VA issues proposed rule for home-based telehealth for vets

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A new proposed rule from the Veterans Administration would enable VA providers offering telemedicine services to more easily administer care across state lines by waiving state licensure requirements to enhance veterans’ access to treatment.

“By providing healthcare services by telehealth from one state to a beneficiary located in another state or within the same state, whether that beneficiary is located at a VA medical facility or in his or her own home, VA can use its limited healthcare resources most efficiently,” the rule states.

This means that veterans in their home can use a mobile app, called VA Video Connect, to access a platform to conduct a home videoconferencing session with a VA provider, says Catherine Pugh, senior director of government affairs at Health IT Now, a coalition of patient, provider, employer and insurer stakeholders.

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The rule is authorized under the VETS Act of 2017, which was introduced in April but has yet to be enacted. However, VA, while not yet having a clear mandate for the program, notes that several existing laws confirm that Congress intends for VA to operate a national healthcare system that includes telehealth and is acting on that intention to lift existing barriers.

VA leaders decided to move forward through regulatory processes rather than wait on a new law, but the proposed rule is squarely in line with the goals of the VETS Act of 2017, Pugh believes.

Further, the rule would authorize the VA Secretary to waive the imposition or collection of copayments for telehealth visits.

The proposed rule would not expand the scope of practice for VA providers beyond what is defined in the laws and practice acts of the provider’s state of licensure.

“This proposed rule will be instrumental in breaking down geographic barriers that for too long have prevented our nation’s heroes from access the care they need where they need it,” says Joel White, executive director at Health IT Now.

The American Medical Association also weighed in on the proposed rule, strongly supporting the use of telehealth to enable VA healthcare providers to increase the availability to care for veterans.

“The AMA supports expansion of clinically validated telehealth services within the VA, and this decision ensures that important patient protections are in place for the delivery of high quality and reliable care,” said Jack Resneck Jr., MD, chair-elect of the AMA Board of Trustees. “The VA has a unique federally controlled healthcare system with essential safeguards to help ensure that both in-person and virtual beneficiary care meet and exceed the standard of care.

“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,” Resneck added. “We applaud the VA’s expansion of telehealth services in a manner that promotes quality and access.”

The proposed rule is available here.

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