[Congressional Record Volume 163, Number 181 (Tuesday, November 7, 2017)]
[House]
[Pages H8556-H8558]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 1530
VETERANS E-HEALTH AND TELEMEDICINE SUPPORT ACT OF 2017
Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 2123) to amend title 38, United States Code, to improve the
ability of health care professionals to treat veterans through the use
of telemedicine, and for other purposes.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 2123
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Veterans E-Health and
Telemedicine Support Act of 2017'' or the ``VETS Act of
2017''.
SEC. 2. LICENSURE OF HEALTH CARE PROFESSIONALS OF THE
DEPARTMENT OF VETERANS AFFAIRS PROVIDING
TREATMENT VIA TELEMEDICINE.
(a) In General.--Chapter 17 of title 38, United States
Code, is amended by inserting after section 1730A the
following new section:
``Sec. 1730B. Licensure of health care professionals
providing treatment via telemedicine
``(a) In General.--Notwithstanding any provision of law
regarding the licensure of health care professionals, a
covered health care professional may practice the health care
profession of the health care professional at any location in
any State, regardless of where the covered health care
professional or the patient is located, if the covered health
care professional is using telemedicine to provide treatment
to an individual under this chapter.
``(b) Property of Federal Government.--Subsection (a) shall
apply to a covered health care professional providing
treatment to a patient regardless of whether the covered
health care professional or patient is located in a facility
owned by the Federal Government during such treatment.
``(c) Construction.--Nothing in this section may be
construed to remove, limit, or otherwise affect any
obligation of a covered health care professional under the
Controlled Substances Act (21 U.S.C. 801 et seq.).
``(d) Covered Health Care Professional Defined.--In this
section, the term `covered health care professional' means a
health care professional who--
``(1) is an employee of the Department appointed under the
authority under sections 7306, 7401, 7405, 7406, or 7408 of
this title, or title 5;
``(2) is authorized by the Secretary to provide health care
under this chapter;
``(3) is required to adhere to all quality standards
relating to the provision of telemedicine in accordance with
applicable policies of the Department; and
[[Page H8557]]
``(4) has an active, current, full, and unrestricted
license, registration, or certification in a State to
practice the health care profession of the health care
professional.''.
(b) Clerical Amendment.--The table of sections at the
beginning of chapter 17 of such title is amended by inserting
after the item relating to section 1730A the following new
item:
``1730B. Licensure of health care professionals providing treatment via
telemedicine.''.
(c) Report on Telemedicine.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on the effectiveness of the use of
telemedicine by the Department of Veterans Affairs.
(2) Elements.--The report required by paragraph (1) shall
include an assessment of the following:
(A) The satisfaction of veterans with telemedicine
furnished by the Department.
(B) The satisfaction of health care providers in providing
telemedicine furnished by the Department.
(C) The effect of telemedicine furnished by the Department
on the following:
(i) The ability of veterans to access health care, whether
from the Department or from non-Department health care
providers.
(ii) The frequency of use by veterans of telemedicine.
(iii) The productivity of health care providers.
(iv) Wait times for an appointment for the receipt of
health care from the Department.
(v) The reduction, if any, in the use by veterans of in-
person services at Department facilities and non-Department
facilities.
(D) The types of appointments for the receipt of
telemedicine furnished by the Department that were provided
during the one-year period preceding the submittal of the
report.
(E) The number of appointments for the receipt of
telemedicine furnished by the Department that were requested
during such period, disaggregated by Veterans Integrated
Service Network.
(F) Savings by the Department, if any, including travel
costs, of furnishing health care through the use of
telemedicine during such period.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Florida (Mr. Bilirakis) and the gentleman from Minnesota (Mr. Walz)
each will control 20 minutes.
The Chair recognizes the gentleman from Florida.
general leave
Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
include extraneous material on H.R. 2123.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Florida?
There was no objection.
Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of H.R. 2123, the Veterans E-
Health and Telemedicine Support Act of 2017.
I believe that telemedicine represents the future of healthcare
delivery, and I am proud of the fact that the Department of Veterans
Affairs is a longtime leader in telemedicine.
Through VA's many different telehealth modalities, VA doctors and
nurses have been able to better serve veterans in remote, rural, or
medically underserved areas and veterans with limited mobility or other
issues that make it difficult to travel to and from the VA medical
facilities for needed appointments and follow-up care. Importantly,
veterans who have had experience accessing care through telemedicine
have demonstrated improved healthcare outcomes, including decreases in
hospital admissions.
It is my hope that all veterans would have access to VA telemedicine
when and where appropriate. However, the continued expansion of
telemedicine across the VA healthcare system has been constrained by
restrictions on the ability of VA providers to practice telemedicine
across State lines without jeopardizing their State medical license.
H.R. 2123, the Veterans E-Health and Telemedicine Support Act of
2017, would remove those constraints by authorizing the VA providers to
practice telemedicine at a location in any State, regardless of where
the provider or patient is located. This would provide VA clinicians
the statutory protection they need to continue providing high-quality
telehealthcare to veteran patients across the country without fear of
penalties imposed by the State medical licensing boards.
