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18 Dec 2015

Practicing Medicine Across State Lines

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Practicing Medicine Across State Lines: 5 Things You Should Know About the Medical License Debate

Written by Laura Dyrda | December 14, 2015

 

Should medical licenses become more like drivers’ licenses?  There are some who think so according to a report in The Bulletin.

 

State currently have different medical licensing standards and it’s a time-consuming process to obtain a medical license in multiple states.  Yet with the interconnectivity growing in the United States, and mobility more prevalent, there are some physicians advocating for more standard requirements allowing physicians to treat patients across the United States.

 

Here are five key thoughts on trends in medical licenses:

 

To continue reading the original and remaining article, please visit Becker’s ACS Review by clicking here:

 

http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/practicing-medicine-across-state-lines-5-things-to-know-about-the-medical-license-debate.html

 

About Physician Licensing Service

Now in our 19th year of business, Physician Licensing Service has been changing the face of healthcare licensure.  We have developed a proven system to remove the barriers common to state medical licenses and get doctors practicing in record time.  Our business model focuses on simplifying the process for all involved parties. This includes the state medical boards themselves, because PLS takes great care to keep abreast of their updates in this ever changing field, and work within those guidelines. For a doctor seeking a medical license, PLS will take on the entire process, including eligibility research, paperwork, verifications, and follow up.

12 Nov 2015

Medicare & Telemedicine: Your Top Reimbursement Questions, Answered

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When it comes to telemedicine, navigating the reimbursement process can be tricky. What rules do you need to follow to ensure you get paid? How do you know your patients are eligible for telemedicine? How does the billing process actually work?

 

We get these questions all the time at eVisit. While the answers vary a bit depending on which payer you’re talking about, it’s usually easiest to start with Medicare.
Presentation
Medicare currently provides coverage for more than 55 million older Americans. Doing telemedicine with your Medicare patients is a huge opportunity to make a difference in their care experience, especially since Medicare patients are the most likely to have multiple chronic health issues and need frequent care.

 

So how does telemedicine reimbursement through Medicare work? The good news is, since Medicare is a national program, the guidelines for telemedicine are the same no matter what state you’re in. That makes things a little easier than navigating reimbursement through Medicaid or private payers.

 

Here are answers to the top questions we hear about Medicare and telemedicine reimbursement.

 

Does Medicare reimburse for telemedicine?

Yes! Medicare has covered telemedicine for many years now in order to increase care access to Medicare patients.

 

What types of telemedicine does Medicare cover?

There are several different kinds of telemedicine, including real-time, store-and-forward, and home monitoring. Currently, Medicare covers real-time, live video telemedicine in all 50 states. Store and forward telemedicine (which involves sharing patient medical data remotely for diagnosis and analysis, and does not require the patient to be present) is actually also covered by Medicare, but not billed as a telemedicine service. CMS advises physicians to bill these services the same way as medical services delivered onsite.

 

As of 2015, Medicare also now provides some coverage for home monitoring under the new chronic care management CPT code 99490.

 

Store-and-forward telemedicine services are only covered in Alaska and Hawaii, and home monitoring is not covered at all.

 

Which Medicare providers can bill for telemedicine?

Only certain healthcare providers can get paid for telemedicine under Medicare. These include Physicians, nurse practitioners, physician assistants, nurse-midwives, clinical nurse specialists, certified nurse anesthetists, clinical psychologists, clinical social workers, and registered dietitians or nutrition professionals.

 

Keep in mind that if you’re a provider not included on this list, you may still be able to practice telemedicine depending on your state medical board recommendations. But under Medicare, you would not be able to bill and get paid for that service.

 

What is an originating site? And what’s a distant site?

If you’ve been reading up on Medicare and telemedicine at all, you probably noticed the terms “originating site” and “distant site.” Understanding these is very important. The originating site means the location where the Medicare patient is at the time of the telemedicine service. The distant site means where the healthcare provider is at the time of the telemedicine service.

 

While many of us now think of telemedicine as a secure video conference between a patient at home and a healthcare provider at their office (or home), Medicare hasn’t yet caught up to this idea. Traditional Medicare does not yet recognize the patient’s home as an eligible originating site.

 

Traditionally, patients participating in telemedicine would come to a local health center to see their primary care doctor, and that doctor would use a telemedicine system to include a distant specialist in the appointment. Now that telemedicine has expanded well beyond this model, the Medicare rules need some updating.

 

So, what qualifies as an eligible originating site?

To qualify as an eligible originating site, the location has to meet two conditions:

 

It has to be located in a Health Professional Shortage Area (HPSA) or a county outside of a Metropolitan Statistical Area (MSA). Check whether an address is in a HPSA with this quick tool.

It has to be one of the following types of healthcare facilities:

Physician or practitioner office

Hospital

Critical Access Hospitals (CAH)

Rural Health Clinics

Federally Qualified Health Centers

Hospital-based or CAH-based Renal Dialysis Centers (including satellites)

Skilled Nursing Facilities (SNF)

Community Mental Health Centers (CMHC)

Note: Independent Renal Dialysis Facilities are not eligible originating sites.

 

 

What health services can be delivered via telemedicine?

You can find a complete list of the covered CPT and HCPCS codes on this handout from Medicare. See pages 3 and 4.

 

How do I bill telemedicine?

As long as you’ve met all the other Medicare guidelines for telemedicine (eligible provider, distant site, originating site), billing is as easy as choosing the appropriate covered CPT code and adding the modifier “GT.” The GT modifier tells Medicare that the service was delivered via telemedicine.

 

How much will I get paid?

You’ll get paid the same amount for a telemedicine service as the corresponding in-person service. Just look-up the CPT code on the Medicare physician fee schedule to see the amount.

 

When will the restrictions on eligible originating site change?

While there’s nothing definite yet, legislators proposed the Medicare Telehealth Parity Act of 2015 this past July that would eliminate some of the restrictions on eligible originating sites. The bill would also expand the eligible healthcare providers and medical services. You can stay tuned on policy updates by following us (@eVisit) and the Southwest Telehealth Resource Center (@UA_ATP)!

 

Does telemedicine reimbursement work differently for traditional Medicare and Medicare Advantage plans?

Yes! All the restrictions and guidelines outlined here apply to traditional Medicare. In contrast, Medicare Advantage plans fall under private payers and have flexibility to cover telemedicine reimbursement as they wish.

 

In other words, if one of your patients has a Medicare Advantage plan, getting reimbursed for telemedicine will likely be much easier!

 

(Written by Teresa Iafolla at Southwest Telehealth Resource Center – http://southwesttrc.org/)

 

About Physician Licensing Service
Now in our 18th year of business, Physician Licensing Service has been changing the face of healthcare licensure. We have developed a proven system to remove the barriers common to state medical licenses and get doctors practicing in record time. Our business model focuses on simplifying the process for all involved parties. This includes the state medical boards themselves, because PLS takes great care to keep abreast of their updates in this ever changing field, and work within those guidelines. For a doctor seeking a medical license, PLS will take on the entire process, including eligibility research, paperwork, verifications, and follow up.

25 Jun 2014

Rumors of USMLE Time Limit Eliminations are Unfounded

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Rumors of USMLE Time Limit Eliminations are Unfounded

The following summary was pulled directly from the UMSLE website this week:

State Board Sponsorship For Step 3 To Be Discontinued In 2014

With the introduction of the restructured Step 3 examination in 2014, the USMLE program will no longer require examinees to apply for Step 3 under the eligibility requirements of a specific medical licensing authority.

 

All other Step 3 eligibility requirements (i.e., medical degree, passing Steps 1-2, ECFMG certification for IMGs) will remain applicable, as will all other USMLE program requirements (e.g., no more than 6 attempts at a Step or a Step component).

 

This change in the application process is tentatively scheduled to begin in August 2014.

Note: Removing state board sponsorship as part of the Step 3 examination application does not impact medical licensing requirements in the United States. Most medical licensing authorities have, and will continue to maintain, specific criteria for completion of the USMLE, such as time and attempt limits.

 

summary of these requirements can be found on the Federation of State Medical Boards website.

 

At this time, there are no plans for the USMLE program to impose a minimum residency training requirement as part of the Step 3 eligibility criteria. However, the USMLE program will likely continue to recommend that individuals take Step 3 at or near the completion of the first year of residency training.

