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UPDATE: 15 States Considering Interstate Medical Licensure Compact

Mon, 2014-09-29 12:44
In response to the finalization of the Federation of State Medical Boards' (FSMB) Interstate Medical Licensure Compact, several states and large healthcare organizations, such as the American Medical Association (AMA), have expressed support and the possibility of endorsement. According to Humayan Chaudhry, DO, president and CEO of the FSMB, “many stakeholders across the spectrum [are] expressing support.” Read herefor a full account of the latest developments.

This post is a follow-up to previous posts on September 9 and August 7 regarding the FSMB's proposed interstate compact. Scroll down to learn more.

Hydrocodone Combo Products Moved from Schedule III to Schedule II: What It Means For You

Mon, 2014-09-29 12:32
Beginning on October 6, 2014, hydrocodone combination products (HCPs) will be moved from Schedule III to Schedule II substances at the recommendation of the Secretary of the Department of Health & Human Services. This change was included in the Federal Register as part of the Drug Enforcement Agency’s recent publication of its final rule on the matter.  Read herefor important need-to-know information on what this change means for family physicians and their patients.

Cautionary Advisory to International Medical Graduates Regarding Certification Requirements

Mon, 2014-09-29 12:25
According to the Educational Commission for Foreign Medical Graduates (ECFMG), some organizations, such as the American Medical Residency Board (AMRCB) may be misrepresenting the requirements for certification for international medical graduates seeking positions in graduate medical education within the US. See the link below for further important information:

UPDATE: FSMB Compact Proposal Released

Tue, 2014-09-09 09:48
According to an article by, the Federation of State Medical Boards (FSMB) has released its finalized planfor an interstate compact for physician licensure “under which physicians who are licensed in one state can use a streamlined process to be quickly licensed in another.” (Read the full article here)

This post is a follow-up to the August 7, 2014 post regarding FSMB’s initial proposal for this interstate compact. Scroll down to view the original post.

DEA to Increase Hydrocodone Combination Product Oversight

Thu, 2014-08-28 10:02
Yesterday, the Drug Enforcement Administration (DEA) announced that it will enforce stronger regulations for individuals who handle hydrocodone combination products (HCPs).  This rule will shift HCPs from Schedule III to Schedule II of the Controlled Substances Act -- the designation for products that are most subject to abuse and mishandling.  This rule will go into effect 45 days from DEA's official announcement.   

What Could Black Boxes in Operating Rooms Tell Us?

Wed, 2014-08-27 10:01
According to HealthData Management, some hospitals have begun to develop black box mechanisms for their operating rooms (OR) in an effort to reduce preventable errors and increase transparency.  The goal is to use black boxes to record OR procedures to help improve patient safety by identifying errors and facilitating teachable moments for all practitioners.  The black boxes models would record both video and voice, as well as other elements, such as room temperature and noise levels.

Read more about it at HealthData

ABIM Pledges to Examine MOC Requirements

Mon, 2014-08-25 13:31
In response to physicians' collective opposition to revised Maintenance of Certification (MOC) requirements, the American Board of Internal Medicine (ABIM) recently announced that it would lessen the financial and course requirements associated with the MOC process, as well as ensure that MOC requirements are clear and consistent across specialty boards.  ABIM also pledged to work closely with the American Board of Medical Specialties and specialty societies to improve the MOC process for all parties. 

Read more about ABIM's MOC initiative.

TJC Amends Standards in Response to May 2014 CMS Rule

Thu, 2014-08-21 15:39
The Joint Commission (TJC) announced that it has revised its hospital and critical-access hospital standards to align with CMS's May 2014 conditions of participation rule.  According to its website, TJC standards "clarify the requirements of a practitioner not appointed to the medical staff who is ordering outpatient services, governing body consultation with the medical staff, and medical staff structure for multihospital systems."

Learn more about CMS's final rule and TJC's revised standards for hospitals and critical-access hospitals

Fast Track For Primary Care Docs At One Calif. University

Fri, 2014-08-08 15:22
From Kaiser Health News:

Some doctors in the state of California will soon be able to practice after three years of medical school instead of the traditional four. The American Medical Association is providing seed money for the effort in the form of a $1 million, five-year grant to the University of California at Davis.