I am grateful to my friend and colleague, Representative Glenn
Thompson from the great State of Pennsylvania, for his leadership on
this issue and for bringing this important bill forward.
I am also grateful to my fellow committee member, Representative
Julia Brownley of California, the ranking member of the Subcommittee on
Health, for her work and advocacy on VA telemedicine.
Mr. Speaker, I urge all my colleagues to join me in supporting H.R.
2123, and I reserve the balance of my time.
Mr. WALZ. Mr. Speaker, I yield myself such time as may consume.
I rise in strong support of H.R. 2123, the VETS Act of 2017.
Since its very inception, the Veterans Health Administration has been
a leader in medical advancements and the delivery of healthcare. This
legislation would ensure it continues this history of leadership by
allowing VA providers to engage in the delivery of telemedicine to
veterans all over the country, regardless of where the provider is
located. These are paper barriers, these are legal barriers, not
barriers of technology, to allow us to deliver care.
Telemedicine and medicine, in general, is changing so rapidly, we
need to make sure that barriers are not put in place, especially for
rural veterans, and many of us have them all over.
Last week, I did a field hearing in International Falls, Minnesota,
which, by the way, will be 1 degree tomorrow for all of you, just so
you know. Those folks are veterans. They have served, but they are
miles from a VA facility. The technology that we have, and we know it
works, allows them to get that.
If we have veterans sitting on State borders, if we have veterans
sitting in remote areas, it sometimes makes it difficult. It will give
VA the tools it needs to remain a leader in the use of telehealth
technology.
I am particularly thankful to Representatives Thompson and Brownley
for their leadership. They identified a problem, worked on it, and came
up with a workable solution that we can put into statute, making sure,
the bottom line, again, that every veteran, regardless of geographic
location, gets the best, most advanced care possible.
Mr. Speaker, I reserve the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I yield 3 minutes to the gentleman from
Pennsylvania (Mr. Thompson), who is the sponsor of the bill.
Mr. THOMPSON of Pennsylvania. Mr. Speaker, I thank the chairman and
ranking member for their support and their kind words.
Mr. Speaker, I do rise today in support of H.R. 2123, the Veterans E-
Health and Telemedicine Support Act, also known as the VETS Act.
Years ago, a constituent approached me to discuss the barriers to
care that his fellow veterans were experiencing through the VA system.
As an Active-Duty soldier, he told me stories of his friends coming
home from deployment and falling through the cracks of the system. Some
were suffering from post-traumatic stress disorder, TBIs, and
depression and required the care of specialists. Others had difficulty
traveling from their rural communities to VA medical centers because of
injuries sustained during combat. Too many of those wound up taking
their own lives.
It broke my heart to hear the stories of this soldier's friends and
comrades not receiving the care that they deserve. What made it more
difficult was the fact that this constituent soldier was my son.
After numerous conversations trying to figure out how we can help our
servicemembers when they return home, we determined that expanding
access to telehealth would be a great start. Many of our veterans live
in rural areas and are unable to travel far distances. Allowing them to
see their healthcare provider in the comfort of their home would
increase their access to care. This is why Representative Julia
Brownley and I introduced the VETS Act.
The VETS Act will allow VA-employed healthcare providers to practice
telehealth across State lines, no matter where the doctor or the
patient is located. It also commissions a report to study the
effectiveness of telemedicine programs utilized by the Department of
Veterans Affairs.
While the VA has made major strides and is a leader in advancing
telehealth access, outdated barriers limit its
[[Page H8558]]
growth. Currently, each State has its own licensing requirements for
healthcare providers to practice medicine within its borders. For
example, if a doctor practices in Pennsylvania and Ohio, they must hold
a license from each State.
VA-provider licensing requirements are different. As long as a doctor
is licensed and in good standing with a single State, they can practice
in-person care within the VA system in any State. This reciprocity,
however, is not afforded to the practice of telehealth. VA providers
seeking to provide telehealthcare to patients must also be licensed in
the State where the patient is located. These outdated regulations are
hurting our Nation's veterans.
The Department of Veterans Affairs has successfully been using
telemedicine for quite some time. Since 2002, more than 2 million
veterans have received telehealthcare through the VA. In 2016 alone,
more than 12 percent of veterans receiving VA care utilized telehealth
in some aspect. Forty-five percent of these veterans live in rural
areas.
Veterans who have accessed telehealth are overwhelmingly pleased with
the quality of care and access they received. Those receiving at-home
care, for example, through telehealth cite an 88 percent satisfaction
rate.
While the VA has done a great job of expanding telehealth access to
veterans across the country, more needs to be done. Our veterans
deserve the best care available to them, and this starts with the
passage of the VETS Act.
I thank Representative Brownley, Committee Chairman Dr. Phil Roe,
Ranking Member Tim Walz, and Chairman Bilirakis for bringing this bill
to the floor today.
I urge my colleagues to vote in favor of the bill to give our
Nation's veterans access to quality, proven healthcare.
Mr. WALZ. Mr. Speaker, I have no further speakers, and I reserve the
balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I yield 1 minute to the gentleman from
Colorado (Mr. Coffman).
