This issue brief explores how six states--California, Florida, Illinois, Massachusetts, New Jersey, and Texas--are using regulation and licensure to promote, structure, or limit the operation of retail clinics. These six states were selected because their recent experiences may provide instructive lessons for other states. The states' approaches to the clinics vary, as do interpretations of how existing regulations fit the retail clinic model. Only one state, Massachusetts, has written new regulations expressly for retail clinics. Among the steps being taken or considered by these states are: (1) Creating a separate regulatory category for retail clinics; (2) Licensing retail clinics as they do other health care facilities; (3) Altering oversight requirements regarding nurse practitioners and physician assistants; (4) Imposing or loosening marketing and advertising restrictions; (5) Developing Medicaid policies to facilitate clinic participation; and (6) Requiring clinics to make referrals to primary care providers. The project's researchers conducted interviews with stakeholders in each of the six states concerning the state's regulation of health services in retail settings. The researchers interviewed representatives of state Medicaid and licensing and certification agencies; retail clinics; organizations that represent health care providers, including physicians, nurse practitioners, and two state primary care associations; and state legislators and/or their staff. Interview protocols were tailored for each stakeholder group. This report addresses some common themes that emerged, as well as each state's unique response to the emergence of retail clinics.
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