Transcript Indian Health Service Providers and Out of State

The federal government approved
a change to the United States
Code Annotated Title 25. Indians
Chapter 18. Indian Health Care
Subchapter II. Health Services
effective March 23, 2010
“Licensed health professionals employed
by a tribal health program shall be
exempt, if licensed in any State, from the
licensing requirements of the State in
which the tribal health program performs
the services described in the contract or
compact of the tribal health program
under the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450
et seq.).”
Alaska Statute also allows consultants
to be licensed in another state:
• Alaska law sections 08.64.170 and 08.64.370
provides that all physicians must have
a license to practice in Alaska except in 5
circumstances one of which is where "a
physician or osteopath, who is not a resident
of [Alaska], who is asked by a physician or
osteopath licensed in the state to help in the
diagnosis or treatment of a case."
What does this mean for your facility?
• Direct hire employees of tribal health
programs do not need to be licensed
by the State of Alaska Medical, Dental
and Nursing Boards
• Locum Tenens are traditionally hired by
a locum company and are not employed
by the tribal health program. The federal
exception does not apply to them.
• In many states physician assistants work
under a collaborative plan
• The licensing states Practice Act must be
consulted to see if State Laws preclude
the physician assistant from using their
license in another state
• The Alaska Medical Board requires all
physician assistants practicing in Alaska
to have a collaborative plan on file with
them
• In many states Advance Nurse Practitioners
work under collaborative agreements and
are not licensed independent practitioners
• Alaska’s Nursing Board allows Advance
Nurse Practitioners to function as licensed
independent practitioners
• An Advance Nurse Practitioner cannot use a
license from a state that requires a
collaborative agreement in Alaska
What you should be aware of when
processing a provider who is not licensed
by the State of Alaska
• The state laws in which the provider
holds a license are the laws you must
follow
• States may have special requirements for
controlled substances
• Many states require a second license for
controlled substances
These states do not require a
controlled substance license in
addition to the DEA:
Alaska
Arizona
Arkansas
California
Colorado
Florida
Georgia
Kansas
Kentucky
Maine
Minnesota
Montana
Nebraska
New Hampshire
New York
North Carolina
North Dakota
Ohio
Oregon
Pennsylvania
Tennessee
Vermont
Virginia
Washington
West Virginia
Wisconsin
These states do require a 2nd
controlled substance license in
addition to the DEA:
Alabama
Iowa
Connecticut Louisiana
Delaware
Maryland
DC
Massachusetts
Guam
Michigan
Hawaii
Missouri
Illinois
Nevada
Indiana
New Jersey
*Puerto Rico requires 3 licenses
New Mexico
Oklahoma
Puerto Rico*
Rhode Island
South Carolina
Texas
Utah
Wyoming
Many State Dental Boards require additional
permits and licenses for analgesia & sedation.
Some even require inspections before granting
sedation permits:
“It is extremely important that sedation facility
inspection appointments are NOT CANCELLED or
rescheduled!”
Please insure you have EVERY item on the checklist
at your office BEFORE you schedule an appointment
and check your calendar carefully before you confirm
the date and time with the inspector.”
“
Texas Dental Anesthesia Permits
Nitrous Oxide/Oxygen Inhalation
Conscious Sedation
Level 1:
Level 2:
Minimal Sedation =
Moderate Enteral =
Level 3:
Moderate Parenteral =
Level 4:
Deep Sedation/General
Anesthesia
Nitrous Plus One
Enteral Drug
Multiple Enteral
Drug
Limited to
Parenteral Routes
of Administration
Oregon Dental Anesthesia Rules and
Educational Requirements
Anesthesia Rules
Educational Requirements for Anesthesia Permits
Anesthesia Permit Applications
Nitrous Oxide Permit Application
Minimal Sedation Permit Application
Moderate Sedation Permit Application
General Anesthesia Permit Application
Idaho Dentists
General Dentist Application and Instructions
Specialist Application and Instructions
Volunteer License Application and Instructions
Application to convert Inactive License to Active Status
Idaho Controlled Substance and DEA Registration
Anesthesia Permits
Application for Anesthesia Permit
Policy For Moderate Enteral Sedation Evaluations
Policy For Moderate Parenteral Sedation Evaluations
Policy For General Anesthesia/Deep Sedation Evaluations
Use of Other Anesthesia Personnel – Rule 62 Notification
Process
Illinois Applications for Physicians
Physician, Licensed Physician
Limited Temporary License Physician
Temporary License Visiting Professor
Visiting Physician
Physician Controlled Substance
• It is not as easy as just ensuring a provider
is license in another state and has their own
DEA.
• It takes a lot of time, work and research to
ensure your facility is in compliance with
another states laws.
• There are no shortcuts
Questions