View Rule

The Department of Veterans Affairs (VA) proposed to amend its medical regulations by standardizing the delivery of care by VA health care providers through telehealth.  The rule would ensure that VA health care providers provide the same level of care to all beneficiaries, irrespective of the State or location in a State of the health care provider or the beneficiary.  This rule would achieve important Federal interests by ensuring the availability of mental health, specialty, and general clinical care for all beneficiaries.

Statement of Need:

VA proposes to amend its medical regulations by standardizing the delivery of care by VA health care providers through telehealth. This rule would ensure that VA health care providers provide the same level of care to all beneficiaries, irrespective of the State or location in a State of the VA health care provider or the beneficiary. This rule would achieve important Federal interests by increasing the availability of mental health, specialty, and general clinical care for all beneficiaries.

Summary of the Legal Basis:

38 U.S.C. 7301(b) establishes the general functions of VHA within VA, and establishes that its primary function is to "provide a complete medical and hospital service for the medical care and treatment of veterans, as provided in this title and in regulations prescribed by the Secretary [of Veterans Affairs (Secretary)] pursuant to this title." In carrying out this function, VHA must ensure that patient care is appropriate and safe and its health care providers meet or exceed generally accepted professional standards for patient care. In addition, because VA is a national health care provider, VHA must ensure that beneficiaries receive the same high level of care and access to care no matter where, in a State, a beneficiary or health care provider is located at the time the health care is provided.

Alternatives:

VA considered the consequences of taking no regulatory action. Doing so would leave VA telehealth providers vulnerable to adverse action, such as discipline or termination of licenses by their state licensing boards if they provide services to beneficiaries in States in which the providers are not licensed, registered, certified, or located. Under those circumstances, VA has found that some of its medical providers cannot effectively practice telehealth, which limit’s VA’s ability to provide care to Veterans, particularly in remote, rural, or medically underserved areas. VA’s only remedy for that issue is to supersede state law, and the appropriate mechanism to do so is in rulemaking. By superseding state law in this rulemaking, VA will ensure greater access to care for Veterans and beneficiaries.

Anticipated Costs and Benefits:

VA anticipates minimal (transfer) costs to VA as a result of this rulemaking. However, VA’s ability to leverage existing resources to expand telehealth under an expanded authority will result in (transfer) savings to VA. These savings to VA will offset the anticipated minimal costs to VA. This rulemaking contains no provisions constituting a collection of information under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 to 3521). Therefore, we expect no increased and/or decreased PRA costs.

Risks: