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The ProviderTrust Blog

Your source for healthcare compliance news, advice from industry experts, and all things related to OIG exclusions.

Long Term Care

Nursing License Verification When Doing Business Across State Lines

Posted by Michael Rosen, ESQ on Thu, Dec 27, 2012

nursing license verification

In today's mobile society many healthcare professionals reside in one state (home state) and travel to or practice in multiple (neighoring states). Since a majority of these professionals are Nurses, many states have signed on to the Nurse Licensure Compact, which enables multistate licensure for nurses

The question is: When is a License not a License? 

By that we mean, when does the fact that a Nurse has a license in his/her home state, but practices in a neighboring state, not meet state licensing laws/requirements? 

For example, a Nurse has a current Tennessee license and works for a healthcare organziation with facilities in multiple states. The Nurse is required to work in a neighboring state as a part of his/her job description.  The state(s) that the Nurse visits/practices/works do not participate in the Nurse Licensure Compact. 

In this case, the client is at risk of placing and/or allowing an unlicensed Nurse to practice, in spite of the case that he/she is licensed in Tennessee.  We have clients who are working through this scenario and developing policies that require the Nurse to be licensed and tracked/monitored for licenses in multiple states if their job requires travel and practice in multiple states. 

However, careful thought must be taken to make sure that the policy does not default to relying on the current status of licensure in one state if the provider works in another state(s). Some clients compare zip codes of home state to payroll in another state in order to double check. 

Further, monitoring across all 50 states for sanctions and OIG Exclusion List is a crucial risk mitigation practice. A sanction can take months to go through the state disciplinary process and appear or be published on a state licensing or disciplinary actions list.

The best practice is to develop and implement a requirement policy that requires (a) licensure in the state where the employee/provider is working, and/or (b) a compact Nurse license that ensures that the employee/provider is working in a state that participates in the Compact. Setting in place a nursing license verification process in your compliance program will significantly reduce the risk involved with this type of license fraud.

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Michael Rosen, Esq.

Written by Michael Rosen, ESQ
ProviderTrust Co-Founder, mrosen@providertrust.com

Michael brings over 20 years of experience founding and leading risk mitigation businesses, receiving numerous accolades such as: Inc Magazine's Inc 500 Award and Nashville Chamber of Commerce Small Business of the Year
Connect with Michael on Linkedin

license verification


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