Open Letter to U.S. State and Federal Policymakers


The Alliance for Connected Care seeks your endorsement of the below joint statement on telehealth across state lines.  Further details below.

To sign on to this letter, please click here 

 Consensus Principles on Telehealth Across State Lines

Patients have long traveled across state lines for specialty care, but the COVID-19 pandemic has demonstrated that this care, particularly delivered through telehealth, can also help alleviate access issues in many other areas of health care. Looking beyond the public health emergency, one important way policymakers and health care regulators can permanently facilitate access to care is by allowing providers and patients to connect with each other regardless of their physical location. The following organizations, representing consumers, health care professionals, health systems, large employers, and others urge you to give your citizens access to, and choice of, health care wherever they reside through the facilitation of telehealth across state lines. Below are consensus principles that can guide policymaking:

Supporting Patients

  • We recognize that patients and their families must sometimes travel across state lines to seek care not available where they reside;
  • We further recognize that the national experience during COVID-19 has clearly demonstrated an opportunity for telehealth and technology-enabled health care to meet many health needs remotely, including over significant distance;
  • We acknowledge that the health care demands of the COVID-19 pandemic have exposed many barriers to patient access posed by the significant fragmentation of state practice laws and regulations;
  • We further acknowledge that patients who lack access to broadband or high-speed internet may not be able to take full advantage of certain telehealth services, and those patients underscore the need for both continued flexibility and infrastructure investment;
  • We believe that, while care across state lines to secure health care may be necessary in any number of circumstances, it can be critically important for individuals who require specialized care, have mobility challenges, or have significant geographic distances from the care they need; and
  • We believe that a flexible telehealth workforce can help increase access to care for the underserved and when there is not access to an adequate clinician workforce – meeting needs for care ranging from primary care and behavioral health services to complex subspecialty care.

Empowering Healthcare Professionals

  • We affirm that all health care professionals must maintain professional licensure and practice standards including successfully passing licensing examinations and maintaining continuing education requirements;
  • We attest to the importance of health care professional compacts which facilitate safe, accountable care delivery across state lines with minimal unnecessary barriers through mutual recognition of licensure;
  • We believe that expanding the ability for licensed clinicians to provide patient care when and where it is most needed would benefit both patients and the health care system; and
  • We support efforts to simplify and accelerate health professional licensure recognition across state lines, through efforts that could be enacted under state authority.

Calling for State Leadership with Federal Support

  • We recognize the leadership of many governors and state health professional boards in temporarily waiving or modifying barriers to providing care across state lines during COVID-19;
  • We affirm the authority of state governments, state licensure laws and the ongoing oversight by state clinical occupational boards, to protect public health, wellness, and safety;
  • We encourage states to expand their participation in those health professional compacts that allow for mutual recognition of licensure among states; and
  • We call on governors and state legislatures to work with health experts to implement solutions that allow for the safe and accountable mutual recognition of health professional licensure among states, thereby providing their citizens with more access to and choice of care.


Alliance for Aging Research

Alliance for Connected Care

ALS Association

American Academy of Neurology

American Association of Nurse Practitioners

American Childhood Cancer Organization

American Parkinson Disease Association

American Physical Therapy Association

American Urological Association



Association for Behavioral Health and Wellness

CirrusMD Inc.

Columbia University Irving Medical Center

Consumer Choice Center


Davis Phinney Foundation


Empower Health & Wellness


Hawai’i Parkinson Association

Higi sh LLC

Infectious Diseases Society of America

Intermountain Healthcare

Johns Hopkins Medicine

Kohnlinq, Inc.

MedStar Health

National Association of Social Workers

National Organization for Rare Disorders

Nemours Children’s Health System

National Committee for Quality Assurance

Parkinson & Movement Disorder Alliance

Philadelphia Neurological Society

REDC Consortium

Stanford Health Care

The Michael J. Fox Foundation for Parkinson’s Research

The Parkinson Alliance

The Parkinson’s Unity Walk


Vesta Healthcare

Women Neurologists Group

 To sign on to this letter, please click here.

We are pleased to release these attached principles, which demonstrate the breadth of support for policies that facilitate the delivery of care across state lines for telehealth.   Patients, clinicians, consumer organizations, health systems, and many others have joined us in this statement.  We expect many more to join us in the following months, as the continued need for cross-state care (expanded in many places during the pandemic) continues to be felt.

Please feel free to reach out to with any questions about this effort and our ongoing work.