Nicholas A. Mirra

Nicholas A. Mirra
Associate

Elizabeth Barry Heddleston

Elizabeth Barry Heddleston
Associate

On April 17, 2020, Governor Northam announced an executive order issued to support the increase in volume of health care workers in Virginia in order to help combat COVID-19.

Executive Order Number 57 (the “Order”) temporarily relaxes the licensure requirements of certain health care professionals in response to the COVID-19 health emergency. Before the Order, health care professionals generally had to be licensed in Virginia to provide services in the state. This E-Alert summarizes the key changes to that standard made by the Order.

For additional details, see the full text of the Order.

Health Care Practitioners Licensed in Other States

A health care practitioner with an active license in another state is deemed to be effectively licensed in Virginia for the same services the practitioner can provide in their licensed state.

  1. Practitioners must be engaged by a hospital, an affiliate of a hospital that shares the same corporate parent, a licensed nursing facility, a dialysis facility, a physician’s office, or other “health care facility.”
    1. For the purpose of the Order, “health care facility” includes assisted living facilities, congregate care settings, and any alternative care facility established in response to the COVID-19 emergency.
  2. The practitioner must be engaged to assist with public health and medical disaster response operations.
  3. Hospitals, affiliates, and health care facilities engaging out-of-state practitioners must submit the following information to the applicable Virginia licensing board within a reasonable time:
    1. The practitioner’s name
    2. The license type
    3. The state of the license
    4. The license identification number

Psychologists, Therapists, and Social Workers

Clinical psychologists, professional counselors, marriage and family therapists, and clinical social workers with active licenses issued by another state may apply for a temporary license in Virginia.

  1. These providers will need to apply to the applicable Virginia licensing board and the board will need to verify that the license is active and in good standing.
  2. These licenses will expire 90 days after the state of emergency in Virginia ends.

Existing vs. New Patients

  1. Practitioners who are currently licensed in another state, but have current Virginia patients, may continue to provide care via telehealth services.
  2. Practitioners wishing to serve new Virginia patients must hold a current Virginia license unless services are provided in accordance with the temporary licensure requirements explained above.

Telehealth

  1. Healthcare practitioners may use non-public facing audio or remote communication products to provide services to patients. Practitioners must exercise discretion in the provision of telehealth services for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of COVID-19.
  2. Other state and federal regulations still apply to telehealth services.

See our previous post on OCR’s and OIG’s guidance on the HIPAA requirements relating to telehealth during the COVID-19 emergency for a more detail discussion of the subject.

Nurse Practitioners

  1. Nurse practitioners licensed in Virginia, except for certified registered nurse anesthetists, with 2+ years of clinical experience may practice and prescribe in their licensed practice category without a written practice agreement in place.
  2. This temporary change is a deviation from the 5-year experience requirement for a nurse practitioner to apply for approval to practice independently without a physician’s supervision.

Interns, Residents, and Fellows

  1. Interns, residents, and fellows with active temporary training licenses may practice in a hospital, clinic, or an alternate care facility operated by a hospital without the supervision of a licensed physician or fully licensed member of the applicable faculty program.
  2. The level of supervision required for each individual providing services under this section shall be established by the training program in coordination with the hospital where the services are provided.

Medical Students

  1. Fourth year medical students may practice in a hospital, clinic, or alternate care facility operated by a hospital without direct tutorial supervision by a licensed physician member of the hospital staff.
  2. The level of supervision required for each medical student shall be established by the institution in coordination with the hospital where the services are provided.

Respiratory Therapy Program Graduates

  1. Individuals who have completed an accredited respiratory care program may practice respiratory therapy for 90 days after completion of their program, or until the individual passes or fails the National Board on Respiratory Care license exam — whichever occurs first.

Physician’s Assistants

  1. Governor Northam clarified in a later public address that failing to include Physician Assistants (PAs) in the Order was unintentional. Governor Northam explained he wants to make sure PAs are included in Virginia’s efforts to combat COVID-19 moving forward.
  2. The Virginia Department of Health Professions has not published any clarifying guidance relating to PAs as of April 23.
  3. The extent and scope of any temporary changes related to PAs remain uncertain.

Conclusions

While the changes summarized above loosen certain licensure requirements for health care practitioners, all other laws and regulations governing the practice of these providers in Virginia still apply and must be followed. The Order remains in effect until June 10, 2020, unless sooner amended or rescinded by another executive order.

Changes impacting healthcare providers are taking place on a daily basis during the COVID-19 health emergency. Be sure to reach out to a Woods Rogers Health Law attorney to help you navigate sweeping changes created by the pandemic.

Read more legal updates on COVID-19 from Woods Rogers attorneys.


If have you questions about Virginia’s licensure requirements during the COVID-19 pandemic:
Contact Nick Mirra at nmirra@woodsrogers.com.
Contact Liz Heddleston at lheddleston@woodsrogers.com.