Doc groups lobbied against telemedicine expansion in DoD funding bill


Both the American Medical Association (AMA) and the American Academy of Family Physicians (AAFP) have put a lot of effort into urging the Defense Department to kill a section of language in its funding bill expanding telehealth.

The 2017 Defense authorization bill (S. 2943) mandates the availability of real-time virtual visits in its TRICARE healthcare program. However, the medical groups oppose language in Section 705(d) that bases reimbursement, licensure and liability on the location of the doctor, rather than the patient, Politico Morning eHealth reports.

“Allowing physicians with a single license to treat TRICARE beneficiaries in any state via telemedicine would create episodes of medical care that the state in which the patient resides cannot readily regulate, if at all,” AAFP wrote in a letter last month to leaders of the House and Senate Armed Services committees.

State licensing boards where the patient is located would have no authority over out-of-state practitioners, and state boards where the practitioner is licensed would lack authority to conduct investigations into care in the state where the patient is located, according to an AMA letter to the committee also sent last month and signed by most state medical boards.

Both point to the Federation of State Medical Boards’ Interstate Medical Licensure Compact as the best workable solution to cross-state licensure. They also mentioned efforts to eliminate “location of care” language in Section 705(d) in their third-quarter lobbying reports filed last week, according to Politico.

The AMA has been warming up to telemedicine, enacting policy in 2014 that emphasizes in-state licensure and establishing a doctor-patient relationship through in-person visits.

At its annual meeting last summer, it called for telemedicine training to be made a core part of medical education, and approved guidance for physicians on their responsibilities with telemedicine and how those visits might differ from in-person care.