Telehealth across state linesFor more than a decade now, clinicians have asked us if they can practice telehealth across state lines, provincial lines, and international lines.

That answer is changing with COVID-19.

As always, formal permission for inter-jurisdictional practice depends on where you hold a license and how much your profession has done to get an inter-jurisdictional practice model put into effect across states. Practicing telehealth across state lines, provincial lines and/or international borders is possible.

Traditionally the process involved getting records from your academic institutions, supervisors, licensing board and in some cases, paying fees. Then, waiting for weeks or months for it all to come together before submitting it all to a foreign licensing board for review. That final review process would often require yet more weeks or months, and more fees before approval to practice telehealth across state lines.

In the time of COVID-19, we see dramatic changes in the number of states expediting their previous processes for inter-jurisdictional practice.

Physicians & the Interstate Medical Licensure Compact for Telehealth Across State Lines

For physicians, the Federation of State Medical Boards (FSMB) has been visibly active in developing a Model Act. The act helps physicians gain access to cross-state and provincial licensure and registration through their Interstate Medical Licensure Compact (IMLC). The Compact offers a voluntary expedited pathway to licensure for qualified physicians who want to practice in multiple states.

The FSMB received a grant from the Office for the Advancement of Telehealth (OAT). Then the FSMB crafted a model act that leads to the expedited transfer of documents between states after physicians meet IMLC conditions.

Designed to increase access to health care for patients in underserved or rural areas, the IMLC’s goal was to allow physicians to more easily connect with medical experts through the use of telehealth across state lines.

The IMLC application process is expedited during COVID-19 by leveraging the physician’s existing information previously submitted in their state of principal license (SPL). The SPL verifies the physician’s information, then conducts a fresh background check. Once qualified, the Physician may practice in any number of other Compact states.

Psychology Interjurisdictional Compact (PSYPACT)

Psychologists have also made headway toward inter-jurisdictional practice. Known as the Psychology Interjurisdictional Compact (PSYPACT), the psychologist’s Model Act involves an interstate compact designed to facilitate the practice of telepsychology and the temporary in-person, face-to-face practice of psychology and telehealth across state lines.

A commission was formed and met in the summer of 2019 to define the Bylaws and Rules and Regulations under which psychologists would be allowed to apply and work in states who formally accept the PsyPACT Model Act as state law. According to the PSYPACT website, to date, 15 states have done approved the PSYPACT, but the PSYPACT Commission has not yet finalized the Rules needed.

ASPPB has acted swiftly to gather information from its member licensing boards and made the results of their work available through their website. The reader is directed to the ASPPB page that describes current COVID-19 activities and the ASPPB commitment to provide COVID-19 updates regularly as they develop.

That page also provides links to these COVID-19 related documents, which may be of use to the reader:

Other Movement by Behavioral Professions for Telehealth Across State Lines?

TBHI is not aware of activity along these lines by any other associations, even during the COVID-19 crisis. So, if you can help shed light on these issues with regard to your profession, please comment below. We will update this page as more information is available.

For more COVID-19 telehealth information that is specific to telebehavioral health, the Telebehavioral Health Institute offers you a listing of other legislative changes HERE: Telehealth Primer for COVID-19.

What Are Your Thoughts?

Please leave your comments below.

Marlene M. Maheu, PhD has been a technologist-psychologist and pioneer since 1994. She has served various organizations to assist with the development of technology-focused standards and guidelines, including the American Telemedicine Association, the American Psychological Association and the American Counseling Association. She has overseen the development and delivery of telehealth training to more than 41,000 professionals worldwide and consulted with hundreds of hospitals, clinics, agencies, groups and independent practitioners seeking start-up guidance.
telemedicine across state lines

How Can I Legally Practice Over State Lines and International Borders?

Whether you want the skinny on where to go to get the information you need, what to do, and how to document your activities, this highly interactive program is designed to answer your questions. Taught by three leading telehealth thought leaders, this program will invite you to cut through the red tape, learn exactly what to do regardless of your profession or specialty area. You will be given the rules of the road, how they can legally and ethically be modified; who needs to know what; how and when they need to know it; the key documents you’ll want to have at your fingertips; and how to get them for free whenever you need them. This highly interactive program is designed to include the audience in a discussion to help you get what you need quickly and efficiently. It will involve case-based learning in the form of real-life consultation notes reflecting appropriate investigation into the inter-jurisdictional practice. This outline will be provided to give you a quick guide for your own investigation of practicing telehealth over state lines or international borders and its documentation.