Telehealth Licensing Requirements and Interstate Compacts

Providers can deliver telehealth services across state lines, depending on rules set by state and federal policies. Interstate compacts simplify cross-state telehealth for specialists in participating states. 

Almost every state has modified licensure requirements/renewal policies for health care providers in response to COVID-19, including out-of-state requirements for telehealth.

The 2005 Public Readiness and Emergency Preparedness Act (PREP Act) authorizes HHS to make declarations that provide immunity from liability in certain emergency circumstances. On December 3, 2020, HHS published Amendment 4 to the PREP Act to preclude state and local governments from enforcing more restrictive policies that keep “qualified persons” from administering countermeasures recommended by a PREP Act declaration. Specifically, this allows for interstate practice of telemedicine to improve public health outcomes in an emergency. This amendment provides liability protection when delivering specific COVID-19 related services, expands telehealth access, and makes it easier to treat and prevent COVID-19. Many states already allow providers to deliver out-of-state telehealth services. The new Declaration, however, ensures specific COVID-19 “covered countermeasures” can be provided or ordered via telehealth across state lines without additional state licensure.