By Jennifer Larson, contributor Jul 12, 2021
The Interstate Medical Licensure Compact
(IMLC) continues to expand in 2021.
Delaware just became the 34th member of the IMLC, which is
an agreement that provides a pathway to expedited licensure in participating
states for qualified physicians. The state’s General Assembly passed
legislation in May, and Delaware Governor John Carney signed House Bill 160
into law on June 23, 2021.
Earlier in June, Texas became the 33rd member of the compact.
With these two recent additions, there
are now 32 states, plus the District of Columbia and the territory of Guam,
that participate in the IMLC.
Which states will be next? Read on for a mid-year IMLC update.
IMLC in 2021 and
Although more than half of the states are now
members of the IMLC, the compact hasn’t actually been around that long. With assistance
from the Federation of State Medical Boards, a group of state medical board
executives, administrators and attorneys drafted the model compact and
introduced it publicly in the fall of 2014. State legislatures soon began adopting
it, and in April 2017, the compact became operational.
Since that time, states have continued to pass legislation to join the
Prior to Texas, Louisiana was the most recent state to join the IMLC,
having made the decision official in late 2020. “They anticipate going live on
July 1,” said Marschall Smith, executive director of the Interstate Medical
Licensure Compact Commission (IMLCC).
And the compact may expand yet again very soon. As of June 29, 2021,
there is active IMLC legislation pending in five states:
According to Smith, Ohio is likely to join the medical licensure compact
Ohio’s Senate recently passed Senate Bill 364,
which put the bill on a path to the House. If the House greenlights the legislation, it
would go to Ohio Governor Mike DeWine’s desk to await his signature. Depending
on how long it takes the bill to make it through these two steps, Ohio could join
the IMLC this summer.
Compact membership might also be on the horizon for North Carolina,
which currently has a bill (Senate Bill 380)
active in committee.
“I would say that has a better than 50-50 chance of passing,” Smith
Could all 50 states eventually become members of the IMLC? Given that
the legislation has languished or died in some states, it’s hard to predict
with certainty, but Smith remains optimistic that even the holdouts may
eventually come around.
“I think there is sufficient pressure,” he said, explaining that the
compact gives physicians more flexibility to help patients in more states via
telemedicine or in-person care—the importance of which came to the forefront as
the COVID-19 pandemic developed.
Smith also noted that license applications surged as COVID-19 cases
grew. During the 12-month period from March 2019 to February 2020, the IMLC
commission processed 3,738 applications and issued 3,877 licenses to
physicians. But during the March 2020-February 2021 time period, they processed
5,282 applications and issued 8,126 licenses.
The IMLCC notes that “licenses are still issued by the individual
states – just as they would be using the standard licensing process – but
because the application for licensure in these states is routed through the
Compact, the overall process of gaining a license is significantly streamlined.”
More awareness of medical licensure issues
The COVID-19 pandemic raised awareness of the need for streamlined
medical licensure as physicians and other healthcare providers were needed to
provide care across state lines in order to assist in hot spots throughout the
country. A number of states waived in-state licensure requirements for
telehealth, and various state and federal legislative acts were used to
increase access to care during the emergency declaration.
In February 2021, U.S. Senators Chris Murphy (D-CT) and Roy Blunt
(R-MO) introduced the Temporary Reciprocity to Ensure Access to Treatment (TREAT)
Act in the Senate, while Reps. Bob Latta (R-OH) and Debbie Dingell (D-MI) introduced
a companion bill in the House of Representatives. The Senate legislation, filed
as Senate Bill 168, would “temporarily
authorize the interstate provision of in-person and telehealth services” and
would apply during and at least 180 days after an emergency, such as the COVID-19
Smith notes that the IMLC already helps physicians who want to incorporate
telehealth into their practice to care for patients across state lines. The
compact streamlines the application process for a medical license to practice
in other states, and the authorization to practice would not be subject to an
tenens physicians who want to take assignments in other states also benefit
from the expedited licensure application process afforded by the IMLC.
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