Key consensus principles would speed up licensure process for physicians practicing in multiple states

The Federation of State Medical Boards (FSMB) announced today substantial progress in an effort by state medical boards to develop a new system for streamlining medical licensure for physicians who wish to practice in multiple states.

The FSMB announced that a newly appointed drafting team will use eight key consensus principles to shape the model compact, which calls for a formal agreement between states that would allow them to speed up the licensure process for physicians who meet rigorous eligibility requirements.

Under the system, known as an "interstate compact," participating state medical boards would retain their licensing and disciplinary authority but would share information and processes essential to the licensing and regulation of physicians who practice across state borders. Physicians practicing in multiple states would receive a license in each state and be under the jurisdiction of the state medical board where the patient is located at the time of medical interaction. Participation in an interstate compact would be voluntary, for both states and physicians.

The new system is expected to significantly reduce barriers to the process of gaining licensure in multiple states, thus helping facilitate telemedicine and widen access to physicians in underserved areas of the nation as the Affordable Care Act is implemented.

The eight consensus principles, agreed to by the FSMB's Interstate Compact Taskforce (ICT) during a meeting in Washington, D.C., in September, establish parameters for state participation in a compact and define key concepts for physicians and state medical boards. The ICT includes representatives from state medical boards and experts in the formation of interstate compacts.

"As our health care system continues to change, the need for increased license portability has become more pressing than ever," said FSMB President and CEO Humayun J. Chaudhry, DO, MACP. "The state medical board community has recognized the need for leadership in this new environment and responded by advancing this promising new cooperative model that would dramatically streamline the process for acquiring medical licenses in multiple states."

"We believe the interstate compact model is the best option currently under discussion for streamlining licensure, one that retains our highest priority as medical regulators: protecting the safety of patients," he said. "Interstate compacts have proven to be effective in addressing a wide variety of circumstances and issues that have multi-state impact, and we are very confident in the model the state boards are developing. The FSMB is delighted to be supporting this effort."

Dr. Chaudhry said the proposed interstate compact model "will maintain state authority and control, establish high standards for physician eligibility, and ensure a well-coordinated and fairly-applied system of oversight and discipline."

More details of how the interstate compact will be structured will be developed by state medical board representatives later this year and shared for review and comment by state boards in early 2014.

The full list of eight consensus principles includes:

• Participation in an interstate compact for medical licensure will be strictly voluntary for both physicians and state boards of medicine.

• Generally, participation in an interstate compact creates another pathway for licensure, but does not otherwise change a state's existing Medical Practice Act.

• The practice of medicine occurs where the patient is located at the time of the physician-patient encounter and, therefore, requires the physician to be under the jurisdiction of the state medical board where the patient is located.

• An interstate compact for medical licensure will establish a mechanism whereby any physician practicing in the state will be known by, and under the jurisdiction of, the state medical board where the practice of medicine occurs.

• Regulatory authority will remain with the participating state medical boards, and will not be delegated to any entity that administers the compact.

• A physician practicing under an interstate compact is bound to comply with the statutes, rules and regulations of each compact state wherein he/she chooses to practice.

• State boards participating in an interstate compact are required to share complaint/investigative information with each other.

• The license to practice medicine may be revoked by any or all of the compact states.