What to Know About Multi-State Healthcare Licensure

June 18, 2021 •

Traditionally, healthcare professionals have selected a single state to call home, completed licensure for that state, and spent many years residing and practicing there. Complex, expensive and time-consuming licensing requirements discouraged healthcare workers from trying to practice in more than one state.

However, all that changed in 2020 during the global coronavirus pandemic. Delivering needed medical care in a safe and effective manner came to the forefront, and emergency orders relaxed regulations and set the stage for more aggressive multi-state licensure initiatives.

Licensure History

The history of licensing healthcare professionals dates back several hundred years and has always focused on the protection of the general public. According to the National Institute of Health, “The general public does not have adequate information to judge provider qualifications or competence; thus professional licensure laws are enacted to assure the public that practitioners have met the qualifications and minimum competencies required for practice.”

Since states have authority in licensing professionals, many variations exist in terms of who requires a license, what must be completed to apply, the scope of practice allowed, and supervision requirements.

For example, each state in the country has a medical board that dictates the necessary requirements for a physician to obtain a medical license. Some states may only require the basics such as graduating from an accredited medical school, finishing one year of residency practice, and payment of fees, while others specify that applicants take extensive tests, complete interviews, and finish additional coursework. The time it takes to get licensed may vary from a few weeks to several months.

Telehealth Changes the Playing Field

Although the idea of telehealth matured during the 2020 COVID-19 pandemic, the Interstate Medical Licensing Compact (IMLC) has been a proponent of expansion of telehealth for years. The goal of the IMLC was to “preserve state regulation of medical practice while making it easier for physicians to provide care remotely and in person to patients in other states.”

The National Council of State Boards of Nursing (NCSBN) established a similar Nurse Licensing Compact (NLC) as well, which has since been updated to the Enhanced Nurse Licensing Compact (eNLC). Prior to COVID, the NLC benefited travel nurses in particular with expanded advantages for nurses in compact states during the pandemic.

As states entered lockdown in early 2020, healthcare professionals scrambled to find ways not only to safely provide care to those infected or exposed to COVID but also to continue care for all other patients. Telehealth systems were quickly established, and states were more interested in both the IMLC and the eNLC as regulations were relaxed to help healthcare providers deliver needed services.

As a result, many healthcare providers have increased access to care, particularly to those homebound patients or families that live in rural America.

How Multi-State Licensure Works

Healthcare professionals practicing in a compact state can more easily obtain multi-state licensure. Currently, 30 states participate in the IMLC and 36 states in the eNLC.

Physicians will typically obtain a primary license in the state they are currently residing in or practicing in. They can then leverage those requirements to obtain a medical license in any compact state. According to the IMLC, roughly four out of five doctors will be eligible for multistate licensure.

Requirements may include having a primary practice in a compact state, medical school accreditation, graduate medical education, and passing required exams. Applying physicians must not have a record of criminal activity, licensure actions and active investigations, and they must pass an FBI background check. Obtaining a license in a compact state may take as little as a few days.

The eNLC allows both registered nurses and licensed practical/vocational nurses to have a single multistate license. Applicants must meet specific requirements, which are a compilation of various state board requirements. The goal was to have all states accept the eNLC, giving nursing professionals more mobility across state borders and increasing patient access to care while continuing to protect the public.

Get Adequate Malpractice Insurance

Regardless of what level of healthcare you work in, it’s important to check in with your professional liability provider to make sure you have all the coverage you need. NOW Insurance offers comprehensive coverage of telehealth services at the same levels as in-person visits.

We deliver affordable and simple insurance quickly to healthcare practitioners and allied health workers. We also offer general liability as an addition to professional liability for private practices and other medical facilities. If you are licensed in multiple states, NOW Insurance can also extend past state lines. Get an immediate quote from our quick and easy online application today.

Related Articles:

Telehealth Rules Relaxed During Pandemic

Telehealth is More Than Just Video Appointments

Helping Hesitant Patients Embrace Telehealth

Supporting Providers in the Age of Telehealth