Population Health Insights

VA Issues Rule on ‘Authority of Health Care Providers to Practice Telehealth’


The U.S. Department of Veterans Affairs has announced a new set of policies that add up to an ambitious expansion of the VA telehealth program — including a new rule that gives providers the authority to actively treat patients who are not only off-site, but who may even be in another state.

This new set of rules, which the agency describes as “paving the way for VA to expand care to Veterans using telehealth,” make the following policy changes:

  • Removing restrictions preventing doctors, nurses and other clinicians to treat patients in other states
  • Expanding access to virtual critical care services, particularly “mental health care and suicide prevention”
  • Introducing a new telehealth video conferencing app for veterans and providers called “VA Video Connect”

The first of these rules is the focus of the VA’s announcement, as well as a good deal of attention from the healthcare media. Under this rule, healthcare professionals are empowered to treat veterans “regardless of where in the United States” they live, “including when care will occur across state lines or outside a VA facility.”

That’s a major distinction: Despite its appearance of a top-down hierarchy, the VA is actually a network of facilities that act semi-autonomously, and which are subject to the laws of the states in which they operate. This situation acted as a roadblock for the agency’s wider adoption of telehealth services, which often (and importantly) involves interaction across state lines.

Thus, it had been previously “unclear whether VA providers could furnish care to Veterans in other states through telehealth because of licensing restrictions or state-specific telehealth laws,” as the agency itself admits in its announcement.

The VA Telehealth Program’s ‘Anywhere to Anywhere’ Initiative

But the newly finalized federal rule overrides those restrictions and state-specific roadblocks. Formally issued under the name “Authority of Health Care Providers to Practice Telehealth,” the Rule “clarifies that VA health care providers may exercise their authority to provide health care through the use of telehealth, notwithstanding any State laws, rules, licensure, registration, or certification requirements to the contrary.” (Emphasis ours, throughout.)

The rule also notes that “laws, rules, regulations, or other requirements are preempted to the extent such State laws conflict with the ability of VA health care providers to engage in the practice of telehealth while acting within the scope of their VA employment.”

How did the VA gain the kind of power needed to pre-empt state laws? With the help of the U.S. Congress, which “passed several bills in support of the measure since the initial announcement, supporting a nationwide telehealth program,” notes Jessica Davis at Healthcare Finance.

The new rule is also part of the agency’s Anywhere to Anywhere initiative, a systemwide effort to boost access of veterans to quality care via telehealth announced last August. In the face of the systemwide staffing crisis that’s gripped facilities in recent years, the VA has been in need of operational improvements that both expand access and reduce expenses.

Increasingly, the VA telehealth program is being seen as the solution to these challenges. Each of the agency’s recent leaders (and even the president himself) has voiced strong support for the expansion of a telemedicine network to expand access to veterans who live in remote areas, or who simply face difficulty traveling to a clinic or facility.

To that end, the new rule will “especially benefit Veterans living in rural areas who would otherwise need to travel a considerable distance or across state lines to receive care,” as the agency promises in the official announcement.

“The rule also will expand Veterans’ access to critical care that can be provided virtually — such as mental health care and suicide prevention — by allowing quicker and easier access to VA mental health providers through telehealth,” it adds.  

You can read more about the VA telehealth program here. And if you’re interested in discovering how telehealth can help your facility or organization achieve greater efficiencies of care, we invite you to schedule a complimentary consultation with a Care Innovations® telehealth specialist

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