Read more online:

FSMB Compact Could Ease Multistate Licensing

Thu, 2014-08-07 11:25

FSMB Compact Could Ease Multistate Licensing Ken Terry
August 05, 2014 The Federation of State Medical Boards (FSMB) has unveiled a draft interstate compact for physician licensure that, it said, should make it easier to practice telemedicine across the country. The compact, which the FSMB expects to finalize in the next month or two, offers a "streamlined alternative pathway" for physicians who want to practice in multiple states, according to a federation news release.Under current state medical board policies, physicians must be licensed in the state where a patient is located to diagnose or treat that patient, a stance that the FSMB recently reaffirmed in its model policy for telemedicine. As a result, physicians who consult remotely with patients in other states must be licensed in those states. That can create barriers to telehealth consultations, especially for on-call physicians who are not licensed in every state where patients may contact them online.The FSMB's interstate compact would allow physicians to apply once and receive licensure in all states that are party to the compact.Once the compact is finalized, individual medical boards can decide whether to endorse it and submit it to their state legislatures for approval. Three state boards, including the Texas and Oklahoma medical boards and the Washington State osteopathic medical board, have already approved the compact in principle, said Humayan J. Chaudhry, DO, president and chief executive officer of the FSMB."Many other boards have it on their agenda and are waiting for the final language before they can present it to their legislatures," he told Medscape Medical News, adding that 15 states are expected to approve the compact in the near term.According to Chaudhry, a house of delegates representing the FSMB's 70 member boards asked the federation to study the concept of an interstate compact. What motivated the boards, he said, was the need to address the nation's growing physician shortage, to ease patient access issues related to the Affordable Care Act, and to facilitate telemedicine in both rural and more populated areas.In addition, he said, the interstate compact could help physicians get licenses in metropolitan regions that cross state boundaries. He cited the situation of Washington, DC, physicians, many of whom have had to obtain separate licenses in Maryland and Virginia to treat their patients.The draft interstate compact specifies that, to be eligible for multistate licensure, physicians must have passed the US Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination, must be board-certified, must have clean records, and must have been in practice for at least 3 years. Because they must also complete a residency program, the latter requirement might be dropped in the final version, Chaudhry said.A "Baby Step"Jonathan Linkous, president and chief executive officer of the American Telemedicine Association (ATA), told Medscape Medical News that the draft interstate compact falls far short of what is needed to promote telemedicine. "The federation is taking a step. But it's a baby step, and what we need is a giant leap."The key area where the interstate compact falls short, he said, is that it would create a "clearinghouse," rather than reciprocity among states. Physicians would be able to apply for licensure to multiple states through a single entity but would still have to pay license fees to each state and would have to "follow every state's unique and peculiar rules regarding how you practice medicine."There are some large differences in those rules, he noted. For example, 24 states allow physicians to prescribe medications in telehealth encounters with patients. The rest require prior patient visits, a presenter in the same room as the patient, or a live follow-up visit.State license fees are also substantial, Linkous pointed out. The ATA performed an analysis in 26 states and found that for the fifth of physicians who had licenses in multiple states, license-related fees cost them about $300 million a year. He granted, however, that those costs might be reduced if physicians filled out a single application and did not have to provide original documents to each medical board.The ATA does not favor national licensure of physicians. What it wants is reciprocity among all states, similar to the way they treat driver's licenses today. If a physician is licensed in one state, he or she should be able to practice in any state, Linkous said.
Medscape Medical News © 2014  WebMD, LL

Data Bank to Reduce Query Fees

Wed, 2014-08-06 09:28
From The Data Bank: Effective October 1, 2014, the new fee to query the National Practitioner Data Bank (NPDB) will be $3.00 for both Continuous and One-Time Queries and $5.00 for Self-Queries. All other aspects of querying will remain the same.

Read more online

From H&HN Daily: Concerns Raised Over IOM's Report on GME

Mon, 2014-08-04 11:01
Hospitals & Healthcare Networks Daily: An influential IOM panel recommended a monumental shift in how graduate medical education is governed and financed. Teaching hospital officials worry the proposed changes would negatively impact patient care and physician training.

Read the entire article here:

Weinstock, Matthew. "Concerns Raised Over IOM's Report on GME." H&HN Daily 30 July 2014: n. pag. Web.

The D.O. Is In Now: Osteopathic Schools Turn Out Nearly a Third of All Med School Grads

Tue, 2014-07-29 17:59
From the New York Times - July 29, 2014

Getting into osteopathic school is still excruciatingly tough. Last fall, more than 144,000 students applied for some 6,400 spots. Touro this year received 6,000 applications for 270 first-year seats for the Manhattan school and a new campus opening this summer in Middletown, N.Y. (The average M.C.A.T. score for students entering this fall was just a point below the M.D. average.)
The boom in osteopathy is striking. In 1980, there were just 14 schools across the country and 4,940 students. Now there are 30 schools, including state universities in New Jersey, Ohio, Oklahoma, Texas, West Virginia and Michigan, offering instruction at 40 different locations to more than 23,000 students. Today, osteopathic schools turn out 28 percent of the nation’s medical school graduates.
Read the full article at the New York Times website
Berger, Joseph. "The D.O. Is In Now: Osteopathic Schools Turn Out Nearly a Third of All Med School Grads." The New York Times 29 July 2014 Published: Web. 29 July 2014.

