Johns Hopkins Medicine and American Telemedicine Association have unveiled a joint three-year effort aimed at addressing regulatory barriers that limit telehealth expansion across state lines. The initiative, titled the Licensure Innovation for Telehealth Transformation (LIFTT), is designed to accelerate telehealth licensure reform by advocating for legislative action at the federal level. Announced Wednesday, the program will focus on building awareness among policymakers and the public regarding the need for broader access to virtual care, while advancing practical federal solutions to close existing gaps in care delivery.
Through the LIFTT Initiative, both organizations intend to highlight challenges tied to continuity of care and access to specialized expertise, particularly for underserved patient groups. LIFTT will mobilize supporters, inform policymakers, and engage health systems to enhance our national strategy for interstate telehealth on behalf of patients nationwide, said Helen Hughes, M.D., medical director of Johns Hopkins Medicine’s Office of Telemedicine, in the announcement. The ATA has been a driving force in promoting telehealth at both the federal and state levels. We are thrilled to partner to transform telehealth through targeted federal licensure solutions. The program positions telehealth licensure reform as a critical step toward enabling seamless healthcare delivery beyond geographic boundaries.
Despite what has been described as incremental progress over the past decade, regulatory change remains fragmented due to state-by-state licensure requirements, according to Johns Hopkins Telemedicine resources. Temporary policy relaxations introduced during the COVID-19 pandemic helped expand virtual care access, but many states have since reinstated stricter frameworks, complicating cross-state treatment. These constraints disproportionately affect patients requiring specialized care, including those with rare diseases, cancer, transplant needs, and individuals in rural communities.
The initiative aims to establish federal mechanisms that complement, rather than override, state-level governance. State-specific licensure rules restrict patients from accessing essential healthcare services, especially specialized care, and create unnecessary obstacles to cross-state collaboration, said Kyle Zebley, ATA CEO, in the announcement. Federal oversight can establish a cohesive strategy for telehealth access nationwide, while respecting local governance structures. Zebley also indicated that a complementary effort aligned with the initiative is in development, with further details expected in the near future.

















