A variety of groups have been dedicated to licensure reform for telehealth in the United States. Two new telehealth bills were recently introduced to Congress: TELE-MED Act (H.R. 3018 and S. 1778). These bills call for “one state license” for practitioners to be allowed to legally work throughout the United States to deliver Medicare and VA services.
The ultimate goal with such licensure would be to operate much like driver’s licenses, where licensure in one state would allow the driver to operate a vehicle in all 50 states. If our licensing boards evolve to such a point, it will be no sooner than five or 10 years. Meanwhile, we are stuck with the antiquated systems we have today.
In states where there is no specific mention of behavioral telehealth, the practice is not restricted. That is, licensed professionals are legally able to practice using telephones, email, text messaging or video, as they deem to be in the best interest of their clients/patients. Reimbursement is an entirely different matter, however. Many insurers will not pay for services delivered in one or more of these modalities.
Another issue is that some states do have laws related to telemental health, but use terms that are not standardized. For example, they may make reference to “telepractice,” “e-therapy,” “online counseling,” “distance counseling,” “behavioral telehealth,” “ web therapy,” etc.
Fueled by the Health Resources and Services Administration (HRSA) licensure portability grants, frontrunners on the professional association front include regulatory leaders at the Association of State and Provincial Psychology Boards (ASPPB), who have been active for almost a decade to develop a new policy for psychology boards to consider. Called the Psychology Interjurisdictional Compact (PsyPact), their proposed model is an updated and serious step in the right direction toward full portability, much like the American Nursing Association’s Nursing Licensure Compact, which has unfortunately been stalled for over a decade.
The Federation of State Medical Boards (FSMB) has also received a HRSA portability grant. Their Medical Licensing Compact model is different from ASPPB’s and involves reciprocity rather than full portability. That is, a licensee in a reciprocity state does not have their licensure apply in other states. Rather, their paperwork is shared by their regulatory board to that of other states for the purpose of getting licensed more easily and quickly in the counterpart state.