Telehealth or telemedicine became one of the most practical applications to use during the COVID-19 pandemic. Its popularity in the healthcare industry has grown since then, increasing its demand. However, to practice telehealth, many states require the certification of medical practitioners. The certification addresses the crucial need for healthcare workers to know how to approach telemedicine and use adequate equipment, appropriate channels, and correct CPT codes.
To have a successful start in telemedicine, it’s important to know the standpoints and requirements of telehealth certification in the United States.
How do states differ for telehealth certification when providing care across state lines?
The United States is a pioneer in telehealth with around 75% of hospitals using remote care. And telemedicine progress in the United States is gaining momentum as every state and territory allows telemedicine in some form and many require telehealth certification. Given that healthcare practitioners can provide care remotely to patients in any location, certain states have requirements they must follow to practice across state lines.
To get a better idea of how states handle telehealth certification when practitioners work in more than one state, let’s look at the regulations:
- Twelve state boards require physicians to obtain a license to practice telemedicine across state lines
- Forty-nine state boards, as well as the medical boards of Puerto Rico, the Virgin Islands, and the District of Columbia, require physicians to be licensed in the same state where their patient resides
- Six state boards require physician registration to practice outside their state
It’s evident that cross-state licensing is one of the most problematic aspects of obtaining a telehealth certification. Each state imposes rules that practitioners must follow. These are in addition to the standard requirements for telehealth certification.
What are the requirements for telehealth certification?
To obtain a telehealth certification, all practitioners need to meet certain requirements proposed by the state where they practice medicine. Because each state has its own rules on telehealth certification, there is no one-size-fits-all guide for licensure demands. The majority of states have the same template, though, to which they add their own “twists.”
Some of the most common requirements for telemedicine certification are:
- Being a citizen or having an up-to-date legal permit to live and work in the United States issued by the Immigration and Naturalization Service
- Not enrolled in a postgraduate medical training program
- Paying a fee proposed by the state you live in
- Being at least 21-years-old and having good moral character
- Having completed one year of Accreditation Council for Graduate Medical Education (ACGME) approved residency training in either Canada or the United States
- Completing the Telemedicine Rules Review Course
- Having a valid, up-to-date medical competency certificate
- Having a license to practice medicine, issued by a state medical authority
- Passing the state board examination, COMLEX-USA, National Boards parts 1, 2, and 3, NBOME, FLEX/USMLE steps 1, 2, and 3, or a combination of these
- Having a Doctor of Medicine in English from a board-approved medical school
It’s important to note that many healthcare providers are against telemedicine because of the many requirements practitioners need to meet in order to practice it. The process of adopting telemedicine is often viewed as painfully slow, but we want to emphasize that it is nowhere near as sluggish as it may seem. Telemedicine is progressing daily, even if it appears that state legislatures move slowly.
What is the Telemedicine Interstate Medical Licensure Compact? And what states are currently part of the Compact?
In 2017, the Interstate Medical Licensure Compact became a solution to the ongoing issue of cross-state licensing for telemedicine.
Knowing how helpful it is to practitioners and patients, the majority of states participate in it. According to CCHP, these are the 33 states that are currently part of the Compact:
- Delaware (planned effective date July 1, 2022)
- District of Columbia (implementation is currently delayed)
- New Hampshire
- North Dakota
- Ohio (implementation is currently delayed)
- South Dakota
- West Virginia
If your state is on the list, you are eligible to practice telemedicine outside its borders. If it’s not a member of the Compact, you must look up the rules on cross-state licensing for your particular state.
Although the Interstate Medical Licensure Compact makes it much easier for practitioners to obtain a telemedicine certification and practice outside their state borders, there are still certain issues that arise when applying for certification.
Each state has its own medical board that reviews telehealth licensure applications and gives feedback. That becomes an issue when one state’s medical board takes a week or two to process your application, but then another state’s medical board takes three months to do the same job.
However, you must get approval prior to getting a license. There are certain requirements that you must meet to know if you are qualified. The process may not be that easy, as your chosen State of Principal License will process your application. If you do not qualify, you will receive a notification via email. You may then contact the SPL to discuss why you were ineligible for Compact participation.
Also, fees for telehealth certification vary. The initial cost to participate in the Compact is $700.00 plus the cost of a license in any Compact state where a physician wants to practice. Do note that all fees are non-refundable.
What are the requirements for practitioners to be part of the Compact?
All physicians who wish to be part of the Compact need to meet certain requirements proposed by the Interstate Medical Licensure Compact. The first requirement is to have a medical license that is able to serve as a declared State of Principal License (SPL). You also need to make sure that at least one of the following applies to you:
- At the bare minimum, 25% of your practice of medicine is in SPL
- Your primary residence is in your licensed state
- You use the SPL as your state of residence for the purpose of the federal income tax
- You are employed by an organization, person, or business situated in the licensed state to practice medicine
Once you submit your application, the SPL determines whether you’re qualified to receive the license. There are a few more requirements that you need to meet, though:
- Must pass the COMLEX-USA, USMLE, or anything equivalent in three attempts at most
- Complete either AOA- or ACGME-accredited medical education
- Be a graduate of an accredited medical school in the International Medical Education Directory
- Hold valid and up-to-date specialty certification or certification obtained through an AOABOS or ABMS board that is time-unlimited
- Have no criminal history
- Not be under investigation during the application process
- No history of disciplinary actions toward your medical license
- No history of controlled substance actions toward your medical license
- Pay a non-refundable fee of $700
If you do not qualify for participation in the Compact, your SPL notifies you via email. You may contact the SPL to discuss your concerns and other questions in regards to why you were ineligible.
What is the Telehealth Certification Institute for mental health providers? What courses does it provide?
The Telehealth Certification Institute was founded in 2014 to provide behavioral healthcare workers with appropriate education, training, and consultation. It has plenty of courses that can help you get a telehealth certification with ease.
For example, the TeleMental Health Training Certificate (THTC) provided by the Telehealth Certification Institute prepares you to provide behavioral health services through telemedicine.
To obtain a THTC certificate for behavioral health telemedicine, you must complete all of the following courses successfully:
- HIPAA Compliance for Mental Health Professionals
- Emergency Management Planning for TeleMental Health
- Introduction to TeleMental Health
- Ethics of Using Technology in Behavioral Health
- Ethical and Clinical Skills of Video and Phone Sessions
- Ethical, Legal, and Clinical Aspects of Selecting Technology
- Screening for Fit for TeleMental Health Services
- Legal Aspects of TeleMental Health
The THTC also offers 10 topics in the program that covers all of the essential competencies of using technology in practice and of providing services from a distance. You may review the details that THTC provides before you apply for their courses.
What are the legal and regulatory issues of telehealth?
Telehealth is one of the most innovative solutions to the lack of healthcare providers in underserved and rural areas. Thanks to the advancement of digital technology, telemedicine or telehealth solves one of the major issues patients struggle with—access to medical professionals.
Telehealth has saved thousands of lives and continues to do so daily. That’s why we encourage all practitioners to get a telemedicine certification and engage in the field as soon as possible.
Even though telemedicine is one of the most advanced answers to issues that have been around for the longest time, it does come with certain setbacks. They are mostly of a legal and regulatory nature. The crucial concerns are:
- Medical malpractice
- Online prescriptions for controlled substances
- Licensure for practitioners
All of these issues are being worked on, with some states working faster than others.
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