Across state lines in Ohio!
Good things in Ohio! In June we mentioned that the Ohio House had passed legislation to allow certain out-of-state licensed healthcare professionals to provide healthcare services on voluntary basis - during a charitable event - without obtaining a permanent Ohio license to do so. Stan Brock was very excited about this. At that time, and referring to RAM’s April Ohio clinic, Rep. John Patterson (D-Jefferson) and Sarah LaTourette (R-Chesterland) announced:
“HB 541 will help temporary clinics, like our recent effort in Ashtabula, to attract healthcare professionals outside our state by waiving their license fees during their period of voluntary service.”
RAM’s Ashtabula clinic served 953 in 2018 and aims to return in 2019. House Bill 541 passed out of committee unanimously and then through both chambers unanimously, with good bi-partisan support. 541 was finalized just over two weeks ago and passed on Thursday December 13th. And by clearing the state legislature this now heads to the governor’s desk!
Patterson added that out-of-state professionals can now practice in Ohio at a volunteer clinic and operate under Ohio’s health laws without paying a fee for an Ohio license.
“The theory was if we could waive those fees we could attract more providers.”
Ashtabula County Medical Center (ACMC), which celebrates its 115th anniversary next year and helped organize the April clinic which took place in Ashtabula Towne Square, announced:
“We would have been able to serve many more patients had we been able to recruit the physicians, nurses, physician assistants and nurse practitioners from outside of Ohio.”
With this news comes word that two more RAM free clinics are now being planned in addition to Ashtabula - one in Youngstown and another in the Dayton area.
According to Claims Journal, Ohio is only the fourth state to allow practitioners to cross state lines - Tennessee was the first in 1995 when its legislature passed the Volunteer Healthcare Service Act, thanks in great part to Stan’s campaign efforts. While much later campaigning for the Healthier Act, an initiative organized in collaboration with Rep. John J. Duncan Jr. (R-Knoxville), Stan said: “We have no problem at all getting volunteers … if they are allowed to cross state lines.”
US doctors sit the same national exams but the practice of medicine across state lines has been beset by multiple issues despite a number of organized schemes such as the AMA’s Interstate Medical Licensure Compact. This has not featured robust uptake thus far. And to confuse things further, there is a different compact for dentistry which Stan pushed for: the Coalition for Modernizing Dental Licensure (https://www.dentallicensure.org/en) was founded by the American Dental Association, the American Dental Education Association and the American Student Dental Association. For vision it is even more complicated, with ophthalmologists and optometrists organized through other associations.
The AMA last year claimed that cross-state licensing process via the IMLC was live in 8 states (https://www.ama-assn.org/practice-management/digital/cross-state-licensing-process-now-live-8-states) but states such as Ohio (via HB 541) have adopted their own legislation to more effectively expedite volunteering across state lines. Whereas the IMLC seems to have become bogged down among several reform models and lack of consensus, according to 'The Traveling Doctor: Medical Licensure Across State Lines’, a seminal article written by Brittany La Couture for American Action Forum. (https://www.americanactionforum.org/insight/the-traveling-doctor-medical-licensure-across-state-lines).
The strength of state medical boards and their pull for share of fee-based profits looks to have forced ad hoc state bills for volunteer events (like Ohio, or Tennessee in 1995, Illinois, or in California two years ago) and now more recently Healthier Act candidacy. In the case of the latter, there’s now grant money for states which pass laws allowing out-of-state health care providers to offer services on a volunteer basis.
NB: On December 21, 2018 Ohio Governor John Kasich signed Sub H.B. 541 (Patterson, LaTourette) into law. This was one among 14 bills. See: https://governor.ohio.gov/Media-Room/Press-Releases/articleid/1063/kasich-acts-on-14-bills
