License for cases out-of-state

[darksideal]

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Hi everyone,
I have a quick question about what cases a state license covers- is it all cases processed in that state (independent of what state they come from) or only from practitioners (hence patients) in that state?
Tks

 

[Circumflex]

The state license covers you practicing medicine in that state. It doesn't matter where the specimens come from - just where you examine them.

 

[readingslides]

The state license covers you practicing medicine in that state. It doesn't matter where the specimens come from - just where you examine them.

Not true. For many states you need a state license in the state where the specimen originated as well.

 

[icpshootyz]

Not true. For many states you need a state license in the state where the specimen originated as well.

Exactly. I spent some time in a large national dermpath lab and specimens from certain states could only go to docs who had valid licenses in those states. Doesn't apply to all states, though.

 

[darksideal]

Thank you for your replies , I just talked to a lawyer - apparently in the state that I'm interested I need a license.

 

[SLUsagar]

The state license covers you practicing medicine in that state. It doesn't matter where the specimens come from - just where you examine them.

Don't think this is correct --I believe NY and also MD require state licenses.

 

[Ruination]

Don't think this is correct --I believe NY and also MD require state licenses.

Nevada also requires a state license.

 

[LADoc00]

I think it depends on the financial arrangement. If the specimen is originating in state X and the pathology group reading it in state Y is then billing back to the group in State X who is then global billing and marking up the service (illegal in CA btw), then I imagine you need a state license.

As a general rule, I dont think you need a state license at the origination point/place of service if all the pathology services are being billed in a different state. That would make stuff like consults from the Mayo clinic etc impossible.

That said NY state is REALLY BIZARRE and there are all sorts of unique laws in pathology that pertain only to NY due to their protectionist legislature there. I think that is why those guys who left Dianon in NJ resettled in Rye, NY.

 

[caw13]

I think it depends on the financial arrangement. If the specimen is originating in state X and the pathology group reading it in state Y is then billing back to the group in State X who is then global billing and marking up the service (illegal in CA btw), then I imagine you need a state license.

As a general rule, I dont think you need a state license at the origination point/place of service if all the pathology services are being billed in a different state. That would make stuff like consults from the Mayo clinic etc impossible.

That said NY state is REALLY BIZARRE and there are all sorts of unique laws in pathology that pertain only to NY due to their protectionist legislature there. I think that is why those guys who left Dianon in NJ resettled in Rye, NY.

This is very state dependent. I am based in CT, but have licenses in all NE states except RI. Every state requires me to have a state license to read bx that originated in that state. Except for RI. Which requires me to have a RI lab license. Even though the lab is in CT. You can see how ridiculous this gets.

You are right about NY. They require both a state license and lab license. And before someone asks, yes a lab inspector from NY will come and inspect your lab before granting the license. As best I can tell, billing has nothing to do with it.

BTW, the Dianon group is located in Shelton CT.

 

[caw13]

This is very state dependent. I am based in CT, but have licenses in all NE states except RI. Every state requires me to have a state license to read bx that originated in that state. Except for RI. Which requires me to have a RI lab license. Even though the lab is in CT. You can see how ridiculous this gets.

You are right about NY. They require both a state license and lab license. And before someone asks, yes a lab inspector from NY will come and inspect your lab before granting the license. As best I can tell, billing has nothing to do with it.

BTW, the Dianon group is located in Shelton CT.

This requirement is for primary diagnosis only, why Mayo and other large consult centers are not burdened by these rules.

 

[LADoc00]

This is very state dependent. I am based in CT, but have licenses in all NE states except RI. Every state requires me to have a state license to read bx that originated in that state. Except for RI. Which requires me to have a RI lab license. Even though the lab is in CT. You can see how ridiculous this gets.

You are right about NY. They require both a state license and lab license. And before someone asks, yes a lab inspector from NY will come and inspect your lab before granting the license. As best I can tell, billing has nothing to do with it.

BTW, the Dianon group is located in Shelton CT.

Ah ok. Honestly New England is another country to me about as culturally and philosophically related to the Western states as England and Germany are...so I didnt know that.

But I thought that Dianon Systems started in like Woodbury NJ, was sold to Lab Corp (who moved it to CT?) who immediately trashed it up, most of the people left, went to Rye, NY and founded CBL Path which was then bought by a New Zealand juggernaut Sonic Healthcare etc etc. CBL Path then dies and the whole process starts anew!

perhaps I was wrong though?

