The proposal is for new policies to ease interstate care barriers and promote healthcare access across state lines.
Johns Hopkins Medicine and the American Telemedicine Association have announced a three-year push for legislative action to reduce state licensure barriers to expand telehealth access.
The two groups say they want tailored federal solutions that complement, rather than replace, state-based licensure and oversight. Despite federal guidance, only a handful of states have adopted exceptions to restrictive telehealth licensure rules, they said.
The LIFTT Initiative (Licensure Innovation for Telehealth Transformation) aims to educate the public on the urgent need for federal reforms to improve telehealth access nationwide, ATA and Johns Hopkins said.
LIFTT will focus on addressing specific gaps in care, such as access to rare expertise, where state-by-state requirements can unintentionally restrict patient access, they said.
During the COVID-19 pandemic, temporary rules made it easier for patients to have video visits with doctors in other states. Those rules have since ended. Many states have gone back to their old, stricter rules about which doctors can treat patients. Johns Hopkins said. This means patients often can’t get care through telehealth from doctors who live in a different state.
Currently, doctors must be licensed in the state where their patient is located at the time of care. People affected most by cross-state telehealth restrictions include: People with rare diseases and cancers; college students who live out of state for school; clinical trial participants who don’t live near academic medical centers; patients with palliative care needs; transplant recipients; people who need mental health services; people who live in rural areas; and people with complex or chronic conditions traveling out of their home state, according to Johns Hopkins.
While there has been incremental progress over the past 10 years to promote reform, enacting change still requires state-by-state adoption, said Johns Hopkins.
“A specialist who wishes to treat patients across state lines needs to invest countless hours and thousands of dollars in obtaining and maintaining multiple licenses, often just to see a limited number of patients for continuity of care purposes in each state.” said Dr, Helen Hughes, medical director, Johns Hopkins Medicine’s Office of Telemedicine. “These licensure restrictions create unnecessary burdens for patients, including people with rare diseases and cancers, college students who live out of state for school, transplant recipients, patients who need palliative care or mental health services, and those living in rural areas.”
Hughes added, “The ATA has been a driving force in promoting telehealth at both the federal and state levels. We are thrilled to partner to transform telehealth through targeted federal licensure solutions.”
LIFTT is intended to mobilize supporters, inform policymakers and engage health systems.
The ATA and Johns Hopkins Medicine said they seek to support and reinforce state regulation with targeted federal pathways that enable essential care to be delivered across state lines, while fully preserving state standards of care and enforcement authority.
“Federal oversight can establish a cohesive strategy for telehealth access nationwide, while respecting local governance structures,” said Kyle Zebley, CEO of the ATA. “In addition to LIFTT, we are also planning a complimentary effort to advance cross-state licensure and look forward to sharing more details in the near future.”
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