Modifications of Telehealth and Interstate License Compacts Due to COVID-19

In response to the COVID-19 pandemic, many states have modified licensure requirements and renewal policies for medical providers to respond to the pandemic, including out-of-state license requirements for telemedicine.

Nationwide, the U.S. Department of Health & Human Services (HHS) is authorized to make declarations during certain emergencies regarding immunity from liability under the 2005 Public Readiness and Emergency Preparedness Act (PREP Act). In 2020 and 2021, HHS added several amendments to the PREP Act including countermeasures for treatment and prevention of COVID-19, interstate telehealth expansion related to COVID-19, and liability protection for medical providers of COVID-19 related services and products.

Covered Persons

Under the PREP Act, covered persons include “manufacturers, distributors, program planners, and qualified persons, and their officials, agents, and employees, and the United States.” To increase access to vaccines, Amendments 5 through 8 expand the categories of covered persons who  may “prescribe, dispense, and administer COVID-19 vaccines” to include:

• State-licensed healthcare providers as well as physicians, registered nurses, and practical nurses who have held a license within the past five years.
• Authorized federal employees, contractors, and volunteers.
• Licensed healthcare providers who normally do not administer vaccines and healthcare profession students with training and under supervision.
• Qualified pharmacy technicians and interns (to patients aged 19 and older and includes seasonal influenza vaccines)

Covered Countermeasures and Liability Immunity

Under Amendment 4, telehealth medical providers are protected from liability when ordering or administering specific countermeasure COVID-19 services and products:

1. Qualified products used to treat, diagnose, cure, prevent, or mitigate COVID-19
2. Drugs, biological products, or devices authorized for COVID-19 emergency use; and
3. Respiratory-protective devices approved by the National Institute for Occupational Safety and Health (NIOSH)

Interstate Compacts

Interstate compacts greatly increase the ease and capacity of licensed healthcare providers  to practice across state lines via telehealth under a contract between two or more states or through expedited licensing. State and local governments cannot require additional state licensure for telehealth medical providers ordering or administering “covered countermeasures” for COVID-19 related services and products. Under Amendment 8, interstate telehealth medical providers of covered COVID-19 care must comply with the laws of the state where they are licensed.

For information on interstate compacts backed by regulatory boards, see the following:

• Physicians: The Interstate Medical Licensure Compact (IMLC) – become licensed in multiple states
• Nurses: Nurse Licensure Compact (NLC) – practice in multiple state under one license
• Psychologists: Psychology Interjurisdictional Compact (PSYPACT) – practice telepsychology across member states
• Physical Therapists: PT Compact – work in multiple member states under a single license
• Emergency Medical Services (EMS) Workers: EMS Compact – work in multiple member states under a single license
• Audiology and Speech Language Therapists: Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC) – practice telehealth and in-person across state lines.

If you have any questions related to your licensure, contact one of the Danna McKitrick health care attorneys at 314.726.1000.

Posted by Attorney Brian S. Weinstock. Weinstock concentrates on real estate and corporate transactional law, workers’ compensation, insurance defense, and other civil and commercial litigation. For businesses, he provides financial and legal analysis as well as operational strategies and ideas to manage risk.

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