:: National Licensure for Quality Healthcare across America
Frequently Asked Questions
Fixing licensure is a complicated issue and we frequently receive questions regarding the project. Please review these Frequently Asked Questions (FAQs.) If you have a question not addressed below, please contact Gary Capistrant at

What are some U.S. models for nationwide licensure?

Congress, with overwhelming bipartisan support, has just expanded the long-standing policy for military health care professionals employed with the Departments of Defense and Veteran Affairs to need only be licensed in their home state to treat the military and veterans, respectively, on federal property. Congress is expanded this to 1) their civilian employees and contractors and 2) to service anywhere

For emergencies, there is the Emergency Management Assistance Compact (EMAC), a federally approved interstate compact that allows signatory states to request and provide assistance to other signatory states. Currently, all 50 states, the District of Columbia, Virgin Islands, Puerto Rico and Guam, are signatory parties of the EMAC agreement. Under EMAC, an individual including a health care professional, who is licensed in one state will be considered authorized to practice in any other state that requests such assistance.

Some states have special arrangements to accommodate telehealth, such as reciprocity or special licenses.

For nurses, there is a Nurse Licensure Compact that 24 states are honor that allows nurses to have one multistate license, with the ability to practice in both their home state and other party states.

Generally speaking, there are 4 alternatives to state licensure and regulation
  • Federalization
  • Pre-Emption
  • State Licensure and Regulation of Physicial Residents
  • Mutual Recognition

What about states’ rights, especially the 10th amendment to the U.S. Constitution?

Physicians and other licensed professionals would still need to be licensed by their “home” state.

Much of health care services are provided by federal employees, under federal contracts or paid for by federal programs, such as Medicare. This is interstate commerce and federal rights trump states rights.

Also, the program could be a voluntary nationwide arrangement for states to participate in and could include other provisions to help or protect states’ interests, such as policing illegal practices and wrongdoing and generating revenue.

How do other countries handle national licensure issues?

Allowing physicians the right of free circulation as providers of medical services within the 25-nation European Union (EU) was part of a founding EU principle for freedom of circulation of goods, persons and services. The EU lays out minimum training requirements for general practice and specialist physicians and provides for mutual recognition of physicians’ qualifications. It also enforces measures to ensure that the licensing provisions of individual Member states permit the free movement of doctors both to establish themselves and to practice their profession in all Member states.

Australia moved in July 2010 from a state-based system to a single national agency to implement a registration and accreditation program supporting the work of national boards governing 10 health professions. Four more medical professions are scheduled to be added to the national system in 2012. is hosted by the American Telemedicine Association
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