Courtesy of USMLE announcement portal

 

This announcement confirms that physicians who are outside timeframe and/or attempt limits for a particular state will still not qualifyfor that state license after the August 2014 changes for state sponsorship go into effect.

 

This is a good opportunity to address trainees who are preparing to take USMLE exams:

Do not take these examinations lightly- Just because you can take the exams again, does not mean that you should. Your ability to practice in the state of your choice in the future isdetermined by your scores, attempts per step and the time frame in which you completed all three steps.  If you do not meet the requirements for a particular state, you will not be able to get a license to practice in that state. Even if you have an offer of employment, even if it’s your home state, even if your spouse has been offered the job of a lifetime in that state- You will not be working as a physician in that state if you do not meet the USMLE requirements for that state.

 

If you have questions about the USMLE requirements for each state, please click here. If you have questions about possible waivers, please call us at 888-551-2140.

26 Mar 2014

2014 Could Be A Challenging Year For Physicians

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Top 10 Challenges Facing Physicians in 2014

From:  Medical Economics

 

Every challenge is an opportunity.

While this list of 10 challenges facing physicians seems daunting and nearly insurmountable for smaller office-based practices, many believe there is tremendous upside for primary care physicians in leading healthcare delivery in the United States in 2014 and beyond. The result could mean more autonomy; it could mean better quality of life for you and your patients, and hopefully result in less interference with the doctor-patient relationship.   But it’s going to take work, management experts say. Physicians will need to reinvent their operations to create efficiencies and thoroughly evaluate the revenue cycle to maximize cash flow. That means you will need to review payer contracts, and look at adopting technology to improve patient care. You may have to re-engineer workloads, workflows and staff responsibilities. It is this premise that Medical Economics is showcasing with this list of 10 challenges and opportunities facing physicians next year. We believe that understanding the dynamics of a changing market will ultimately help physicians shape it, adapt to it and succeed. Over the course of this past year, we have learned through interviews and surveys that you find tremendous professional satisfaction from helping patients improve their lives. In fact, it continues to be the reason you entered medicine, and the reason you will stay. At the same time there are trends outside of this relationship that are interfering with your time with patients and continually threatening the economic viability of your practice. Healthcare is in the throes of great change. And history has shown that large-scale disruption incubates innovation. Our collective opportunity as a healthcare profession is to build a stronger healthcare delivery system rightfully led by primary care that seeks to remain cost conscious, efficient in its delivery, and fairly compensated for helping people attain the most precious commodity of all—a healthy life. —Daniel R. Verdon

Challenge #1: Payment for medical services

ACA and changing payment trends Healthcare’s ailing reimbursement system will likely take a turn for the worse in 2014, before it recovers.

 

And while 2013’s payment structure seems dehydrated to many physicians because of tighter negotiated payments by health insurers, escalating costs of doing business, and the seemingly endless cascade of bureaucracy tied to payments, some believe relief won’t be felt for the cadre of U.S. physicians in office-based practices for some time.

 

Why? Healthcare is in the midst of transformational change in the way it is financed. Fifteen of the 16 key provisions of the Affordable Care Act (ACA) will take effect in 2014, and they will most definitely impact the numbers of patients you see and the way you are paid for medical services.

 

Despite the flawed rollout of the insurance exchanges this fall, coverage for new health insurance enrollees begins on January 1. The new law stipulates that insurance companies cannot drop coverage based on pre-existing conditions. For states that have opted to expand Medicaid, that coverage also begins in January.

 

While more people are reportedly enrolling in the exchanges, U.S. residents will be required to have qualifying health coverage or face financial penalties. Wellness programs allow employers to offer employees rewards of up to 30%, potentially increasing to 50%, of the cost of coverage for participating in a wellness program and meeting certain health-related standards. The ACA also creates a 10-state pilot program (by July 1, 2014) to track and monitor successes.

 

On March 31, the insurance exchanges close for 2014 enrollment, and we will have a barometer to gauge how many newly insured Americans entered the market. Data related to physician payments for services by health insurers will also offer another indicator. Here are some of the keys to watch for next year.  

 

The narrow networks squeeze

Payers are consolidating networks and repositioning in markets as a result of the ACA. We saw the results play out from October through December as physicians received termination notices from key health insurers in more than 10 states regarding network consolidation for Medicare Advantage.  These moves have impacted thousands of physicians and patients, and this trend may not go away anytime soon.

