In their April 2013 meeting the Federation of State Medical Boards (FSMB) passed a resolution to establish a streamlined process for physicians to obtain licenses in multiple states through an expedited process. This would be voluntary for states and physicians to take part in. The Compact aims to leave all existing medical laws in place.
Starting in 2015, state legislatures and medical boards began considering the costs and benefits of adopting the Multi State Licensure Compact. On January 28, 2016, the Michigan State House of Representatives passed HB 4582 and HB 4583, sponsored by Rep. Jim Tedder. These tie-barred bills seek to allow physicians in a minimum of seven different states to be a part of the Multi State Medical Licensure Compact.
House Bill 4583 would establish the state’s participation in the Compact through representation on a Commission and create the expedited license process, granting full licensure by a Compact member state to an eligible physician. The Commission, with representation from all participating states, would be responsible for maintaining a database of qualified physicians, establishing rules, and enforcing compliance, among other responsibilities. House Bill 4582 would add medical doctors and doctors of osteopathic medicine with expedited licenses to sections of the public health code.
All states that belong to the Multi State Medical Licensure Compact would join by passing a bill in their own state that is identical to Representative Tedder’s bill package. The aim of this legislation is to make access to medical care easier for residents of member states by increasing the number of licensed physicians in each state. The inspiration for this bill stems from the Affordable Care Act.
The Affordable Care Act intends to bring millions of new patients into the existing system of privatized doctors. The influx of new Affordable Care Act patients will lead to an increased demand to see all types of doctors. HB 4582 and HB 4583 aim to allow people to maintain easy access to medical care by allowing physicians to make themselves more available in states other than just their state of primary residence.
By allowing interstate licensure, doctors can practice medicine without fear of losing their license in a state where they would not normally be able to practice. The certification process would be overseen by the FSMB with doctors from every state in the multi-state compact sitting on the board. Medical standards of practice in each state would remain the same or increase in severity.
The Multi State Licensure Agreement allows doctors to have greater access to patients and patients to have greater access to doctors. In the past, doctors could pursue licensure in multiple states by applying for each state’s medical board exams and by meeting the required criteria. The Multistate Licensure Compact aims to expedite the process by giving doctors the ability to practice in multiple states by taking a general exam that is approved by all member states.
Doctors who apply for Multi State Licensure will apply through the Department of Licensing and Regulatory Affairs (LARA) in order to be able to practice in Michigan. This type of licensure will not be mandatory for all doctors. Instead, the Multi State License will be supplementary to obtaining a license to practice in Michigan for Michigan doctors. The process of obtaining a Multi State license will be an “expedited” process that will concur with the standards of all member states.
A major controversy surrounding this issue involves the difference in how the Compact and the state define the term “physician,” i.e., what type of doctors to include in the Compact. Additionally, people are concerned that those physicians would be required to participate in Maintenance of Certification, i.e., continuous learning and education activities, and that Maintenance of Certification is required to participate in the compact. The unrestricted license that the Compact grants to physicians is the same as what would be issued using the traditional licensure pathway. This means a physician will still have to adhere to the existing renewal and continuing medical education requirements that are currently in place. Nothing about the way that physicians maintain their licenses to currently practice would change under the Interstate Medical Licensure Compact. People are also concerned that the compact would change a state’s Medical Practice Act and that it would be expensive for a state to extricate itself from the Interstate Medical Licensure Compact. Participation in the compact is voluntary. States are free to withdraw and may do so by repealing the enacted statute. The last concern people have with HB 4582-3 is that the Compact represents regulatory excess, which will increase costs and burdens on the state. The Compact aims to reduce costs by streamlining the process for licensees. Instead of applying for individual licenses in multiple states and having to take multiple exams in order to qualify to practice, licensees will only have to take one exam for a valid application to practice in multiple states.
If the Multi State Licensure Compact becomes law, physicians and patients will be able to provide and receive care in the member states. The process of achieving licensure will be more efficient than the current system of individual applications and examination in states where physicians want to gain licensure. This expedited process will get more doctors in more locations in less time while still upholding the strict policies of all member state medical boards.
The best course of action is to pass the House Bills creating the Multi State Compact so that doctors can expand their practices with relative ease. Allowing state medical boards to share information with each other will lead to better quality care for more patients. The passage of the compact will uphold the current standards while allowing more doctors to provide more services to more people.
"HB 4582-3 Revised Summary as Introduced." Michigan Legislature. House Fiscal Agency, 7 Dec. 2015. Web. 24 Feb. 2016.
"Interstate Medical Licensure Compact Latest News." Interstate Medical Licensure Compact. Federation of State Medical Boards, 8 Oct. 2014. Web. 24 Feb. 2016.
"Medical Boards Explore Licensure Compact." Federation of State Medical Boards. Web. 24 Feb. 2016.
"State House Approves Legislation Allowing for Multi-state Medical Licensure - Michigan House Republicans." Michigan House Republicans. Tedder Newsletter, 02 Feb. 2016. Web. 24 Feb.2016.