MSNVA News

U.S. Senator Tom Udall (D-NM) is prepared to introduce the Increasing Credentialing and Licensing Access to Streamline Telehealth Act (ICLAST Act) 

Purpose
To increase access to timely, appropriate care for consumers; and reduce time, cost and effort spent by licensed health care providers and health facilities on redundant administrative expectations without compromising quality or accountability. The current system creates excessive duplication and a lack of portability of licenses and standard credentials information, especially related to emergency response, telemedicine and volunteering; and strongly affecting medically underserved areas.

Problem
Telehealth holds the potential for increasing access to care, reducing patient travel and appointment wait time and cost. For the provider, telehealth increases access to specialist consultation as well as allowing remote counseling of patients, supervision of mid-level staff, and store and forward for documents and images. In addition to mobility of health care services across state lines, increased use of health technology allows health care providers to provide quality health care virtually.

The health professional licensing and credentialing requirements currently established by states, third party payers, credentialing, accrediting and quality organizations are frequently redundant and burdensome. The resulting delays affect access to services, and the ability to either respond to emergencies across state lines or to volunteer in health shortage areas.  Licensure and credentialing are important tools for patient protection - states regulate medical licensure to ensure patient safety and guard against fraud and abuse, verifying competence and character to practice medicine. Currently, there is no comprehensive, nationwide system or repository of license and credentials information.

Proposal
A strategy to increase health care providers’ ability to practice across state lines.

• A voluntary national license in tandem with one state license, which would allow seamlessness across all federal health care programs, as well as license portability across state lines. States would retain their authority to investigate and discipline related to licensure

A strategy to increase access to timely, verified credentials information. 

• An interoperable, comprehensive, secure data exchange system for primary source verified credentials, which can be used by employers, third party payers, and accrediting and credentialing agencies (and other appropriate parties) to streamline approvals for hiring and reimbursement.

A strategy to allow health providers to respond quickly in case of emergency, with license and credentialing information easily accessible to state boards.

• An emergency responder registry, in coordination with existing registries and data exchange system.

National tandem licensure would provide a uniform set of standards, a uniform application process, a rigorous minimum threshold scope of practice; a comprehensive, secure, interoperable data exchange system of primary sourced credentials, and enhanced license portability. This proposal requires that a health care provider hold one state license to be eligible for a national tandem license. National licensure/credentialing would be implemented in phases:

• An advisory board of technical experts within and outside HHS would develop the data exchange system, recommending parameters for content and confidentiality - criteria, standards, processes and evaluation. Program components would include a centralized database of information related to licensure and credentialing, including primary source-verified information, adverse licensure actions, malpractice payouts, and criminal background information.

Phase 1
Require physicians employed full-time in federal agencies that provide health care, such as IHS, VA, DoD, Federal Bureau of Prisons, to obtain the national medical license - one license application and credentialing process across all federal agencies that provide healthcare; within two years.

• Incentives will be available for states to recognize the national tandem license, and for physicians to obtain a national tandem license.
• All physicians would be encouraged to voluntarily obtain a national license in any phase of the program. All national license holders will register with the medical board in the state in which they physically practice.

Phase 2
Required for physicians who accept payment from federal sources, such as Medicaid, Medicare (and Medicare Advantage), TRICARE, etc.; within four years, with incentives to apply for a national license earlier. Nationally licensed physicians may be considered credentialed for all federal payers, including Medicare, Medicaid, and all private plans that contract with federal payers.

Phase 3
HHS consider national licensure for other licensed health professionals. HHS can consider a tandem license for any licensed health profession once the law is passed.

• National task force on e-health and telemedicine comprised of executive and administrative leaders as well as other national experts to communicate, coordinate and collaborate on e-health needs, standards, federal goals and federal efforts.

 

Groups in Support
American Telemedicine Association
National Rural Health Association
New Mexico Primary Care Association
New Mexico Psychological Association
University of New Mexico Center for Telehealth and Cybermedicine Research
Students National Medical Association
UNM Project ECHO
Presbyterian Healthcare Services, New Mexico

For more information or to support this bill, please contact: Fern Goodhart, 202-224-6621, fern_goodhart@tomudall.senate.gov.