 

Narrow networks are believed to offer payers more bargaining power in negotiating contracts with providers and lowering costs of care.  Narrow networks also limit choice for patients with a smaller pool of providers and hospitals.

 

Quality and quantity

The year 2014 will be about cost control, says a recent report from consulting giant pricewaterhousecoopers (PwC) titled “Medical Cost Trend: Behind the Numbers 2014” despite one of the greatest healthcare insurance expansions in history. “For an industry that until recently had consistently seen double-digit growth, the ongoing slowdown poses immediate financial challenges. At the same time, the imperative to do more with less has paved the way for a true transformation of the health ecosystem, from fee-for-service medicine to consumer-centered care that rewards quality outcomes,” PwC says. Traditional fee-for-service is moving toward a payment structured leaning toward compensation based on outcomes. And many variations will likely surface. Models that will be further developed include:

 

  1. bundled payments for services, (and in some cases bundled payments for multiple providers),
  2. episode of care, (providers paid to treat a specific condition over a period of time),
  3. Physician Quality Reporting System (incorporating quality metrics),
  4. shared savings programs (physicians split savings with the insurer), and
  5. Patient-Centered Medical Home

 

High-deductible health plans will also pose business challenges for most practices and will require a more aggressive collection policy at the time of visit.  PwC estimates that employers offering high-deductible plans as their only option has grown 31% since 2012.

 

Opportunities abound

And while the predictions sound dire, there are plenty of opportunities for primary care to assert its leadership, showcase its status as a relative bargain among healthcare providers, and advance its mission to experiment with direct pay, ancillary services, and team up with employers and insurers to capitalize on innovative wellness programs to improve the health of your patient population and the practice’s bottom line. Primary care will need to reinvent its services to patients, reassess its use of technology to better monitor population health and engage patients in new ways.

 

Challenge #2: Government mandates   2014: The year of the government mandate

 

When primary care physicians (PCPs) of the future look back on 2014, they may well recall it as the “year of the mandate.” That’s because PCPs will see their practices affected by four major government-sponsored requirements:

 

  1. the use of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) coding system for billing, effective October 1;
  2. the second stage of the Meaningful Use incentive program (MU2) for electronic health records (EHRs);
  3. updated rules for the Health Insurance Portability and Accountability Act (HIPAA) and;
  4. the Physician Quality Reporting System (PQRS).

 

ICD-10: Convert or don’t get paid

Of these, the requirement to use the ICD-10-CM coding system will probably have the greatest impact, for the simple reason that practices not using the new code set will no longer be reimbursed by third-party payers. The ICD-10-CM codes require a far greater level of specificity than the current ICD-9-CM code set, and thus require training for coders, billers, and providers, as well as extensive changes to—and testing of—billing software. A 2008 study estimated that conversion costs will range from $83,000 to $2.7 million, depending on the size of the practice.  

 

Meaningful use: Attest next year or face penalties

The coming year will also be important for doctors taking part in the government’s Meaningful Use (MU) incentive program to adopt electronic health record (EHR) systems. Those who successfully attested to MU1 in 2011 or 2012 can choose any 90-day period in 2014 to meet their MU2 objectives and qualify for the next round of incentive payments. In addition, 2014 is the last year in which doctors who have not previously participated in MU can do so and avoid financial penalties beginning in 2015.

 

The biggest challenge many doctors will face in attesting to MU2 is meeting the requirements for electronically exchanging patients’ health information with other providers, especially those using a different EHR system. EHR vendors are working to include information exchange capabilities in their systems. Participating in a health information exchange network will also enable doctors to meet the interoperability requirements, although the networks are not available everywhere.  

 

HIPAA: risk analysis required this year, plus more stringent penalties

HIPAA’s more comprehensive rule for guarding patients’ protected health information (PHI)—and more stringent penalties for failing to do so—began in September,  but 2014 will be the first full year in which medical practices feel their effect.

 

Among other things, HIPAA rules require a practice to conduct and document a risk analysis for their PHI, review its practices and procedures for when PHI is lost or stolen, having the ability to send health information to patients electronically, and update its notice of privacy and ensure its availability to patients. The HIPAA rule also sets and describes the four categories of penalties for rule violations and the dollar amounts for each.  

