VA Issues Proposed Rule to Allow Telemedicine Across State Lines

October 2017 ~

The U.S. Department of Veterans Affairs has released a proposed rule that would allow associated healthcare providers to treat patients anywhere through telehealth across state lines or within states. Under the VA’s Anywhere to Anywhere VA Health Care Initiative, VA doctors would be granted the authority to use telehealth and telemedicine to treat veterans regardless of state guidelines on originating sites or licensing requirements.

“This proposed rulemaking would clarify that VA healthcare providers may exercise their authority to provide care through the use of telehealth, notwithstanding any state laws, rules, or licensure, registration, or certification requirements to the contrary,” the proposed rule states. “In so doing, VA would exercise federal preemption of state licensure, registration, and certification laws, rules, regulations, or requirements to the extent such state laws conflict with the ability of VA healthcare providers to engage in the practice of telehealth while acting within the scope of their VA employment.”

The VA says its proposed rule is needed for the agency to continue growing its telehealth services, especially mental health services, to ensure all veterans have access to care – including those living in rural areas. According to the VA, approximately 702,000 veterans used telehealth or telemedicine in FY 2016, accounting for 2.17 million telehealth episodes. Of that group, 45% were living in rural communities.

“The data collected in FY 2016 demonstrates that telehealth, particularly in the mental health context, improves patient care and improves patient outcomes,’ the proposed rule states. “In FY 2016, there was a 31% decrease in VA hospital admissions for beneficiaries enrolled in the Home Telehealth monitoring program for non-institutional care needs and chronic care management. Also, beneficiaries who received mental health services through synchronous video telehealth in FY 2016 saw a reduction in the number of acute psychiatric VA bed days of care by 39%.”

The rule also includes proposals to improve remote monitoring for veterans with limited mobility or difficulties traveling to a healthcare provider, and its use as an incentive to recruit more VA healthcare providers, intended to help reduce the national shortage.

The American Medical Association (AMA) recently shared its support of the proposed rule and the VA’s overall expansion of telehealth services in a statement, “The AMA strongly supports that the proposed rule explicitly provides that this program’s multi-state licensure exception applies only to VA-employed providers and would not be expanded to contracted physicians or providers who are not directly controlled and supervised by the VA and would not necessarily have the same training, staff support, shared access to a beneficiary’s EHR and infrastructure capabilities.”

The proposed rule was published in the Federal Register on October 2nd and the public comment period will run for the next 30 days.



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