VA proposed rule would expand healthcare access through telehealth
Monday, October 30, 2017
President Donald Trump announced in August that new efforts were required to better use technology to improve healthcare for veterans and greatly expand their access to care, especially for mental healthcare and suicide prevention.
Thanks to efforts by the Veterans Administration, initiatives have since been underway to use video technology and diagnostic tools to conduct medical exams. Thus, veterans — especially those living in rural areas — are now better able to use mobile devices to make and manage appointments with VA doctors.
"We call it 'anywhere to anywhere' VA healthcare," VA secretary David Shulkin said in August.
The goal is better healthcare for veterans wherever they are. Moving forward, the U.S. Department of Veterans Affairs recently announced a proposed rule that would allow its healthcare providers to treat patients anywhere through telehealth, regardless of state laws.
The proposed rule would bring about change more quickly than H.R. 2123, the Veterans E-Health and Telemedicine Support (VETS) Act, which was designed to waive state telemedicine laws for VA physicians. The House bill was referred to the Veterans' Affairs Committee back in April.
VA officials have said the proposed rule is needed for the agency to continue growing its telehealth services, obviously crucial for veterans who need mental healthcare, which is a primary focus of the rule. The efforts backed by Trump have seemingly increased dramatically as administration officials attempt to improve care for veterans and remove hurdles to accessing care.
The move, ultimately, means the VA can build its telehealth program and show some positive steps forward after a rough few years. Michael Shores, director of regulation policy and management in the VA secretary's office, wrote that the rule could "eliminate veteran suicide and provide access to mental healthcare ... the VA's number one clinical priority, and this proposed rule-making would improve VA's ability to reach its most vulnerable beneficiaries."
In 2016, VA providers saw 702,000 patients via telemedicine in 2.17 million episodes of care. Nearly half of those who received telemedicine care live in rural areas.
"By increasing VA's capabilities to provide telehealth services, VA would be able to expand these services," Shores wrote.
Currently, VA telehealth care is caught up in state restrictions purgatory. If a physician were to see a patient via telemedicine in a state in which the physician is not licensed to practice, that physician could lose his or her credentials and be fined. Thus, in this specific case, the proposed rule means there are no penalties for providing telemedicine outside the states where providers are currently allowed to practice.
A federal rule is necessary to relax these restrictions, because it would take too long for every state to nix the penalties. Thus, those VA physicians providing care in such a fashion will likely be in favor of the rule.
According to a statement, the American Medical Association (AMA) supports the proposed rule and the VA's expansion of telehealth services overall.
"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," said Jack Resneck Jr., chair-elect to the AMA Board of Trustees.
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