Announcement of Public Workshop, "Examining Health Care Competition" ("Health Care Workshop") Project No. P13-1207
A comment was made during the "Examining Health Care Competition" conference that the FTC should look at the Veterans Administration (VA) as a model for professional licensure. Only one active, unrestricted state license is required to practice in every VA facility across all 50 States, the District of Columbia, and U.S. Territories (although practitioners may choose to hold multiple licenses). It is important to note that the VA is a closed health care system with its own disciplinary procedures (38 U.S.C. 501(a), 7401, 7403). A centralized disciplinary process allows the VA to investigate and adjudicate complaints and report their decisions to the appropriate state licensing body. However, the majority of health care practitioners do not work in a closed system. Having a state licensure system affords a patient the option of filing a complaint against a health care professional, which, if necessary, will be adjudicated in the same state. If the VA model of a single license requirement were adopted nationally, a patient could file a complaint in Maryland but the health care practitioner might be licensed in California. Maryland would not have the authority to conduct an investigation because the professional does not hold a Maryland license. Would California be required to conduct an investigation in Maryland? If so, how would the logistics of the investigation be handled and who would pay the costs? As was mentioned during the hearing, both the National Council of State Boards of Nursing and the Federation of State Medical Boards have attempted to tackle this as well as other issues through licensure compact models (see www.ncsbn.com and www.fsmb.com). As the FTC continues to review the current state licensure system, it is suggested that it contact the Division of Practitioner Data Banks, Health Resources and Services Administration, HHS to obtain data on health care practitioners' disciplinary trends. The National Practitioner Data Bank (NPDB) is a clearinghouse of information created by Congress with the primary goals of improving health care quality, protecting the public, and reducing health care fraud and abuse in the U.S. The NPDB collects information on medical malpractice payments and certain adverse actions, including licensure, and discloses that information to eligible entities to facilitate comprehensive reviews of the credentials of health care practitioners, health care entities, providers, and suppliers. Information is available to the general public in aggregate form, only. Thank you.