The practice of radiology has long been at the forefront of technological innovation. This has led to the increased reliance, especially in some rural areas, on telemedicine, specifically teleradiology. However, the increased utilization of this technology has the potential for rendering state and international borders practically obsolete. This fact has given rise to some legal and regulatory questions pertaining to state licensure and medical liability requirements, as well as appropriate Medicare reimbursement, for image readings performed across state borders or even outside the United States.
Telemedicine involves technology such as real-time video conferencing, digital imaging and the Internet to link hospitals with specialists like radiologists for in-depth advice. For radiology, hospitals send images over the Internet to a team of radiologists located in another state or country, who interpret the image and send back a diagnosis in minutes.
These profound technological advances have fueled numerous radiology groups to begin providing teleradiology services across state lines. To accelerate the growth of teleradiology domestically, some groups are pushing for legislative changes to existing licensure requirements that would permit radiologists to only obtain a medical license in the state where they practice, rather than the current system of acquiring licenses both in the state where they practice and the location of the patient. Select proponents of expanded telemedicine are even pushing the revolutionary concept of a national medical license. Yet, the current policy of the ACR is to require those physicians interpreting images in other states be licensed in both the state where the image was generated as well as the state where the interpretation takes place.
There has been a growing trend of radiologist groups expanding their practice to foreign countries in order to facilitate 24-hour coverage. Many of these radiologists residing overseas are licensed in the state where the group’s practice is located and are credentialed by the appropriate affiliated hospital. However, Medicare does not pay for physician interpretations that are performed in other countries.
The current policy of the ACR is to require those physicians interpreting images in other states be licensed in both the state where the image was generated as well as the state where the interpretation takes place.
The Interstate Medical Licensure Compact is an agreement among participating U.S. states to streamline and speed up the licensing process for physicians who want to practice in multiple states. Physicians who qualify are afforded an expedited pathway to licensure. While the compact shortens the processing time to obtain medical licenses to practice in multiple states, it also enhances the ability of states to share investigative and disciplinary information.
The Compact currently includes 29 states, the District of Columbia and the Territory of Guam. Other states are currently in the process of introducing legislation to adopt the Compact. Visit the Interstate Medical Licensure Compact website for more information.