The advantages of telemedicine have been advocated by doctors and healthcare experts for years.  By connecting a provider and patient virtually from any location and at any time, care can be obtained almost immediately resulting in improved patient outcomes from a trusted provider at a lower cost.

Despite the tangible benefits of telemedicine, there are still barriers limiting the use of these new technologies.  One of the important is medical licensure laws that tie providers to state boundaries rather than empowering them via the Internet.  State medical board requirements often severely limit the ability of doctors to practice across state lines.


During my time in Congress and now in the private sector, I have seen technology advance but the policy obstacles still remain. Breaking down the interstate licensure barriers for telemedicine that currently exist in the Medicare program will help America’s seniors gain access to quality, affordable healthcare.

Seniors as a group are rapidly increasing, with more than 10,000 Baby Boomers reaching the age of 65 every single day.  This rate is expected to continue for the next 20 years and, by the year 2050, the number of senior citizens in the United States is projected to skyrocket to 89 million. At the same time, Medicare is facing a 38 trillion dollar shortfall over the next 75 years.

Telemedicine is a perfect tool to use as our population grows older and thus the need for medical attention increases. For seniors with health conditions like diabetes, heart failure, or chronic obstructive pulmonary disease (COPD) receiving treatment can be inconvenient and complicated. For the aging population, these conditions can make it difficult to independently live in their home and in many cases require them to live in assisted living in order to have vital signs and symptoms routinely checked.

Take for example, a senior living in Ohio who regularly sees their doctor to manage their diabetes, no problem right? Well what happens when that senior travels to Florida in order to avoid the Ohio winter? In the current system, that senior has to find another doctor in Florida who isn’t up to speed on the current treatment plan and medical history. Wouldn’t it be easier for the senior to stay in contact and receive care via telemedicine with their current doctor they know and are comfortable with?

Luckily there is new legislation being introduced into Congress by Reps. Devin Nunes (R-Calif.) and Frank Pallone (D-N.J.) called the TELEhealth for MEDicare Act (TELE-MED) to address these concerns. The bill allows healthcare professionals who are Medicare providers and are licensed to practice physically in one state to be able to treat Medicare patients electronically in any other jurisdiction.

It would also permit that when a provider who has been granted a license to physically provide care within a state or jurisdiction becomes a Medicare provider, he or she may provide care electronically to those with whom they have an established patient-provider relationship regardless of where the patient is located in the United States.

Interstate licensure has already been proven successful by government programs. The Department of Defense has expanded telemedicine opportunities to service members regardless of whether they are on base or at home, and regardless of what state the provider is licensed in. The Department of Veterans Affairs has moved to mostly eliminate cost sharing on telemedicine, recognizing that treating veterans at home is less expensive than treating them in a VA facility. Medicare has the ability to do the same.

As a former Member of Congress, I have worked on many pieces of legislation pertaining to Medicare issues, and it is evident to me that this bill provides a simple solution to a growing problem.

Gradison served in the House of Representatives from 1975-1993. He is currently scholar in residence in the Health Sector Management Program at Duke’s Fuqua School of Business.