 

PQRS: Reward next year, penalties in 2015

The final mandate requiring PCPs’ attention in 2014 is PQRS, the federal program that rewards physicians and practices for successfully reporting on 138 outcome quality measures. That’s because 2014 is the last year in which the financial rewards—equal to 0.5% of covered Medicare Part B Physician Fee Schedule (PFS) services—are available. Beginning in 2015, the incentive turns into a penalty equal to 1.5% of covered Part B PFS services. The penalty rises to 2% in 2016. To-date, physicians’ participation in PQRS has been fairly low. It remains to be seen whether the threat of a penalty will cause more doctors to report.

 

Challenge #3: Payer headaches and the fine print  

Navigating a convoluted payment maze

 

The health insurance landscape is more uncertain now than it has ever been. Many physicians are feeling they are on uneven ground, with insurance companies having the upper hand when it comes to how and if they can properly treat the patients who choose to see them.

 

The Affordable Care Act has caused many insurance companies to make drastic changes—dropping physicians from panels, causing patients to scramble for new plans and new doctors, and making the whole process of finding quality healthcare even more confusing and tedious.  

 

Medical Economics recently polled physicians on their concerns for 2014, and dealing with payers was one of the top issues cited. “Getting done what patients need will be very difficult if we have to call for everything including for medications,” one doctor told Medical Economics anonymously. “Paymentwise, MDs have no say. Take it or leave it. Like UnitedHealthcare thinks now patients are theirs and not doctors’.”

 

“Insurance companies dictate which doctor, which medicine, which test, how long in the hospital,” said another surveyed physician. “Insurance companies have planted themselves between the patient and doctors and on top of the money pile.”  

 

Unitedhealthcare drops physicians

In a developing story, UnitedHealthcare cut physicians from its Medicare Advantage program, with plans to reduce its 350,000-nationwide physician panel by up to 52,500 in 2014.

 

Doctors in at least 10 states have already received letters from multiple payers telling them they are no longer part of certain networks, according to the American Medical Association. Aside from class-action lawsuits, restraining orders, and appealing, which could take months or years, there isn’t much a physician can do to fight back against being dropped. Experts believe that the uncertainty surrounding health insurance will continue to fall on physicians—and that patients will ultimately be the ones to suffer as a result. UnitedHealthcare is said to be the first of many payers who will start dropping Medicare Advantage physicians, and any other physicians who can’t adhere to strict metrics that don’t fully consider quality of care.

 

Prior authorizations consume time, money

In the office, prior authorizations continue to sap time and money from practices. With more time and staff dedicated to communicating with payers, prior authorization activities can cost a practice up to $3,430 per full-time physician, according to a 2013 study published by the Journal of the American Board of Family Medicine.

 

“This all wastes a lot of our time, and it’s not reimbursed,” says Jeffrey Kagan, MD, an internal medicine practitioner in Newington, Connecticut, and Medical Economics editorial adviser. “I feel that if an authorization has to be done the insurance company should allow a higher level of billing for the visit or a surcharge. I’m sure attorneys don’t bring motions before a judge for free.”

 

With more patients entering the healthcare system and more payers involved with more physicians, the pressure from insurance companies is not likely to yield in 2014 or in the near future.

 

Challenge #4: Time  

 

Finding time for patients despite escalating administrative noise 

Primary care physicians (PCPs) pursued medicine because they want to help patients. But every year, physicians complain they are spending less time with patients and more time dealing with the noise that surrounds the business of medicine.

 

In 2014, it may be deafening.

 

So, what is the noise? It’s all the requirements that pull physicians away from seeing patients and helping them become or remain healthy. It’s the government regulations and private payer requirements they must meet; it’s the day-to-day difficulty of trying to a run a business, not have enough time.

 

Next year may be a perfect storm that forces physicians to spend even less time with their patients. The rollout of the Affordable Care Act means business uncertainty, new requirements, and possibly floods of newly-insured patients crowding already busy patient panels. October 1 has been set as the date for the switchover to International Classification of Diseases, 10th Revision, Clinical Management (ICD-10-CM) coding language. Practices that don’t successfully make that switch will simply not get paid.

 

In addition, practices will either be playing catch-up to meet Meaningful Use 1 or embarking on the much more challenges stage 2 requirements.  

