Governor Announces Licensing Flexibilities for Health Care Professionals in Response to Novel Coronavirus (COVID-19)

In continuing to respond to the healthcare needs of Virginians during the state of emergency declared under Executive Order 51, Governor Ralph Northam has issued Executive Order 57, which affects the licensing of health care professionals. Effective April 17, 2020, EO 57 offers temporary licensure for out-of-state practitioners, expands telehealth coverage, provides temporary autonomy to nurse practitioners, and authorizes residents, interns, and certain senior students to practice in the Commonwealth. The goal of these changes is to increase the number of practicing health care practitioners in response to the increased demands on the Commonwealth’s health professional workforce as a result of the novel coronavirus. The full order can be accessed here.

Temporary Provision of Care to Virginia Residents by Out-of-State Practitioners

The Executive Order expands opportunities for out-of-state practitioners to work in various health care settings without a requirement for licensure in Virginia. For the duration of the state of emergency, a health care practitioner will be deemed to have an active license issued by the Commonwealth if:

  • The practitioner has a license in good standing issued by another state;
  • The practitioner provides the same type of health care or professional services for which the license was issued in another state;
  • The practitioner has been engaged to assist with public health emergency response operations by a:
    • Hospital or hospital affiliate;
    • Licensed nursing facility;
    • Dialysis facility;
    • Physicians’ office; or
    • Other health care facility in the Commonwealth, including assisted living facilities, congregate care settings, and any alternate care facility established in response to the COVID-19 emergency; and
  • The facility engaging the practitioner submits a report to the applicable licensing board as soon as possible including the out-of-state health care practitioner’s name, license type, state of license, and license identification number.[1]

Clinical psychologists, professional counselors, marriage and family therapists, and clinical social workers with an active license in good standing issued by another state may be issued a temporary Virginia license by endorsement as a health care practitioner of the same type for which such license is issued following submission of an application to the applicable licensing board and approval of a temporary license. Any temporary license shall expire ninety (90) days following the cessation of the state of emergency, upon which time the practitioner may seek a full Virginia license or transition patients to Virginia-licensed practitioners.

Out-of-state practitioners with an active license may continue to provide care to their existing Virginia-resident patients through telehealth services. Out-of-state practitioners may not establish a relationship with a new patient through telehealth, unless the out-of-state practitioner has been temporarily licensed in Virginia pursuant to this order. EO 57 clarifies that telehealth is to include any non-public facing audio or remote communication product that is available and may be provided for any reason, not solely for the diagnosis and treatment of COVID-19.

Nurse Practitioners, Individuals Pursuing Medical Degrees, and Graduates of Respiratory Care Programs Granted Temporary Authority to Practice

Under EO 57, Nurse Practitioners with two years of experience have been latitude to practice without practice agreements with physicians and certain students and other professionals in training may provide services without direct supervision. EO 57 provides authority to practice for the duration of the state of emergency as follows:

  • Nurse practitioners licensed in the Commonwealth of Virginia (with the exception of those licensed as certified registered nurse anesthetists) with two or more years of clinical experience may practice within their certified and licensed practice category and prescribe medications without a written or electronic practice agreement;
  • Residents, interns, and fellows with active temporary training licenses issued by the Virginia Board of Medicine may practice in a hospital (including a clinic or alternate care facility) without the supervision of a licensed physician or fully licensed member of the applicable faculty program;
  • Senior fourth year medical students may practice in a hospital (including a clinic or alternate care facility) without the direct tutorial supervision of a licensed physician member of the hospital staff; and
  • Individuals who have completed an accredited respiratory care program may practice respiratory therapy for ninety (90) days after completion or until the individual has taken the National Board of Respiratory Care licensure examination, whichever occurs first.


The Governor of Virginia continues to issue necessary executive orders with the intent to ensure that the needs of Virginians are being met during this state of emergency. In light of the expected demand on healthcare resources and associated strain on the healthcare workforce, EO 57 will temporarily increase the number of individuals allowed to provide healthcare services to Virginia residents. Virginia facilities who intend to engage out-of-state practitioners to supplement their workforce should be mindful to submit a registration to the appropriate Virginia licensing board as soon as possible. Individual practitioners who are practicing without supervision under this Order should ensure that they are complying with the applicable rules and regulations regarding standards of practice and care during this time.

Should you, your practice, or your business have any questions about the implications of this Executive Order, please contact Peter Mellette, Harrison Gibbs, Elizabeth Dahl Coleman, or Scott Daisley at Mellette PC.

This client advisory is for general educational purposes only and does not cover every provision of the Executive Order. It is not intended to provide legal advice specific to any situation you may have. Individuals desiring legal advice should consult legal counsel for up-to-date and fact-specific advice.

[1] The DHP reporting form to be used by organizations to report these out-of-state practitioners is available at

Categories: Client Advisory