New rule eliminates state regs on VA telehealth

Medical practitioners in the Veterans Health Administration system will be able to conduct telehealth appointments regardless of location under the new "anywhere-to-anywhere" rule published May 11 and taking effect in June.

The long-sought rule frees VA clinicians from a patchwork of state licensing and insurance rules that hampered the delivery of telehealth, and it introduces the possibility that the agency can drive new efficiencies by making more clinicians available for appointments with beneficiaries around the country.

"I think this is going to be the killer app for us," said acting VHA Chief Carolyn Clancy at a May 9 Senate hearing.  The emphasis on telehealth will not only improve care but also improve recruiting because the VA is "so far ahead of the rest of the health care system" when it comes to telehealth technology, infrastructure and experience.

"By 2020 it will be a routine experience that all of our clinicians -- [that] telehealth is part of the job. This is not a unique, boutique activity."

The rule applies only to VA employees, not to contractors or to private-sector practitioners delivering care as part of the Choice Program. VA was urged by some during the comment period to include outside clinicians. Ultimately, the agency changed the language of the rule to clarify that it only covers VA staff, "because of the public comments in which there is confusion as to whether a contractor is a VA employee."

The VA was an early adopter of telehealth, seeing it as a way to reach a far-flung and aging patient population. The agency also announced a nationwide expansion of its VA Video Connect application at a White House event last August.