 

Medical Economics provided physicians with an opportunity to make anonymous comments about the challenges facing primary care. Many were concerned that the onslaught of requirements are drowning out the joy of why they chose medicine in the first place.

 

“I love the patient interaction as much as ever but it is being slowly eroded by so many factors which are beyond our control,” a physician told Medical Economics. “I think both the patient and the physicians are fearful about the future of medicine.”

 

Challenge #5: Technology costs

 

Sticker shock: The cost of technology

Practice owners can expect some big health information technology expenses in 2014, as ICD-10 goes live in October, and continuing costs of electronic health records (EHR) systems and Health Insurance Portability and Accountability Act (HIPAA) compliance continue to be significant.

 

“We are still slowed down 2-plus years after switching to an EHR, and there seems to be a never-ending stream of updates and other expenses, not to mention the costs of the IT guys when something goes wrong,” Rebecca Preston, MD, a family physician at Preston Family Practice in Western Springs, Illinois, told Medical Economics in a recent poll. “I dread the thought of ICD-10, especially when a lot of it does not have anything to offer me as a primary care doctor.”

 

This is even more of a challenge when physicians see much of the technology they must purchase as a hindrance, not a benefit, to their practice.

 

“Many practice-based physicians will be challenged to find time and resources to fully understand all of these programs and associated operational implications, and implement new and updated supporting technologies while focusing on their primary role—patient care,” says Mickey McGlynn, Health Information and Management Systems Society EHR Association chair.

 

Though there are EHR holdouts—20% of primary care physicians still don’t have them, and 34% say they don’t plan on ever getting an EHR system, according to Medical Economics 2013 Continuing Survey—the reality is that technology upgrades could make or break your business in the next year.

 

“Our industry is in a period of rapid transformation. Physician practices are doing more and more to innovate and respond to our rapidly changing environment to meet the needs of their patients, but with fewer resources,” says Susan L. Turney, MD, MS, FACMPE, FACP, president and chief executive officer of the Medical Group Management Association.

 

Top 10 challenges facing physicians in 2014, numbers 6 – 10 coming next week.

12 Mar 2014

Why Medical Licensing In Puerto Rico Is So Difficult, Part II

Healthcare Licensing, Physician Licensing, State Medical Board No Comments
In this installment of Why Medical Licensing in Puerto Rico Is So Difficult, we will cover some eligibility requirements, time-frames & expectations.

What you need to know:

  1. Expiration:  Applications usually expire after 1 year from the date it is received by the Board
  2. This Board does not accept FCVS profiles.
  3. Interview:  Not required
  4. The Board loses an average of 1 in 5 pieces of mail every week; expect to re-request documentation at some point during the process.
  5. The Board will not answer phones or e-mail as a general rule of thumb.
  6. The Board will consider hand-delivered applications first and foremost.  If you have a friend or family member who can walk documents directly into the Medical Board in Rio Piedras, your chances of success are much higher.
  7. The Board strongly prefers two references from physicians licensed in Puerto Rico. (see Q&A section below)
  8. The website www.salud.gov.pr is NOT active and nobody is currently monitoring the web correspondence.  That website has not been updated in the last 24 months and none of the current board employees are allowed to login to the site at the present time.  Information on the site cannot be trusted as accurate nor current.
  9. The Board strongly prefers that all communication be in Spanish.  If you are fluent in Spanish and you conduct all verbal and written communication in Spanish, you will be more likely to receive a response from the Board.  Alternatives include using a translation application to convert all your correspondence to Spanish before sending to the analyst in Puerto Rico.

 

Eligibility Requirements:

  1. USMLE Attempt Limit: None
  2. USMLE Time Limit: Must complete USMLE steps I, II, & III within 7 years of passing the first step
  3. PGY (AMG): 1 Year
  4. PGY (IMG): 1 Year
  5. SPEX/COMVEX: Not required
  6. ECFMG not required
  7. Background check required – very quick and affordable compared to other states (BCI is recommended)

 

Question Regarding References from Puerto Rico Licensed Physicians:

Q.  If I’ve never worked or been licensed in Puerto Rico, how on Earth am I supposed to get a PR licensed physician to give me a reference?

A.  If you work with a physician in your home state who holds a license in PR, that will satisfy the requirements. Please note that there are not a lot of actively licensed physicians who are licensed in Puerto Rico and meeting this requirement is not always an option. Just be advised that this can significantly delay your medical license.

 

 

In all, licensing in Puerto Rico presents different challenges that applicants will not find in other states, but with the expertise and knowledge of Physician Licensing Service, we can make the process as painless as possible.

 

About Physician Licensing Service

Now in our 16th year of business, Physician Licensing Service has been changing the face of healthcare licensure.  We have developed a proven system to remove the barriers common to state medical licenses and get doctors practicing in record time.  Our business model focuses on simplifying the process for all involved parties. This includes the state medical boards themselves, because PLS takes great care to keep abreast of their updates in this ever changing field, and work within those guidelines. For a doctor seeking a medical license, PLS will take on the entire process, including eligibility research, paperwork, verifications, and follow up.

05 Mar 2014

Why Medical Licensing In Puerto Rico Is So Difficult, Part 1

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If you’ve ever made event the most rudimentary inquiries into researching the requirements for a Physician License in Puerto Rico, then you’ve likely come up against an impenetrable wall.  The Puerto Rico Medical Board won’t answer their phones of e-mails most of the time, and doesn’t even have a useable website containing pertinent information – so getting answers is nearly impossible.

 

We receive numerous calls each and every week from people seeking answers or solutions.  The most common question is, “Why can’t I get in touch with them?”

 

The Puerto Rico licensing question is a difficult one to answer and there is currently no easy solution to be found.  Perhaps the best way to understand the problem in Puerto Rico is to take a look at recent board history to understand how the current landscape came to be.

 

Excerpted from an article by Danica Coto, Associated Press  |                .

 

August 3, 2007 San Juan, PR — Federal agents arrested dozens of doctors accused of obtaining medical licenses through fraud or bribery, carrying out sweeping raids across Puerto Rico.

A federal grand jury indicted 88 doctors following an investigation into members of the US territory’s medical-licensing board, who allegedly altered low test scores to certify unqualified candidates.

The doctors paid board members bribes as much as $10,000, according to the indictment. Most of the suspects failed the licensing exam multiple times.

At least five states recognize Puerto Rican medical licenses — Arizona, Florida, New York, Texas, and Virginia — but none of the suspects were known to have practiced on the mainland, according to Puerto Rico’s medical licensing board.

The defendants face charges that include mail fraud and making false statements to Medicare. If convicted, most face five to 20 years in prison. 

 

In all, 113 indictments were brought against nearly ninety suspects in 2008, including Puerto Rico board members and employees – the medical board has struggled to recover from the scandal.  Since the Government sought cooperation from the FSMB in its investigation and owing to the island’s inherent mistrust of mainland politics, the Puerto Rico Medical Board has since limited all communication with those outside of the territory – including the FSMB, it’s overseeing entity.

 

Since 2008, turnover at the Puerto Rico Medical Board has been astronomically high, whether from fear or apathy, is hard to say – but each time Physician Licensing Service develops a solid, responsive contact at the medical board, that employee is gone with-in months.  Maintaining a relationship with individual employees and building rapport remains a challenge to this day.  Even our independent contacts on the ground in Puerto Rico have difficulty in getting timely answers at present.

 

Physician Licensing Service has discussed these issues directly with the Federation, which is keenly aware of the problems, and we are still actively seeking resolution with them – but the FSMB is currently hesitant to impose sanctions on the Puerto Rico Medical Board, fearing that the appearance of punitive action against the board will further exacerbate the existing problem.

 

Until an accord is reached, Physician Licensing Service will continue to strive for the very best possible solutions to applicants seeking licensure in Puerto Rico.

 

Next week’s blog will discuss Puerto Rico licensing timeframes and requirements.

 

About Physician Licensing Service

Now in our 16th year of business, Physician Licensing Service has been changing the face of healthcare licensure.  We have developed a proven system to remove the barriers common to state medical licenses and get doctors practicing in record time.  Our business model focuses on simplifying the process for all involved parties. This includes the state medical boards themselves, because PLS takes great care to keep abreast of their updates in this ever changing field, and work within those guidelines. For a doctor seeking a medical license, PLS will take on the entire process, including eligibility research, paperwork, verifications, and follow up.

