Update on Interstate Compact to Help Ease Medical Practice Across State Lines

Dear friends,

The following article is about the Federation of State Medical Boards
interstate compact, which would expedite licensure of physicians in multiple
states, resolving post-acute providers' problem of orders from physicians
licensed in states other than the state in which patients reside. Feel free
to share this information. If you decide to use this material, please
include our copyright designation that is shown at the end of the article
and send us a copy of any publication in which the material appears.

Please do not hesitate to contact us with comments, questions, or requests
for additional information.


Elizabeth E. Hogue, Esq.

Office: (877) 871-4062

Fax: (877) 871-9739

Twitter: @HogueHomecare


Update on Interstate Compact to Help Ease Medical Practice Across State

Home health agencies, private duty agencies, hospices and home medical
equipment (HME) suppliers have wrestled with the issue of orders from
physicians licensed in states other than the states in which patients live.
Can home care providers accept these orders? Although this problem may be
most common in areas close to state borders and rural areas, it is becoming
more common in urban areas as patients travel out-of-state to seek
specialized care. The problem also arises with regard to telehealth

Several years ago, the Federation of State Medical Boards, which is composed
of state licensure boards in each state that license and discipline doctors,
drafted legislation in the form of an interstate compact, i.e., a legally
binding agreement among states. The purpose of the interstate compact is to
expedite licensure of physicians in multiple states. The compact permits
doctors who meet certain requirements to apply for licenses in multiple

The interstate compact must be adopted by state legislatures in order to be
effective in the states where it is adopted. Eighteen states have adopted
the compact so far, including Alabama, Arizona, Colorado, Iowa, Illinois,
Kansas, Minnesota, Missouri, Montana, New Hampshire, Nevada, Pennsylvania,
South Dakota, Utah, Wisconsin, West Virginia and Wyoming. Legislation has
been introduced in the following state legislatures to adopt the interstate
compact: Arkansas, Michigan, Nebraska, North Dakota and Washington.

In states that have adopted the interstate compact, physicians who want to
practice in multiple states must designate one state as their state of
principal practice. They must also choose additional states where they will
seek licensure. Physicians must have full, unrestricted licenses in states
where their principal practices are located, must reside in the state where
their principal practice site is located, and at least 25% of their medical
practice must occur in the primary state. The primary state can also be the
state where physicians' employers are located.

Among participating states, the primary state where physicians practice
verifies physicians' existing licenses and eligibility, and provides
credentialing information to the federation so that physicians can receive
licenses in additional states. Physicians must then pay licensure fees in
the additional states in which they wish to be licensed.

State medical boards in all of the states in which physicians practice have
authority over physicians who practice in multiple states and may take
disciplinary action against physicians licensed in their states, if

The usefulness of the interstate compact for homecare providers will depend
largely on how many states adopt the compact. Adoption of the interstate
compact by eighteen states is a good start! Effectiveness will also depend
upon physicians' willingness to be subject to multiple state licensure
boards and to meet requirements of various states. It's a good beginning to
address an issue that has periodically been problematic for many post-acute

C2017 Elizabeth E. Hogue, Esq. All rights reserved.

No portion of this material may be reproduced in any form without the
advance written permission of the author.
Sign In or Register to comment.