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.