The New Law
On October 5, 2018, the Sports Medicine Licensure Clarity Act (SMLCA) was signed into law by President Trump. Under the new federal law, health-care services provided by a covered sports medicine professional to an athlete, an athletic team or a staff member of a team outside of the sports medicine professional’s home state will be deemed to have occurred in the professional’s primary state of licensure. Medical services provided in the secondary state will be treated as having occurred in the primary state, if the secondary state’s licensure requirements are “substantially similar” to those in the primary state. The definition of “substantially similar” licensure requirements is set forth in the language of the new statute.
The purpose of the SMLCA is to empower sports medicine professionals to be able to engage in the treatment of injured athletes across state lines without fear of being prosecuted for practicing without a license and the threat of losing their licenses for practicing outside their jurisdiction of licensure. They will also be protected from the threat of monetary loss possible from practicing outside the boundaries of their coverage by professional liability insurance. The new law will benefit high school athletics programs, especially those whose teams and athletes regularly compete in neighboring states and that have in the past struggled to hire athletic trainers because of jurisdictional barriers.
Before enactment of the SMLCA, many states offered no legal protections for sports medicine professionals and athletic trainers whose jobs required travel for work outside their primary state of licensure. The legal exposure for such individuals existed because medical liability insurance carriers often did not cover medical services performed outside the primary state and because state licensure laws often provided for sanctions for practicing outside the primary state such as criminal prosecution, loss of license and monetary fines.
The legislation received near-unanimous bipartisan support in Congress (roll call votes in favor of enactment in the House of 428 and in the Senate of 98) and was endorsed by the American Medical Association, the American Medical Society for Sports Medicine, the American Academy of Neurology, the National Athletic Trainers Association, all American professional sports leagues (NFL, NBA, MLB, NHL and MLS), the United States Olympic Committee, the NCAA and the NFHS.
In a press release, NATA president Tory Lindley stated, “While [the new law] advances safety practices for all sports medicine professionals, it will greatly impact athletic trainers who routinely travel with teams to provide preventative and immediate care. It recognizes, at an unprecedented level, the integral and life-saving role athletic trainers, as well as all sports medicine professionals, play in athletic health care.”
It is imperative that school and athletics administrators, along with all sports medicine professionals and athletic trainers, understand the nuances and precise extent of the legal protections offered by the SMLCA in order to take full advantage of the law and avoid violating any of its parameters.
The Details of the SMLCA
The full text of the new federal law is available here.
Section 2-A of the statute sets forth the protections provided by the new law to sports medicine professionals, including athletic trainers.
“In the case of a covered sports medicine professional who has in effect medical professional liability insurance coverage and provides in a secondary State covered medical services that are within the scope of practice of such professional in the primary State to an athlete or an athletic team (or a staff member of such an athlete or athletic team) pursuant to an agreement described in subsection (b)(4) with respect to such athlete or athletic team:
Section 2-C of the statute provides a definition of “substantially similar,” albeit one that is somewhat vague in terms of providing precise guidance, to be used in comparing the licensure requirements of the secondary state to those of the primary state.
“The term substantially similar, with respect to the licensure by primary and secondary States of a sports medicine professional, means that both the primary and secondary States have in place a form of licensure for such professionals that permit such professionals to provide covered medical services.”
Section 2-C of the statute provides a definition of “athlete” and “athletic team” to whom the sports medicine professional or athletic trainer seeking the legal protections of the new law may provide covered medical services, with the clear intent of the definitions being to apply to professional athletes and teams, those competing within the sanction of organizations such as the U.S. Olympic Committee or U.S. Paralympic Committee, college athletes and teams, and high school student-athletes and teams.
“The term athlete means an individual participating in a sporting event or activity for which the individual may be paid; an individual participating in a sporting event or activity sponsored or sanctioned by a national governing body; or an individual for whom a high school or institution of higher education provides a covered sports medicine professional. The term athletic team means a sports team composed of individuals who are paid to participate on the team; composed of individuals who are participating in a sporting event or activity sponsored or sanctioned by a national governing body; or for which a high school or an institution of higher education provides a covered sports medicine professional.”
Section 2-C of the statute also defines the nature and extent of medical services that may be provided by the sports medicine professional, who may be a physician, athletic trainer or other licensed health-care professional and who has disclosed his or her provision of services to the entity that provides his or her liability insurance coverage in the primary state.
“The term covered medical services means general medical care, emergency medical care, athletic training or physical therapy services. Such term does not include care provided by a covered sports medicine professional at a health-care facility or while a health-care provider licensed to practice in the secondary State is transporting the injured individual to a health-care facility. The term health-care facility means a facility in which medical care, diagnosis or treatment is provided on an inpatient or outpatient basis. Such term does not include facilities at an arena, stadium or practice facility, or temporary facilities existing for events where athletes or athletic teams may compete.”
Section 2-B of the statute sets forth five additional limitations on the legal protections provided by the new law.
“Rules of construction – nothing in this section shall be construed:
Benefits of the SMLCA for High Schools
No longer will high school athletic programs have to incur the expense when traveling to compete across state lines of hiring separate athletic trainers licensed in the secondary state where the competition will take place. Nor will those schools located near state lines that routinely compete in neighboring state(s) be forced to limit their hiring practices for athletic trainers to those with multi-state licensure in all of the nearby states where the schools’ athletes and teams will compete. As long as school and athletics administrators exercise care in observing the limitations in the legal protections of the SMLCA, the new law should reduce the overall cost and provide significant encouragement for schools not already doing so to provide athletic trainers at all school sports contests to safeguard the health and well-being of student-athletes.
Lee Green is an attorney and Professor Emeritus at Baker University in Baldwin City, Kansas, where for 30 years he taught courses in sports law, business law and constitutional law. He is a member of the High School Today Publications Committee. He may be contacted at Lee.Green@BakerU.Edu.