- A new bill that seeks to modernize the oft-criticized Department of Veterans Affairs includes a provision allowing VA doctors to treat veterans via telemedicine no matter where they live.
The 125-page Veterans Community Care and Access Act of 2017, filed this week by Sens. John McCain (R-Ariz.) and Jerry Moran (R-Kansas), uses the same language as that featured in the Veterans E-Health & Telemedicine Support (VETS) Act of 2017 (H.R. 2123), which was passed by the House last month and now awaits a Senate vote.
Both bills would allow VA-affiliated practitioners to treat veterans through telemedicine in any state, bypassing state licensure laws, as long as they follow established healthcare standards and have an active and unrestricted state license.
Both bills also call on VA Secretary David Shulkin to report back to Congress within a year “on the effectiveness of the use of telemedicine by the Department of Veterans Affairs.”
Shulkin has included the same telemedicine provision in his “Anywhere to Anywhere VA Health Care” program, unveiled in September and backed by the Justice Department.
While the VETS Act, co-sponsored by Reps. Julia Brownley (D-Calif.) and Rep. Glenn Thompson (R-Pa.), sailed through a unanimous House vote in early November, its companion bill in the Senate, submitted by Sens. Joni Ernst (R-Iowa) and Mazie Hirono (D-Hawaii), still awaits a vote – not a sure bet, given the Senate’s busy workload and a lack of progress on single-item bills.
With their bill, McCain and Moran are tacking the telemedicine provision onto a much larger effort to modernize the VA and repair its less-than-stellar image in serving veterans.
The bill would establish a Veterans Community Care Program that coordinates healthcare inside and outside VA health systems for the nation’s veterans, including establishing access and quality standards, safe prescribing standards and a walk-in care protocol. It also calls on VA facilities to coordinate care with non-VA providers by sharing medical records and determining reimbursement.
“In the wake of the scandal in care at VA hospitals in Phoenix and around the country, we vowed to guarantee our veterans timely access to quality treatment,” McCain said in a joint release issued by the two senators. “The Veterans Choice Program was the first step in delivering on that promise, but much more needs to be done to provide all veterans a choice in when and where they receive care.”
“Our bill would strengthen and improve the core elements of Choice by consolidating and streamlining the VA’s community care program,” he continued. “Moreover, the bill would deliver long overdue, critical reforms to the VA, including commonsense reporting standards that ensure cost-efficient care to our nation’s veterans.”
“Demand has demonstrated that veterans want and need healthcare options in their communities, but there must be reform at the VA to create a system that works for them,” Moran added. “This joint effort to reform the VA will offer veterans an integrated healthcare system within their community that reduces red tape, enhances their quality of life and provides care that is worthy of their service and sacrifice.”
The VETS Act has received support from a broad range of organizations, including the American Telemedicine Association, American Medical Informatics Association, Federal Trade Commission, Health IT Now, the American Academy of Family Physicians, the College of Healthcare Information Management Executives (CHIME), Teladoc, Oracle, the American Psychological Association, the Brain Injury Association of America, the National Association of Social Workers and the University of Pittsburgh Center for Military Medicine Research.
The AAFP’s support was guarded, however. The organization said it would support this specific bill to improve veterans’ access to much-needed healthcare services, though it “still strongly supports state-based licensure and regulation of physicians and other healthcare providers as well as the states’ ability to regulate the practice of telehealth in their state.”
Among those opposed to the provision is the Medical Board of California.
In an Oct. 30 letter to Shulkin, the board said the VA secretary’s proposed rule “would undermine California’s ability to protect healthcare consumers, as the board will have no ability to discipline VA providers that are licensed in another state and providing telehealth outside of a VA facility in California, as they do not hold a license to practice in California.”
“Although the board believes that telehealth is a useful tool that can be used to provide appropriate service to patients in California, the board believes that it is very important for physicians treating patients in California to be licensed in California,” the letter concluded.