Legislation/Regulatory Updates National Credentialing Forum February 20

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Legislation/Regulatory UpdatesNational
Credentialing ForumFebruary 20 21, 2004

• Tim Knettler, MBA
• Vice President, Member Support Services
• Federation of State Medical Boards
• Tknettler_at_fsmb.org
• 817- 868- 4006

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Legislation/Regulatory Updates

• State Licensure How it Relates to Telemedicine
• Licensure by Endorsement/Reciprocity
  Portability (Does Physician mobility create a
  national adverse action verification problem?)
• State Medical Board Criminal Background Checks
• State Medical Board Methods of Medical School and
  PGT Verification
• Other National Updates

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JCAHO 2004 Standards Telemedicine

• Like all other standards, these standards assume
  that the organization is following applicable law
  and regulation such as appropriate licensure to
  practice medicine or telemedicine in the state
  where the Originating Sites and Distant Sites are
  located.

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Main Points to Remember

• The practice of medicine (includes telemedicine)
  is deemed to occur in the state where the patient
  is located
• Importance of personal exam (HP)
  physician/patient relationship
• Physicians must hold a valid license in all
  states where he/she provides professional services

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Special Purpose License 9 States

• Not limited to telemedicine
• Any medical act occurring when the patient is
  located in one state and the physician is located
  outside the state
• Includes transmission of vital individual patient
  data across state lines by any means
• Does not allow opening an office in the state
• Preceded advent of Internet Prescribing

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State Licensure Requirements

• Nine states have authorized an expedited process
  for telemedicine licensure similar to FSMBs
  recommendations (CA has authorized, but not
  implemented)
• Thirty-seven (37) states and D.C. have statutes
  or rules requiring full and unrestricted
  licensure

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FEDERATION OF STATE MEDICAL BOARDS Telemedicine
Licensure By Jurisdiction
VT-O
ME_M
WA-M WA-O
ME-O
ND
MT
VT- M
NH
MN
MA
NY
OR
MI-M
WI
CT
ID
SD
PA-M
MI-O
WY
NJ
RI
PA-O
IA
OH
MD
NE
DE
IN
WV-M
UT-M
NV-M
IL
NV-O
WV-O
VA
UT-O
CO
KS
MO
KY
CA-M
NC
CA-O
TN-M
TN-O
OK-M
SC
AR
AZ-M
OK-O
NM-M
AZ-O
NM-O
GA
AL
MS
TX
LA
FL_M
AK
FL-O
STATE KEY
HI
Full and unrestricted medical licensure
Not currently implemented Requirements similar
to full and unrestricted license Statute
provides for an expedited process
Telemedicine license
No requirement known
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License Portability

• Development steps
• Special Committee Policy Report
• Common License Application Forms
• State Medical Board Initiatives
• Regional Pilots
• Standardized System of Credentials Verification
• FCVS or an approved process

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Does physician mobility create a national adverse
action verification problem?
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Disciplined Physicians in 2002 withOne or
Multiple Licensesnumber of physicians 4074
58
42
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Physician with Multiple Licenses and Sanctions in
2002
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State Criminal Background Checks on New License
Applicants
Optional Federal /or State Criminal Background
Checks on New License Applicants
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State Medical Board Methods of Medical School and
PGT Verification
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Other National Updates

• Emergency Preparedness
• Patient Safety/Medical Errors
• Scope of Practice
• Maintenance of Licensure
• Clinical Skills Examination as a Requirement for
  Licensure