Expiration of State Licensure Waivers and Out-of-State Telemedicine Relationships
When state licensure waivers expired over the course of the COVID-19 pandemic, out-of-state telemedicine relationships declined, with many patients discontinuing care instead of switching to in-person visits. This effect that was strongest for long-distance patient–clinician relationships.
In general, clinicians must have a license in the state where their patients are located. During the COVID-19 pandemic, temporary state licensure waivers enabled individuals to access care from out-of-state clinicians via telemedicine. As these waivers expired, policymakers, payers, and other stakeholders faced uncertainty about how reinstating licensure requirements would affect access to care, particularly for patients relying on long-distance or specialized telemedicine relationships.
Published in JAMA Network Open, in partnership with other researchers, this study examined how expiration of state licensure waivers affected continuity of out-of-state telemedicine relationships. Results showed that waiver expiration was associated with fewer continued patient-clinician relationships, especially for geographically distant care, without a corresponding shift to in-person visits.
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