VA Proposal Would Expand Access to Care Via Telemedicine
By Christopher Parrella J.D.
Challenged by limited healthcare resources, the U.S. Department of Veterans Affairs has issued a proposal that would allow VA healthcare providers to serve patients across state lines via telehealth, regardless of where they are licensed to practice.
For fiscal year 2016, VA healthcare providers had 2.17 million telehealth episodes serving more than 700,00 veterans, 45 percent of which lived in rural communities. The VA notes that increasing its capabilities would allow it to expand the services it currently delivers.
“Telehealth enhances VA’s capacity to deliver essential and critical health care services to beneficiaries located in areas where health care providers may be unavailable or to beneficiaries who may be unable to travel to the nearest VA medical facility for care because of their medical conditions,” the proposed rule states.
Healthcare provided by the VA via telemedicine faces the same restrictions as telemedicine provided outside of the department. Physicians are limited by state regulations which dictate how and when they can deliver healthcare via telemedicine.
Many VA providers are concerned about providing telehealth services because they fear it could jeopardize their credentials, or result in fines and imprisonment for unauthorized practice of medicine.
Because the proposed rule would preempt certain state laws, the VA said it consulted with various state organizations and medical boards advising them of its intent to allow VA healthcare providers to practice telehealth irrespective of the location of the provider or patient.
Many medical boards have stated that they are in support of the rule, particularly because it allows for the provision of healthcare to veterans who live in areas where they do not have immediate access to physical and mental healthcare.
The VA is seeking comments on its proposal until November 1.
While limited to the VA, this rule could serve as an important first step toward expanding the role telemedicine plays in today’s healthcare environment.
In doing so, FSMB president and CEO Humayun Chaudhry stated: “The launch of the Compact will empower interested and eligible physicians to deliver high-quality care across state lines to reach more patients in rural and underserved communities.”
Eighteen states have adopted the Compact and eight additional states and the District of Columbia have introduced legislation in support of a pathway for license portability.
At the same time, Congress is considering how to go about expanding access to healthcare through telemedicine. One of those ways is the Telehealth Innovation and Improvement Act, which we wrote about in April.
The bill would expand access to healthcare in both rural and urban areas by paving the way for Medicare to cover additional telehealth services. Currently, Medicare covers limited telehealth services, setting a poor industry standard, discouraging innovation, and restricting access to specialized services.
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