Licensing and Credentialing

The Centers for Medicare & Medicaid Services (CMS) has issued a temporary waiver to allow physicians who are licensed in one state to provide services to a patient another state. This applies to Medicare and Medicaid.

For Medicare, this policy only applies if the following conditions are met:

  • the physician or non-physician practitioner must be enrolled as such in the Medicare program;
  • the physician or non-physician practitioner must possess a valid license to practice in the State which relates to his or her Medicare enrollment;
  • The physician or non-physician practitioner is furnishing services – whether in person or via telehealth – in a State in which the emergency is occurring in order to contribute to relief efforts in his or her professional capacity; and
  • The physician or non-physician practitioner is not affirmatively excluded from practice in the State or any other State that is part of the emergency area.

In addition, this policy does not have the effect of waiving State or local licensure requirements or any requirement specified by the State or a local government. Those requirements would continue to apply unless waived by the State. In other words, in order for a physician to deliver services in another state, that state would have to waive its licensure requirements for the type of practice for which the physician or non-physician practitioner is licensed in his or her home State.

For information on individual states that have waived certain licensing requirements or expedited licensure of retired health care workers, please click here.

For more information on CMS’ waivers, please visit here

CMS has not addressed credentialing issues with respect to telehealth but has pointed out that this is within the jurisdiction of the states to address. However, the CMS Administrator, Seema Verma, has raised the need for it with states.

CMS has also released COVID-19 Medicare Provider Enrollment relief FAQs. The information covers waiver flexibilities for provider enrollment, hotline information, and information on options for providing care in alternative settings.

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