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Department of Veterans Affairs Aims to Trump State Telemedicine Rules

By Mary Gorder Saturday , 04th November, 2017

The U.S. Department of Veterans Affairs (“VA”) is taking a significant step towards expanding needed services to Veterans by proposing a rule to preempt state restrictions on telehealth.

Most states currently restrict providers (including VA employees) from treating patients that are located in that state if the provider is not licensed there. As a result, the VA has had difficulty getting a sufficient number of providers to furnish services via telemedicine for fear that they will face discipline from those states for the unlicensed practice of medicine.

The VA has a real need for expanding its telemedicine capabilities as many of its patients are located in rural and underserved areas. The VA’s top clinical priority is mental health, and having more robust telemedicine capabilities could help improve timeliness of treatment (a reputational sore spot for the VA).  The VA could also use telemedicine to reach more people in need that may not otherwise seek help.  The rule would allow the VA to more evenly distribute care by hiring providers in urban areas where there is larger pool and have them treat in rural areas (via telemedicine).

Not everyone is happy about the proposed rule, however. Organizations such as the American Medical Association oppose the rule as undermining each state’s ability to govern the practice of medicine within its borders.  The concern is that states would have no ability to regulate their citizens’ care under this new framework.

While this rule is limited only to VA patients and providers, the hope is that other federal agencies or even states will follow the VA’s lead. Given the importance of increasing access to care and the advances in the delivery of care via telemedicine, it might be time for states to reexamine their restrictive approach to professional licensure.

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