Health care systems across the world are under increasing pressure due to the spread of the COVID-19 pandemic. In a recent press briefing, Michael Ryan, executive director of the World Health Organization’s Health Emergencies Program, stated that health care systems are “collapsing under the pressure of too many cases.”
In the United States, a patchwork of anti-competitive regulatory policies is exacerbating the problem and limiting access to vital care. Fortunately, some states and federal agencies are wisely taking steps to roll back some of these regulations.
Social distancing and quarantines associated with COVID-19 have highlighted the value of telemedicine services, which allow patients to interact with physicians remotely. Most people infected with the coronavirus will not require hospitalization but may still need to seek advice from medical professionals. Telemedicine allows these patients to avoid spreading the virus by receiving care at home rather than visiting clinics or hospitals.
Unfortunately, outdated regulations prevent telemedicine from reaching its full potential. Licensing laws, for example, prevent physicians and other medical professionals from providing telemedicine services across state lines. This is because providers are generally licensed on a state-by-state basis. Interstate licensure compacts between states allow physicians and nurses to more easily obtain licenses in multiple states, but not all states participate in these compacts. Moreover, there are no such compacts for physician assistants and pharmacists.
A better approach would be for states to simply recognize licenses from other states. Last year, Arizona became the first state to recognize out-of-state professional licenses, but the policy only applies to new residents and not to telehealth providers in other states. Fortunately, states and federal authorities are beginning to see the value of telemedicine and universal license recognition amid the COVID-19 pandemic.
On March 15, the Department of Health and Human Services issued temporary licensure waivers that allow physicians participating in federal health care programs to receive payment for telemedicine services in states where they do not hold a license. Federal authorities are also encouraging the use of telemedicine by suspending enforcement of certain rules issued under the Health Insurance Portability and Accountability Act of 1996. This will allow telemedicine providers to use popular platforms like Apple’s FaceTime, Zoom, Facebook Messenger, Google Hangouts and Skype.
However, state laws still prevent physicians from providing telemedicine services across state lines. In light of the COVID-19 pandemic, several states have taken actions to allow out-of-state physicians to practice without seeking an additional license. More states should follow suit to make full use of telemedicine and expand the supply of health care professionals.
Broader licensing reforms to expand scope of practice would also improve health care access. Scope of practice refers to the range of services, like prescribing medication and signing certain documents, that a medical professional is permitted to provide.
Even in states where out-of-state medical providers can practice telemedicine without an additional license, scope of practice laws limit the impact of telemedicine. Telemedicine providers must be familiar with, and adhere to, the scope of practice laws in each state where they serve—even if the state in which they are licensed allows for a wider scope of practice. As states allow the use of telemedicine across state lines, lawmakers should also consider the impacts of these scope of practice laws.
While many states are taking temporary measures to roll back unnecessary regulations, there is no reason to bring them back after the coronavirus pandemic has passed. These restrictive, unnecessary policies aren’t just a problem during pandemics, they limit access to health care every day.