingIdentification/DL_ID_Compacts/Compact%20Member%20Joinder%20Dates.pdf

7/27/2019 Medical Licensing Compacts Backgrounder

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pact language should be ready or legislative consideration

by 2015.

Medical Licensing CompactCSG is working with The Federation o State Medi-

cal Boards to assess the easibility o a medical licensing

compact. Several actors, including changing demograph-

ics, the need or better and aster access to medical care in

rural and underserved areas, the passage o the AordableCare Act and the rise o telehealth have created unprece-

dented demand or health care services. Former Wyoming

Gov. Jim Geringer initially proposed the concept, which

memberships o CSG and The Federation o State Medi-

cal Boards have supported through resolutions. Compact

drating is set to begin in November.

Federation o the State Boards o Physical TherapistsBuilding on the EMS and medical licensure projects, the

Federation o State Boards o Physical Therapy also has

begun exploring a license portability compact or physi-

cal therapists. The physical therapy boards membership

recently passed a resolution endorsing the exploration o

a compact.

ADDITIONAL RESOURCES

The National Center or Interstate

Compactswww.csg.org/ncic The Kaiser Family Foundationwww.kf.org

The American Academy o Family

Physicianswww.aap.org

Health IT Nowwww.healthITnow.org

Crady deGolian, Director, CSG National Center for Interstate Compactscdegolian@csg.org

National Board or Certifcation in Occupational TherapyThe National Board or Certifcation in Occupational

Therapy is planning a session at its annual meeting in No-

vember o this year to explore the need or license portabil

ity across state lines. The session will include presentations

on the broad need or reciprocal licensing agreements and

how interstate compacts can address that need.

While it is too early to speculate how these various eor

will turn out, it is clear that compacts are viewed as a viablemechanism to increase access to high quality health care

across state lines.

For more inormation, contact Crady deGolian, director

o CSGs National Center or Interstate Compacts, at 859-

244-8068 or cdegolian@csg.org.

http://www.csg.org/ncichttp://kff.org/mailto:cdegolian%40csg.org?subject=mailto:cdegolian%40csg.org?subject=mailto:cdegolian%40csg.org?subject=mailto:cdegolian%40csg.org?subject=http://kff.org/http://www.csg.org/ncic