VA proposed rule would override state licensing restrictions to expand access to telehealth

David Shulkin and Donald Trump
A new proposed rule overriding state licensing restrictions is a key part of the VA's new telehealth initiative.

The Department of Veterans Affairs has issued a proposed rule that would allow VA providers to treat patients in any state via telehealth, regardless of where they are licensed to practice.

The proposed rule would override state licensing restrictions that the agency says are limiting its telehealth program and allow VA physicians to treat patients anywhere in the country using the VA's telehealth technology. 

That change is a critical part of the VA’s “Anywhere to Anywhere VA Health Care” program, unveiled by VA Secretary David Shulkin, M.D., and President Donald Trump last month. During that announcement, Shulkin said he was working with the White House’s Office of American Innovation and the Department of Justice to issue a new medical practice regulation to support telehealth initiatives.

RELATED: VA expands telehealth services with new ‘Anywhere to Anywhere’ initiative

According to the proposal, “many VA medical centers” have not expanded telehealth programs because of state laws, and “many physicians” refuse to practice telehealth out of fear they will jeopardize their medical license.

“As VA’s telehealth program expands and successfully provides increased access to high quality healthcare to all beneficiaries, it is increasingly important for VA health care providers to be able to practice telehealth across State lines and within states free of restrictions imposed by State law or regulations, including conditions attached to their State licenses,” the rule states.

Rather than lobby each state to remove licensure restrictions, the VA argues that preempting state law would allow the agency to quickly expand telehealth services.

“By allowing VA telehealth providers to more easily treat patients across state lines, we can ensure that recent advances in technology-enabled care reach the most deserved among us and spur better outcomes for the 20 million veterans in the VA system today,” Health IT Now Executive Director Joel White said in a statement supporting the regulatory change.

​​​​​​RELATED: Behavioral health advocates back telehealth bill; regulation to loosen VA practice restrictions advances

Currently, VA providers can waive state licensing requirements if both the physician and the patient are in a federally owned facility. But with the development of a new mobile app, the VA wants to reach veterans in their homes to expand access to mental health services and make it easier for those with limited mobility to get necessary medical care.  

This week, behavioral health advocates came out in support of the VETS Act of 2017, which proposes similar regulatory changes. But the VA’s rulemaking process could move faster. The proposed rule will be open for comments for 30 days.