VA Physicians to Start Practicing Across State Lines

Starting June 11, VA healthcare providers will be allowed to deliver care via telemedicine across state lines.

As we wrote about last October, the U.S. Department of Veterans Affairs had issued a proposal that would allow for the provision of telemedicine services, regardless of where providers are licensed to practice.

On May 11, the VA finalized that rule. By doing so, the VA is exercising federal preemption of conflicting state laws relating to the practice of healthcare providers to the extent that they “conflict with the ability of VA healthcare providers to engage in the practice of telehealth while acting within the scope of their VA employment.â€

Previously, VA physicians could only provide telemedicine treatment across state lines if both the veteran and the doctor were located in a federally owned facility. The new rule allows virtual care regardless of where in the U.S. the provider or the veteran are physically located.

The VA noted that this rule was necessary because “it would be impractical for VA to lobby each state to remove any restrictions that impair VA’s ability to furnish telehealth services to beneficiaries and then wait for the state to implement appropriate changes. That process would delay the growth of telehealth services in VA, thereby delaying delivery of healthcare to beneficiaries.â€

The VA received 75 comments on the proposed rule during the 30-day comment period. It noted that most of the comments supported the proposed rule stating that it not only would benefit those who live in rural and medically underserved areas, but also would improve clinical outcomes along with quality of care at the VA. Others commented that it would be more cost effective, decrease the rate of no-shows, and reduce the number of hospital and emergency room visits.

There were some concerns including one in which a commenter worried that the rule would “undermine the state’s ability to protect healthcare consumers.†VA stated that it has “robust requirements for disciplining providers who fail to provide adequate healthcare, which includes reporting that provider to his or her licensing board.â€

In addition, patients would still have the ability to file tort claims and states would still have the ability to prosecute for any criminal offenses.

The rule does not include VA-contracted healthcare providers such as those who participate in the Veterans Choice Program or any other community care program.

In outlining specific state rules and laws, the VA pointed out that the Florida Board of Medicine does not prohibit the practice of telehealth except in certain circumstances and provided as an example that an in-person examination is required each time a physician issues a certification for medical marijuana.

“This final rule supersedes any state requirement regarding the practice of telehealth, such as the in-person examination requirement in Florida, and would maintain the restrictions imposed by federal law and policy regarding the prescription of controlled substances,†the VA noted.

Not only can patients be treated for physical healthcare-related issues, but also for mental health services.

In March, the VA announced the launch of a nationwide telehealth pilot program targeting veterans dealing with PTSD. It connects 12 community-based outpatient clinics across the nation with veterans in need of PTSD treatment.

Although limited to the VA, this rule is being viewed as an important first step toward expanding the role telemedicine plays in today’s healthcare environment. As the role of telemedicine continues to grow, we can assist with any compliance needs associated with your practice’s telemedicine model. Feel free to contact us for additional information at 305-358-4500 or send an email to info@vitalehealthlaw.com and let’s discuss how we might be able to help.