Mr. COFFMAN. Mr. Speaker, I rise today in support of H.R. 2123, the
Veterans E-Health and Telemedicine Support Act of 2017.
Under current law, VA healthcare providers must possess a current,
unrestricted license issued by a State to practice medicine at a VA
facility. However, VA providers are restricted from practicing
telemedicine across State lines. This limits the VA's continued
expansion of telemedicine and, as a result, reduces the accessibility
of healthcare for so many veterans.
As technology continues to evolve and Congress considers what the VA
of the 21st century should look like, there is no doubt that methods
like telemedicine, coupled with more regulatory flexibility, are long
overdue.
Geographical location in our country is no longer a challenge thanks
to modern technology. VA healthcare providers should have the
opportunity to practice telemedicine across State lines to provide
medical advice to our veterans that is more timely and responsive to
the patient's needs.
Mr. Speaker, I encourage my colleagues to support the passage of H.R.
2123.
Mr. WALZ. Mr. Speaker, I have no further speakers, and I reserve the
balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I yield 1 minute to the gentleman from
the great State of Michigan (Mr. Bergman).
Mr. BERGMAN. Mr. Speaker, I rise today in support of H.R. 2123, the
Veterans E-Health and Telemedicine Support Act.
For veterans in my district, the challenge of receiving timely,
quality care from the VA is, at times, impossible. In fact, winter has
already arrived in northern and upper Michigan. Travel is complex and
sometimes hazardous.
With some of the most rural geography in the country, veterans in
Michigan's First District are forced to travel long distances, often
hours, into Wisconsin or hundreds of miles down into mid- and southeast
Michigan just to keep simple doctors' appointments.
Innovative healthcare solutions like telemedicine are long overdue.
Veterans in my district will help validate the requirements for and the
quality of such innovations.
H.R. 2123 will allow VA-licensed healthcare providers to practice
telemedicine at any location, in any State, regardless of where the
provider or patient is located. This bill will make it easier for
veterans in my district and all across the country to access healthcare
services in a convenient setting that fits their schedule, ultimately,
putting the veteran first. I have long said that if a program or policy
can work in Michigan's First District, it can work anywhere.
Mr. Speaker, I urge support of H.R. 2123.
Mr. WALZ. Mr. Speaker, again, it makes sense. Removing some of these
paper barriers, as the gentleman from Michigan said, geography,
weather, other things, it makes sense to use the technology to improve
the care.
I urge my colleagues to support H.R. 2123, and I yield back the
balance of my time.
Mr. BILIRAKIS. Mr. Speaker, this puts the veterans first, as the
gentleman said; and, again, the veteran has a choice as to whether to
use telemedicine or go to see the doctor, because it doesn't work for
everyone.
But, in any case, this is a great bill. It puts the veteran first. I
urge my colleagues to pass this particular bill.
Mr. Speaker, I yield back the balance of my time.
Ms. BROWNLEY of California. Mr. Speaker, I rise in support of H.R.
2123, the Veterans E-Health and Telemedicine Support Act, or VETS Act.
As we approach Veterans Day, a time when we honor the service and
sacrifice of those who fought bravely on behalf of our nation, we must
rededicate ourselves to ensuring that the VA has the tools it needs to
be the 21st century, world-class healthcare system that our veterans
deserve. One way the VA can modernize is by embracing telehealth and
using new technologies to provide more timely and convenient care for
our veterans.
The VA has seen tremendous growth and interest in telehealth over the
past few years, and we should continue to find innovative ways to
connect veterans with the providers that they need, no matter their
physical location. This will particularly help rural veterans, and will
help us expand access to specialty care from the medical centers to the
community clinics, and even into veterans' homes. I have seen this
firsthand at the Oxnard community clinic in my district, which is able
to connect veterans to retinal specialists and audiology specialists
using telehealth technology, making it easier for veterans to get
better care closer to home.
The House Veterans' Affairs Committee has also heard from many
veterans who have used telemedicine services. For instance, at a field
hearing in my district, Zachary Walker, a Navy veteran, testified about
the fast and efficient service that telemedicine can deliver to our
veterans, getting him in the door to his local clinic faster than a
traditional appointment.
Our bill is a commonsense solution that will allow us to further
expand on these telehealth services by permitting VA providers to
conduct telehealth treatment across state lines no matter their
location, connecting more health professionals with the veterans who
need their care.
It has been my pleasure to work with Congressman Glenn `GT' Thompson,
and Senators Joni Ernst and Mazie Hirono, to advance this bipartisan,
bicameral bill, which has received widespread support from the Veterans
Service Organizations and the VA. I urge my colleagues to support this
commonsense legislation.
=========================== NOTE ===========================
November 7, 2017, on page H8558, the following passage appeared
in Ionic typeface: Ms. BROWNLEY of California. Mr. . . . my
colleagues to support this commonsense legislation.
The online version has been reset to appear in Helvetica
typeface.
========================= END NOTE =========================
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Florida (Mr. Bilirakis) that the House suspend the rules
and pass the bill, H.R. 2123.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
____________________