Physician licenses become collateral damage of immigration law

Georgia physicians are turning to state legislators to amend an immigration law that they say is resulting in expired licenses for doctors and other health professionals and forcing physicians to prove their citizenship unnecessarily.

Starting in January, House Bill 87 required health care employees to prove their citizenship or legal residency as they apply for or renew their professional licenses. However, licensing administrators say understaffed offices can’t keep up with the deluge of new paperwork and increased responsibilities.

“Physicians in Georgia are frustrated,” said Donald J. Palmisano Jr., executive director and CEO of the Medical Assn. of Georgia. The association “has received a number of complaints regarding the law’s proof-of-citizenship requirements. Physicians are filing this information with the medical board, but the medical board simply doesn’t have the resources to verify the information in any timely way.”

At this article’s deadline, messages left with Georgia Gov. Nathan Deal’s office had not been returned.

Confirming health professionals’ citizenship was among several provisions of the Illegal Immigration Reform and Enforcement Act of 2011. As part of the act, licensing boards must obtain a secure and verifiable document from each applicant who applies for a new or renewed license. Such documentation must be provided for each license, even if the health professional holds other licenses in good standing.

The law’s purpose is to prevent employers from hiring illegal immigrants and to penalize those who do, said Georgia State Rep. Edward Lindsey, a co-sponsor of the law.

“In Georgia and a number of other states, there are a number of folks that are not here legally. The economic impact on the state is estimated at $2 billion a year,” Lindsey said. The law seeks to “protect us citizens and legal residents from having to compete against someone here illegally and to protect businesses that are doing it right.”

But the act has turned what was a simple process into a time-consuming and burdensome procedure, said Bob Jeffery, director of operations for the Georgia Composite Medical Board.

“It certainly has affected the time it takes for [doctors] to renew both in terms of what they have to do as well as the interval between submitting their renewal [paperwork] and the time the license is renewed,” he said. The new process “requires human intervention. Now we have to take the same number of staff and devote a significant part of their time to processing what would have been a routine renewal that was completely automatic.”

Before the new requirement, physicians could expect to have their licenses renewed online within minutes, Jeffery said. Now the wait time is about 10 days, with 29% of license renewals taking 10 days or more. Ten percent of renewals are taking 30 days or more, he said.

Of 1,749 physicians who applied for license renewals since the new requirements took effect, 13.5% of the licenses expired before they were renewed. Last year, only 2.8% of medical licenses were renewed late, according to board data.

“That’s a big deal,” Jeffery said. “Doctors can be reprimanded for practicing without a license, but & if there’s some sort of billing problem or a malpractice suit, they might not be able to get insurance coverage” or might have trouble defending against a liability claim.

Legislative intervention sought

The same processing delays are occurring at the Georgia Secretary of State Office, which processes nursing licenses. Renewals used to take days, said Jared Thomas, a spokesman for the office. Currently, the average time for a “clean” license application is 17 days. If an application is missing information, the wait is much longer, he said. New license applications can take up to three months.

From Jan. 1 through Sept. 30, Thomas’ office has received and processed 97,843 renewal applications and 43,665 new applications. Since that time, staff has sent 9,575 deficiency letters to applicants and licensees who submitted initial or renewal applications that were missing citizenship verification information, according to office data.

“You can’t start until you get your license,” he said. “You can see obviously how frustrating that can be not only to the [health professional], but also the hospital or whoever was going to employ them.”

Lindsey, the state lawmaker, said the renewal delays are an unintended consequence of a necessary immigration law.

“We need to fix that,” he said. “Once someone is in the state government database having established a legal right to a license, the next time they come back to renew or get another, there should not be a need for that person to [prove citizenship]. That’s just needless paperwork.”

The requirements should apply only to new licensees, he said.

Legislators attempted to amend the law to address this issue during the Legislature’s most recent session, but they were unsuccessful. They plan to try again next session, Lindsey said.

Doctors also are encouraging legislators to change the law.

“The Medical Assn. of Georgia would support legislation that would remove the proof-of-citizenship requirement for physicians to obtain a medical license in the state,” Palmisano said.