These laws and similar changes anticipated in other states will create a significant barrier to the effective use of telemedicine and other medical communications technologies. Several state medical boards have issued restrictive interpretations of their regulations. More states are expected to act in the near future. The Federation of State Medical Boards has drafted a model law for the regulation of cross-state communications and it is anticipated that the majority of states will consider bills based upon the Federation's model law. Every state requires a license for the practice of medicine.
Violations are punishable by civil and, in many states, criminal penalties.
A physician with a license in one state alleged to have practiced medicine in another state without a license may also be at risk of losing his license in his home state. Cross-state communications between physicians did not raise licensing concerns until recently for two reasons. First, technology limited these exchanges to phone conversations, faxes and correspondence. It was and is commonly believed that a physician who receives and reviews data on a patient from another physician, and drafts a response to that physician, is practicing medicine only in his home state where the work has been performed, without regard to where the receiving physician is located. The consultation exemption permits the state's physicians access to the expertise of physicians outside the state.