TREAT Act Has Support from Healthcare Community

During the COVID-19 pandemic, state licensing restrictions on health professionals have disrupted mobility and quick access to care, including physicians and advanced practitioners who are available to work in locum tenens assignments or in telehealth.

In their crisis response to COVID, states that are not a member of a state licensing compact, such as the Interstate Medical Licensure Compact (IMLC) for physicians, had to temporarily modify licensure requirements in limited circumstances for certain providers. However, state-by-state variability of these emergency waivers has created significant confusion and administrative burden, causing unnecessary delays in care.

The Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act, which was reintroduced to Congress in February, would provide temporary state licensing reciprocity for all licensed and certified practitioners or professionals (those who treat physical and mental health conditions) in all states for all types of services (in-person and telehealth) during the COVID-19 Public Health Emergency.

This temporary license reciprocity would continue through the end of the public health emergency declaration, followed by a 180-day phase-out period.

Under the TREAT Act, a provider who holds a valid license in good standing in any state and is not barred in another state, would be permitted to practice in every state for the duration of the emergency declaration, and a limited normalization period once the declaration of public health emergency is lifted (after which state licensure reverts to the status quo).

A bipartisan group of lawmakers reintroduced the TREAT Act (S. 168, H.R. 708) to both houses of Congress on February 2, 2021, and the legislation has been referred to committee in each house. Sens. Chris Murphy (D-Conn.) and Roy Blunt (R-Mo.) and Reps. Debbie Dingell (D-Mich.) and Bob Latta (R-Ohio) co-sponsored the bills.

A similar version of the TREAT Act was introduced in the last Congress.

“Allowing health care providers to treat patients wherever they live will help our health care system better adapt to the physical and mental health challenges of this pandemic,” said Sen. Blunt in a press release. “The TREAT Act eliminates bureaucratic hurdles that impede access to care without taking away any of the safeguards patients should expect. The bill is widely supported by the medical community and is one way we can support their critical work through this public health emergency.”

“Right now, America is in the midst of a public health crisis and Congress should be doing everything we can to allow licensed medical practitioners to provide their services from any location,” added Sen. Murphy. “By providing temporary uniform licensing standards, the TREAT Act seeks to remove bureaucratic red tape and make telehealth more accessible to anyone in need. It’s all hands on deck until we get this pandemic under control, and this legislation helps us get ahead of the virus.” 

Organizations showing support for TREAT Act

In a letter thanking the members of Congress for reintroducing the legislation, the Association of American Medical Colleges (AAMC) Chief Public Policy Officer Karen Fisher, JD, said that the TREAT Act “provides important flexibility during an emergency to ensure that patients receive the care they need. This would have many important benefits for patients, including providing access and continuity of care for mental health treatment, oncology patients, and others with serious or life-threatening conditions, and allowing health systems to draw on available licensed clinicians to meet the demands of a surge as outbreaks continue to arise.”

The AAMC was also part of a coalition of more than 50 associations for higher education that wrote a letter on March 8, 2021, in support of the TREAT Act, authored by Ted Mitchell, president of the American Council on Education (ACE). 

In the ACE letter, Mitchell noted, “Even as the use of telehealth and tele-mental health has risen dramatically during the COVID-19 crisis, state licensure rules and complexity remain an impediment to providing much-needed health and behavioral care via telehealth technology to patients, including college students.” He went on to urge Congress to pass the TREAT Act “as soon as possible to address this urgent problem now while the best path to longer term licensure reform is explored.”

The TREAT Act is also supported by the American Hospital Association, the AMGA (American Medical Group Association), and other organizations. 

How TREAT Act differs from Equal Access to Care Act

On the same day that the TREAT Act was reintroduced to Congress, the Equal Access to Care Act (S.155), sponsored by Senators Ted Cruz (R-TX) and Marsha Blackburn (R-TN), was reintroduced in the Senate and a companion bill (H.R. 688) was introduced by Rep. Ted Budd (R-NC) in the House of Representatives. This bill would allow health care providers to deliver telehealth services in any U.S. jurisdiction with only one license; it does not address in-person care across state lines.

The bill moves the location of care to the location of the provider, requiring the provider to follow the practice laws and regulations in the state where they are licensed as opposed to the state where the patient is located. 

Unlike the Equal Access to Care Act, the TREAT Act addresses concerns related to state-based licensure, discipline and licensure compacts through the addition of three provisions:  

  • Investigative and Disciplinary Authority (Section 4f) – this provision would allow jurisdictions to investigate and take disciplinary action against a provider by precluding him/her from practicing in their jurisdiction, and then require such as preclusion to be reported to the licensing authority in the provider’s state of licensure.
  • Multiple Jurisdiction Licensure (Section 4g) – this provision would require a provider to follow the practice laws and regulations in the jurisdiction where the patient is located if the provider holds a license in that jurisdiction, alleviating legal confusion about which license would apply.
  • Interstate Licensure Compacts (Section 4h) – this provision would exempt providers that hold a multistate license or privilege to practice in multiple jurisdictions through an interstate compact from being subject to this bill.

    Staff Care, as part of AMN Healthcare, is part of a large coalition of supporters for the TREAT Act that includes a cross section of hospitals and health systems, academic institutions, associations and nonprofit organizations. 

    Individual supporters who would like to advance the TREAT Act can help by letting their representatives know. To find and contact your Congressional representative, use these links: Find My House Representative and Find My Senator

    Sources:

    TREAT Act – Congress.Gov 
    Equal Access to Care Act – Congress.Gov 
    Legislation to Address Health Professional License Portability During a Public Health Crisis - NCSBN



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