Is your state one of the 23
that have joined the
national Nurse Licensure 
Compact?  Find out here.    

Wondering where Medicare
will reimburse for telehealth
services?  Medicare's
policies in this area are still
evolving, but you can learn
more about current
guidelines here!                   

Are you aware of a recent
change in state licensure
law?  Let us know about it
here!                                   

Licensure Main Page

Healthcare professionals must obtain a license to practice their profession.   The responsibility for licensing health professionals has been largely a state responsibility.   Telehealth technology presents some significant challenges to a state-based licensure system.  

The primary issue involves multi-state licensure.  What are the licensure standards when the provider and the patient are located in different states?    Must the provider be licensed in the patient's state or is it sufficient for the provider to be licensed in the provider's location.  Over the last ten years, state legislatures and the state medical and nursing boards have begun to address this topic.  More information on the current law and history of nursing licensure appears at our Nurse Licensure page,and information on physician licensure can be found on our Physician Licensure page.

The Center for Telehealth and E-Health Law has been actively involved in tracking developments in telehealth licensure for over 10 years.   In 1997 CTeL prepared a report, Telehealth Law Licensure Recommendations, that reviewed examined some of the problems with the current licensure laws and recommended a serious of actions to improve this situation.     Since that time, a number of key developments have occurred.   

Medical Practice Acts

There has been a substantial evolution in the area of the medical practice acts.  Physicians are now generally required to obtain licenses to in order to diagnosis or treat patients in other states using electronic communications tools.    Consultation exceptions may permit physician to physician interactions without a local license in some circumstances.   The Federation of State Medical Boards has also promoted the adoption of a special purpose license to cover telehealth interactions.  To date, approximately 10 states have adopted some version of the FSMB model.    In addition, the FSMB was also recently awarded a OAT Contract to further multi-state coordination of physician licensure laws.

Nurse Licensure

The nurse licensure playing field has been substantially altered over the last 10 years.   The National Council of State Boards of Nursing, initiated a detailed review of state licensure laws in the 1990's and came to the conclusion that states might benefit from greater coordination on the issue of multi-state licensure.   This project resulted in the development of the Interstate Nurse Licensure Compact.   

The compact is both a licensure law and an agreement between the participating states.   23 states have now adopted the compact.   Participating states agree to work together on interstate enforcement actions.   In return, they accept each of the other participating states initial licensure determinations.   It is similar in many respects to the Interstate Driver's License Compact.   The Nursing Compact has been operating for nearly 10 years.  The Compact Administrators prepared a report in 2003 which outlined the benefits associated with this new licensure model.

Other Health Professionals

While the medical and nursing professions have been most active in addressing telehealth licensure issues, other health professional groups have also begun to explore this topic.   Examples include:

-- psychology
-- dietitians
-- speech language and hearing