Under federalism, states retain the authority to license medical professionals. That fact will prevent the application of telemedicine across state lines and significantly hamper telemedicine's growth. Licensure is an important issue for interstate telemedicine because the violation of state licensure laws has serious consequences for the practicing physician. Moreover, practicing medicine without a valid license is often a criminal offense and thus carries a serious penalty much beyond the sancations of the profession. Kansas is the first state to directly apply its licensing statute to telemedicine.
Similar legislation is reported to be pending in Maine.
The Kansas legislation does exempt from the licensure requirement physicians who are referred a patient from a Kansas physician or who are in consultation with a Kansas physician and do not regularly practice in Kansas. The Kansas law has the effect of requiring any physician who establishes a regular telemedicine link with that state to have a Kansas license. Existing licensing laws in all other states can be interpreted to similar effect by the licensing boards or the courts of those states. State licensing boards clearly have an obligation to protect the patients of their state and to ensure that physicians practicing in that state are appropriately qualified. Requiring physicians to be licensed in every state where a regular telemedicine link is established will, however, pose a significant obstacle to interstate applications of telemedicine.