[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.

                          ____________________