 

05 Feb 2014

A Record Setting Year for Physician Licensing Service

Healthcare Licensing, Physician Licensing No Comments

2013 was a record setting year for PLS.  During the year we strategized and implemented a broad-scale restructure in an effort to improve leadership, increase efficiency, and make our innovative licensing processes even more effective.  The result from this introspection is even better licensing services to both individual doctors and large corporate clients alike.  Our licensing consultants are more proficient and better trained.  In fact, one of our Consultants issued nearly 600 medical licenses in 2013.  That’s more than most licensing companies produce in a year’s time.

 

Companywide we reduced the cost per issued license by 30%.  We reduced the hours of work per issued license by 35% while increasing total licenses issued by more than 5%. Those are big shifts.   About to celebrate our 17th anniversary, PLS has been in medical licensing more than twice as long as our nearest competitor.   From telemedicine, to the Affordable Care Act, to an aging US population, the medical industry is experiencing a number of forces pulling it in a variety of directions.  Medical licensing serves a vital purpose as an anchor through all of this change.  It ensures that consumers of healthcare receive safe and effective care.  Physician Licensing Service is working daily to make sure we are in the best possible position to serve an expanding section of the US economy and to take good care of the people we trust to care for our loved ones.

 

 

About Physician Licensing Service

Now in our 16th year of business, Physician Licensing Service has been changing the face of healthcare licensure.  We have developed a proven system to remove the barriers common to state medical licenses and get doctors practicing in record time.  Our business model focuses on simplifying the process for all involved parties. This includes the state medical boards themselves, because PLS takes great care to keep abreast of their updates in this ever changing field, and work within those guidelines. For a doctor seeking a medical license, PLS will take on the entire process, including eligibility research, paperwork, verifications, and follow up.

29 Jan 2014

“Ground Rules” When Applying For Medical Licensure

Healthcare Licensing, Physician Licensing, Uncategorized No Comments

The American Medical Association has put together what they call “ground rules” when applying for medical licensure.  Here are some highlights of the article we found interesting and what Physician Licensing Service does to help.

 

Increasing public demand for protection, coupled with the growth in the number and sophistication of fraudulent practitioners over the past 2 decades, has resulted in stronger and more complex licensing boards and licensing statutes throughout the country.

 

Within this context, a physician seeking initial licensure or subsequently applying for a license in other states should anticipate the possibility of delays due to the necessary investigation of credentials and past practice, as well as the need to comply with necessary licensing standards.  These suggestions aka “Ground Rules” will not apply in all cases but generally will help most physicians applying for licensure as well as benefit the licensing board of the state in which the physician wishes to practice.
Read more

23 Jan 2014

When To Hire a Medical Licensing Company, Part Two

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In “When To Hire a Medical Licensing Company, Part One” we outlined the larger, more obvious reasons to hire a licensing assist agency to help with your physician licensing application.

 

In this installment, we would like to address the mathematical approach to hiring a medical licensing service.  Residents:  Listen up!  This will apply to you a little later…

 

Put simply – you really cannot afford not to.  On average, Physician Licensing Service issues most medical licenses anywhere from 15-40% faster than a physician attempting to attain licensure independently.  In real-time, those numbers translate into anywhere from two weeks up to six months in time saved.  Now, do the math; if you get your license two weeks earlier and go to work two weeks sooner, our $600 fee should more than justify itself just in time saved. Read more

08 Jan 2014

Medicaid Leads To More ER Visits…

Healthcare, Uncategorized No Comments

Having Medicaid leads to 40% more ER visits, say researchers

January 3, 2014 | Medical News Today

 

New Research suggests that adults who have their medical care covered by Medicaid use emergency rooms 40% more than adults in similar situations who do not have health insurance.  This is according to a study published in the journal Science.

 

In 2008, the state of Oregon introduced a Medicaid lottery to assign the health insurance to an additional 10,000 low-income adults after realizing they had additional funds for the program.

 

Individuals in Oregon are eligible to apply for the lottery if their annual income is below the federal poverty level set by the US Department of Health and Human Sciences.  For 2013, this is approximately $23,550 for a family of four and $11,490 for a single person.

 

The study researchers, from the Massachusetts Institute of Technology (MIT) and the Harvard School of Public Health, Read more