 

[caw13]

You are mostly corrrect. Dianon was sold to LabCorp, who did trash it. Many of the pathologists did go to CBL, which is in Rye NY. Some went to Bostwick on Long Island as well. Sonic does now own CBL, so you are right, it is probably just a matter of time before the circle of life starts all over. Many of the Dianon/Labcorp executives now work for Aurora and Strata, proof that those labs don't have long either.

You should really visit NE sometime. At least visit NH. "Live free or die" seems like it is right up your alley. I had several roommates in med school from Southern Cal. They could never get over how green it was around here.

 

[WEBB PINKERTON]

Ah ok. Honestly New England is another country to me about as culturally and philosophically related to the Western states as England and Germany are...so I didnt know that.

But I thought that Dianon Systems started in like Woodbury NJ, was sold to Lab Corp (who moved it to CT?) who immediately trashed it up, most of the people left, went to Rye, NY and founded CBL Path which was then bought by a New Zealand juggernaut Sonic Healthcare etc etc. CBL Path then dies and the whole process starts anew!

perhaps I was wrong though?

God, you have to love working in this industry. I guess the goal really is just to start a lab and sell.

I think I may have to start "The Dollar Lab" and sell it. Hope that name isnt taken.

 

[WEBB PINKERTON]

I think it depends on the financial arrangement. If the specimen is originating in state X and the pathology group reading it in state Y is then billing back to the group in State X who is then global billing and marking up the service (illegal in CA btw), then I imagine you need a state license.

As a general rule, I dont think you need a state license at the origination point/place of service if all the pathology services are being billed in a different state. That would make stuff like consults from the Mayo clinic etc impossible.

That said NY state is REALLY BIZARRE and there are all sorts of unique laws in pathology that pertain only to NY due to their protectionist legislature there. I think that is why those guys who left Dianon in NJ resettled in Rye, NY.

California has quite a few protectionist laws as well. Hell, doesnt planned parenthood use California cytopathology labs instead of their usual lab in Texas? And Bio-reference had to buy Hunter otherwise they couldnt get Medi-Cal patients.The state seems to be trying to keep labs out of there.

 

[darksideal]

FYI the state that I was interested was South Carolina , and they require a license. For consults, most of the states have waived the license requirements.
This is the CAP point of view http://www.cap.org/apps/cap.portal?...appZZ.html&_state=maximized&_pageLabel=cntvwr

 

[Torsed]

I think there was a pathologist in Washington state who got in trouble for looking at a case from Oregon and accused of practicing medicine without an Oregon license. Maybe I'm just getting old.

 

[dermpathdoc]

Not true. For many states you need a state license in the state where the specimen originated as well.

Agreed, I read dermatopathology slides for the Atlantic states for Labcorp and found I needed licenses for NY, MD, Delaware and not just NJ and Penns where I had licenses...then when I relocated to the PNW I read slides in Washington but needed yo,get licenses in Idaho, Oregon, Alaska, Montana and Calfornia..the California license was the hardest to get, Idaho was easiest....

 

[dermpathdoc]

I think there was a pathologist in Washington state who got in trouble for looking at a case from Oregon and accused of practicing medicine without an Oregon license. Maybe I'm just getting old.

No he was a a colleague of mine, thought he could do it side he only read one or two a month....the Problem is in some states reading one case is ok...more than one case is a felony...for California read one case without a license and it is a felony. Get a felony on your docket and lose your license...permanently

 

[Torsed]

Uber ******ed that would be a felony. An evil machine that controls our profession.

 

[member0007]

Uber ******ed that would be a felony. An evil machine that controls our profession.

What about all the consultations that are done with out of state pathologists? Seriously, lot of this garbage is some nit wits trying to control the business (personally, dealt with quite a few of these *****s). Of course, it has nothing to do with patient care.

 

[jp123ok]

What about all the consultations that are done with out of state pathologists?

Consults aren't a problem. At my fellowship program we get consults from all over the country every day. Providing a consultation is simply offering advice, which is very different from signing out a case... In terms of the need for a license it's all about whether you actually sign out the case.

 

[member0007]

Consults aren't a problem. At my fellowship program we get consults from all over the country every day. Providing a consultation is simply offering advice, which is very different from signing out a case... In terms of the need for a license it's all about whether you actually sign out the case.

That's a distinction that cannot technically be true as well. Offering expert opinion is not distinguishable from offering a diagnosis. Most consultations are only sent to an expert with the expectation that a second opinion is offered that equates to diagnosis. That's technically signing out a case unless it's suddenly not.