Interstate Medical Licensure: Major Reform of Licensing to Encourage Medical Practice in Multiple States

Tue, 2014-07-29 17:50
From the Journal of the American Medical Association - July 28, 2014

The Interstate Medical Licensure Compact is a streamlined process that would allow physicians to rapidly become licensed to practice medicine in multiple states. If the compact were to be approved by state legislators and incorporated into the laws of most, if not all, states, it could catalyze many substantial changes in medical practice. 

Read more at JAMA

Corresponding Author: Robert Steinbrook, MD, Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, I-456 SHM, PO Box 208008, New Haven, CT 06520 ( Online: July 28, 2014. doi:10.1001/jama.2014.9809.Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

AOA House of Delegates Approves Single GME

Tue, 2014-07-29 11:15
The American Osteopathic Association (AOA) House of Delegates recently voted to approve the AOA Board of Trustees' decision to implement a single accreditation system for graduate medical education.  This movement stems from an agreement that the Accreditation Council for Graduate Medical Education and the American Association of Colleges of Osteopathic Medicine reached earlier this year to collaborate to create a single GME accreditation program.  The new accreditation system will be fully implemented in July 2020. 

Read more about the new accreditation policy at

U.S. Supreme Court to Determine States' Authority to Set Scope of Practice

Wed, 2014-07-23 12:16
In early October, the U.S. Supreme Court will hear North Caroline Board of Dental Examiners v. the Federal Trade Commission to determine scope of practice regulation. The case stems from the North Carolina Dental Board's policy that prohibits non-licensed dentists from administering teeth-whitening treatments.  This issue came to light when the North Carolina Board of Dental Examiners issued cease and desist letters to spas, mall kiosks, and other pedestrian locations that began to offer teeth-whitening services. 

State medical and dental boards in all 50 states currently regulate scope of practice.  The Federal Trade Commission (FTC) asserts that this facilitates monopolies and inhibits competitive pricing in many cases.  Medical and dental groups argue that the FTC doesn't have the authority to oversee state practice and that patient safety is a critical component to any medical or dental care.  Scope of practice is, thus, a critical component to ensuring that those administering such treatments are qualified, competent, and certified.   

What do you think? Does a federal agency have the right to interfere with state law? Should state medical and dental boards oversee scope of practice?

Read more about this case at 

Kentucky Law Allows Certain Nurse Practitioners to Prescibe Medications

Thu, 2014-07-17 13:43
Advanced Practice Registered Nurses practicing in Kentucky who have completed a designated four-year collaboration agreement with a physician will now be able to prescribe certain medications without a physician's supervision. This movement stems from the ongoing national discussion regarding nurse practitioner scope of practice. 

Read more about Kentucky's law from Kaiser Health News.

AOA's Single GME Accreditation System Gains Momentum

Wed, 2014-07-16 13:47
According to the American Osteopathic Association (AOA), over 40 state, specialty, and national associations have formally declared support for a single General Medical Education accreditation system.  This extensive effort continues to be a professional collaboration that includes developing standards, establishing processes for education programs, and securing appointments to committees involved in planning and executing this initiative.  The AOA House of Delegates will further discuss this issue during its meeting in July. 

Read more about the initiative's progress at

ACGME Voices Concern over Missouri's Assistant Physician Law

Fri, 2014-07-11 11:26
In an attempt to address the state's ongoing physician-shortage problems, Missouri Governor, Jay Nixon, recently signed into law a provision that would allow medical school graduates who haven't completed residency to practice in primary care settings. 

The law stipulates that these graduates, deemed assistant physicians, undergo a 30-day supervision period with a collaborating physician. Once completed, assistant physicians could begin seeing patients within 50 miles of the supervising physician. 

The Accreditation Council for Graduate Medical Education's CEO, Dr. Thomas Nasca, voiced concern that without residency experience, assistant physicians may not be able to provide the level of care necessary to independently medically manage patients.

Read more about it in a HealthLeaders Media interview with Dr. Nasca. 

FSMB Continues Work on Medical Licensure Compact

Wed, 2014-07-09 10:34
The Federation of State Medical Boards (FSMB) has begun work on the third draft of its medical licensure compact.  The compact will enable physicians who practice in multiple states to obtain licensure more efficiently in states participating in the compact.  This will prove particularly helpful for physicians who provide telemedicine services across multiple states.

The compact is gaining momentum, and in early 2014, 16 U.S. senators signed a letter supporting FSMB's initiative.  NAMSS continues to watch these developments and looks forward to continuing to work with FSMB and other industry partners to continue to advance the credentialing and licensing processes.

Read more about FSMB's Medical Licensure Compact here and here.