Bill to Expand Telehealth in TRICARE Preserves State Licensure

December 14, 2016 11:15 am News Staff

A bill passed by the House and Senate to expand telehealth services for active duty and retired military personnel and their families will maintain safeguards on state medical licensure, as the AAFP and other health organizations had called for.

Because increasing access to care for veterans and their families is a priority for legislators, they added new telehealth benefits to the TRICARE program in the National Defense Authorization Act,( the annual spending authorization bill for the Defense Department.

The final bill calls for telehealth services to be treated as if they were provided in a face-to-face office visit and without cost-sharing in the form of deductibles or copayments. Medical professionals can seek reimbursement for telehealth services for health evaluations, diagnosis, treatment supervision and monitoring of outcomes.

The AAFP lent its support to the measure as long as it preserved state medical licensing laws.

In the initial Senate version of the bill, telehealth services were considered to be only those furnished at the physician's location -- not the patient's -- for purposes such as licensure, payment and liability. Legislators agreed to remove that language from the final version at the urging of the AAFP and others.

"If enacted, this language will supplant longstanding state rules providing that when provider and patient are in different jurisdictions, the law of the place of the patient governs," (then) AAFP Board Chair Robert Wergin, M.D., of Milford, Neb., wrote on Sept. 1(2 page PDF) to the chairs and ranking members of the Senate and House Armed Services committees.

To maintain the integrity of state medical licensure, the AAFP and others sought to preserve existing state laws that use the patient's location to determine where care is provided. The AAFP warned legislators of the consequences of changing this longstanding rule for the 8 million TRICARE beneficiaries.

"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," the letter stated.

Under the bill that is awaiting President Obama's signature, physicians who provide telehealth services to patients in other jurisdictions will continue to be subject to licensing regulations in the patient's state of residence.

The AAFP noted that the Interstate Medical Licensure Compact, an agreement adopted by 17 states, is a more appropriate pathway to facilitate telehealth services across state lines.

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