For years telemedicine has had a significant barrier – interstate licensure. Clinicians regularly see patients in their offices who live out of state, but when it comes to telemedicine they have for the most part been prohibited from doing this. In fact, it is easier to see an out-of-state patient when they actually leave the country by telemedicine than when they stay home. This might all be finally changing. In November representatives from state medical boards from around the US announced after a meeting of the Federation of State Medical Boards that they had made progress in a new option for medical licensing that will speed up issuing licenses for physicians who want to practice in multiple states. The proposed system is called the Interstate Medical Licensure Compact and physicians who are interested in practicing in multiple states would be able to receive a license in each state and be under the jurisdiction of the state medical board where the patient is located at the time of the medical interaction. The participating state medical boards would still retain their licensing and disciplinary authority but would agree to share information and processes essential to the licensing and regulation of physicians who practice across state borders. For both states and physicians participation would be voluntary, but from the telemedicine perspective it is huge! There would be a significant reduction of barriers, helping facilitate licensure portability and telemedicine. The committee is still finalizing the document and language in the document, dealing with key issues such as physician eligibility, information-sharing between boards, and disciplinary responsibilities. The proposal has recently been applauded by 16 US Senators including. If your senators are not aware of this effort it may be worth your time and effort to make them aware and recruit their support! With any luck will see significant progress on the critical issue in 2014!