State-to-state licensure agreements: Endorsement and reciprocity
Most healthcare professionals are regulated through the licensure process or through testing or certification by a specialty organization. The federal government is not involved in professional licensure (with the exception of the federal Drug Enforcement Agency certificate); each state establishes requirements and practices. For this reason, a license is valid only within the state that issues it.
State boards may grant licenses to health professionals licensed in other states that have equivalent standards through a process known as "endorsement." In this case, the state may entirely accept the licensure requirements of the other state, or may require additional qualifications or documentation before endorsing a license issued by another state.
Another option that state licensing agencies use is reciprocity. With reciprocity, each state gives licensure applicants of the other state certain privileges on the condition that its applicants have the same privileges. Reciprocity requires each state to negotiate and enter into agreements to recognize licenses issued by the other state without a review of individual credentials, thus allowing a practitioner licensed in one state to practice in another.
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