In the early days of the pandemic, the State Licensing Commission gave up restrictions and gave doctors the freedom to provide virtual medical services to patients, no matter where they were

In the early days of the pandemic, the State Licensing Commission gave up restrictions and gave doctors the freedom to provide virtual medical services to patients, no matter where they were. When millions of people received medical care safely at home during the raging pandemic, the value of telemedicine was proven, but the State Licensing Commission is now back to the Luddite mentality.
As states relax activities such as indoor dining and travel, the licensing committees in six states and the District of Columbia have effectively closed their borders to doctors engaged in telemedicine outside the state, and more people are expected to follow suit this summer. We need to start thinking about how to support and standardize telemedicine in a different way, so that it is covered by insurance, can be used by doctors, and will not cause unnecessary difficulties for patients.
Bridget has been a patient in my clinic for more than 10 years. She would drive an hour from Rhode Island to go on a date. She has a history of multiple chronic diseases, including diabetes, hypertension, and breast cancer, all of which require regular visits to a doctor. During a pandemic, traveling across states and entering a medical center is extremely risky for patients with comorbidities. Telemedicine, and the exemption to practice in Rhode Island, allowed me to control her blood pressure while she was safely at home.
We cannot do this now. I had to call Bridget to see if she would be willing to drive from her home in Rhode Island to a parking lot on the Massachusetts border to welcome our upcoming appointment. To her surprise, even though she is an established patient of mine, my employer no longer allows me to see her through telemedicine while she is outside the Commonwealth of Massachusetts.
There is some hope, but it may be too late. Doctors and other stakeholders have been providing feedback to the Massachusetts Insurance Department on how to regulate telemedicine, but it is expected that the survey will last at least until the fall, when it will not be part of the umbrella of mental health or chronic disease management.
Even more confusing is that these rapid changes will only affect Massachusetts insurance companies, including MassHealth. It will not affect the support of medical insurance for telemedicine, which is related to the state of emergency. The Biden administration has extended the public health emergency until July 20, but many believe it will be extended further until the end of the year.
Telemedicine was initially covered by medical insurance and was suitable for patients in rural areas where they did not have adequate access to medical services. The location of the patient is the basis for determining eligibility. In response to public health emergencies, Medicare has broadly expanded its coverage to allow doctors to provide telemedicine to all patients.
Although telemedicine has surpassed this limitation, patient location has become critical, and its role in eligibility and coverage has always existed. Now anyone can use it to prove that the location of the patient is no longer a deciding factor in whether insurance covers telemedicine.
The State Medical Licensing Board needs to adapt to the new pattern of healthcare services, and most patients hope that telemedicine is still an option. Asking Bridget to drive across the state line for a virtual visit is a ridiculous solution. There must be a better way.
Implementing a federal medical license may be the best solution, at least for telemedicine. But the state may not like this, even though it is an elegant and simple solution.
Solving this problem legislatively seems tricky because it involves the physician licensing systems of 50 states and the District of Columbia. Each of them must change their licensing laws to achieve this goal. As the pandemic has proved, it is difficult for all 50 states to respond to an important issue in a timely manner, from the mandatory wearing of masks to the lockdown to the convenience of voting.
Although IPLC provides an attractive option, deeper research reveals another cumbersome and expensive process. The cost of joining the contract is $700, and each additional state license can cost up to $790. So far, few doctors have taken advantage of this. It is Sisyphean’s approach to predict which state permits I may need to obtain for patients who are on vacation, visiting relatives, or going to college-it may be expensive to pay for this.
Creating a telemedicine-only license may solve this problem. This is not unheard of. After a study showed that the cost of requiring healthcare providers to be licensed in other states would outweigh any benefits, the Veterans Administration has already done so, allowing early use of telemedicine providers.
If states see enough hope in giving up licensing restrictions, then they should see the value of creating telemedicine-only licenses. The only thing that will change at the end of 2021 is that the risk of contracting COVID has decreased. Doctors who are exempt from providing care will still have the same training and certification.