CLEAR

Survey indicates support for expanded NP scope of practice

A survey by the Alliance for Connected Care indicates that 82% of patients and almost 80% of healthcare providers support expanding nurse practitioner scope of practice to include the full extent of their education and clinical training. Twenty-six states currently have full practice authority for NPs.

The survey also indicates that 91% of healthcare providers agree that telehealth options should continue post-pandemic, with accessibility and flexibility noted as key drivers.

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Comparison of telehealth model legislation

This report compares model telehealth bills and guidelines from the American Medical Association, Uniform Law Commission, and Federation of State Medical Boards. "The model bills and guidelines cover similar pertinent telehealth policy issues brought to light by the COVID-19 pandemic. All three organizations delineate requirements for out-of-state licensure and address, to varying degrees, coverage and payment of telehealth services. The AMA bill is more comprehensive in nature; it includes model language across a broader range of policy areas that are not addressed by the ULC and the FSMB, including considerations related to originating sites and accounting for telehealth within network adequacy standards." The report provides detailed comparative analysis with supporting source language.

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Telehealth legislation tracker tool

Manatt Health has developed a tool for tracking federal and state telehealth legislation during the COVID-19 pandemic. An executive summary is available here. A few highlights include the following:

• South Carolina allows independent social workers with a license in another state to register with the South Carolina licensing board and provide behavioral telehealth services to South Carolina patients.
• Vermont allows certain patients to request life-ending prescriptions via telehealth, with prescribers receiving legal immunity and protection from professional discipline.
• Virginia's Board of Health is directed to create a Statewide Telehealth Plan to promote the introduction and use of telehealth services.
• Twenty-one states have implemented payment parity on a permanent basis, requiring that healthcare workers are reimbursed the same amount for telehealth services as for in-person services.

States introduce long-term telehealth legislation

In response to the COVID-19 pandemic, many states introduced or amended telehealth legislation on a temporary basis via waivers. Several states are now introducing legislation to allow telehealth on a more permanent basis.

According to Manatt's tracking, "Three states introduced legislation that would allow health care providers licensed, certified or registered in another state to provide services via telehealth to patients in state if specific criteria are met. One state has introduced a bill that specifically creates an allowance for out-of-state providers who deliver behavioral or mental health services. Three states introduced bills that would enable providers licensed in the state in which their patients are located to deliver telehealth services without being physically present in the state. Two states introduced bills that would require the creation of a commission or regulatory system to support and guide state actions related to out-of-state providers delivering care via telehealth."

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Legislative and policy trends upcoming in 2022

An article by Venable LLP outlines ten anticipated trends for the 2022 legislative session that could have an impact on occupational licensing boards.

Worker mobility legislation - Given the Biden administration's focus on addressing impediments to worker and economic mobility, the article suggests state regulatory bodies consider the uniformity of licensing requirements across the US.

Antitrust concerns - The article suggests a review of regulatory structures and level of state supervision to address continued antitrust enforcement.

Diversity, Equity and Inclusion  - The article suggests considering whether eligibility rules, education requirements, and other licensing criteria truly serve their purposes or are arbitrary and overly burdensome.

COVID-19 modifications - Licensing boards will need to be prepared for which changes legislatures will roll back or introduce for permanent adoption, particularly around telemedicine.

Read for the rest of the list.

Year-in-Review: 2021 Regulatory News Trends

CLEAR’s Regulatory News blog strives to bring you news and updates about what’s going on in the professional and occupational regulation arena. What were some of the trends we saw in 2021? The following is not a ranking of importance or an exhaustive list, but here are some of the themes we reported on in 2021:

• Disciplining practitioners for COVID mis/disinformation,
• Mobility,
• DEI and discrimination in regulation,
• Reducing barriers to licensure,
• Licensure issues for veterans and military members, and
• Telepractice.

Read the full year-in-review article

CLEAR will be releasing a podcast episode in February to review trends in professional regulation and hear reactions and further examples from international perspectives.

Update: Arizona passes broad telemedicine law

New telemedicine legislation in Arizona is the first of its kind to permanently allow out-of-state healthcare professionals to provide telemedicine services to Arizona patients. The law also ensures that telemedicine providers receive equal compensation from insurance companies for services as for in-person services.

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State-by-state report on telehealth

A new report from the Reason Foundation, the Cicero Institute, and the Pioneer Institute for Public Policy Research examines best practices in telehealth policies, considering modality-neutral options, supporting the ability of all practitioners to use telehealth, and allowing for interstate licensure. Twenty-two states allow any provider to use telehealth. More than half of states are modality-neutral, meaning allowing both synchronous and asynchronous forms of care. But almost all states have barriers to practicing telehealth across state lines.

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NABP releases task force reports

The National Association of Boards of Pharmacy's task force on state oversight on drug importation released a report focused on areas of concern for regulating prescription drug importation: supply chain issues, enforcement responsibility, Section 804 Importation Programs, patient safety, and the Drug Supply Chain Security Act. The task force recommends that NABP develop resources for boards to use in educating legislators when an importation bill is being considered, communicate with Canadian pharmacy regulators about NABP programs that can assist with regulatory oversight, and collaborate with other stakeholders to develop consumer education programs as well as educational tools for healthcare providers and regulators.

The Work Group to Consider Extending Waivers [issued during the pandemic] met and recommended changes to the Model State Pharmacy Act to reflect expanded pharmacist scope of practice to administer testing and vaccines, allowed alternatives to in-person counseling, use of remote Automated Pharmacy Systems, and other provisions during unusual public health circumstances or declared emergency.

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US: comments invited on telepharmacy regulations

The US Drug Enforcement Administration has released notice of proposed rulemaking on telepharmacy regulations. State regulatory authorities, professional associations, and the general public are invited to provide input "to more clearly identify how the telepharmacy practice operates and what industry-standard practices have developed over recent years."

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