[House Report 119-221]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 119-221
======================================================================
PROTECTING VETERAN ACCESS TO TELEMEDICINE SERVICES ACT OF 2025
_______
July 29, 2025.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Bost, from the Committee on Veterans' Affairs, submitted the
following
R E P O R T
[To accompany H.R. 1107]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 1107) to amend title 38, United States Code, to
authorize certain heath care professionals employed by the
Department of Veterans Affairs to deliver, distribute, or
dispense to veterans certain controlled medications via
telemedicine under certain conditions, and for other purposes,
having considered the same, reports favorably thereon without
amendment and recommends that the bill do pass.
CONTENTS
Page
Amendment........................................................
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 3
Subcommittee Consideration....................................... 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 5
Committee Oversight Findings..................................... 19
Statement of General Performance Goals and Objectives............ 19
Earmarks and Tax and Tariff Benefits............................. 19
Committee Cost Estimate.......................................... 19
Budget Authority and Congressional Budget Office Estimate........ 19
Federal Mandates Statement....................................... 20
Advisory Committee Statement..................................... 20
Applicability to Legislative Branch.............................. 20
Statement on Duplication of Federal Programs..................... 20
Section-by-Section Analysis of the Legislation................... 20
Changes in Existing Law Made by the Bill, as Reported............ 21
Purpose and Summary
H.R. 1107, the ``Protecting Veteran Access to Telemedicine
Services Act of 2025,'' was introduced by Representative Steve
Womack of Arkansas on February 6, 2025. This bill would
authorize qualified Department of Veterans Affairs (VA) health
care professionals to prescribe, deliver, distribute, or
dispense controlled substances via telemedicine, even if an in-
person medical examination has not occurred. The bill aims to
preserve access to essential medications for veterans,
particularly those in rural or underserved areas, by making
flexibilities permanent for patients, which were granted during
the COVID pandemic, while also ensuring compliance with the
Controlled Substances Act and expanding modern, equitable
access to VA telehealth services for veterans nationwide.
Background and Need for Legislation
Section 1: Short Title
This Act may be cited as the ``Protecting Veteran Access to
Telemedicine Services Act of 2025.''
Section 2: Delivery, distribution, and dispensation of controlled
medications by covered Department of Veterans Affairs health
care professionals via telemedicine
The Ryan Haight Online Pharmacy Consumer Protection Act of
2008 [P.L. 110-425] was enacted to curb the rise of internet
pharmacies by requiring practitioners to conduct at least one
in-person medical evaluation before prescribing controlled
substances. Controlled substances are defined according to
section 102 of the Controlled Substances Act [P.L. 91-513].\1\
Drugs or substances such as opioids are designated under
``schedules'' subject to varying levels of regulation by the
Drug Enforcement Administration (DEA). The law imposes the
strictest regulations on drugs or substances classified as
Schedule I, with less stringent controls on those in Schedules
II through V. The in-person requirement has proven increasingly
burdensome for many veterans, particularly those residing in
rural and remote parts of the United States and its
territories.
---------------------------------------------------------------------------
\1\See Section 102(6) of the Controlled Substances Act (P.L. 91-
513) (defining ``controlled substance'' as ``a drug or other substance,
or immediate precursor, to a schedule under Part B of this title,
whether by transfer from another schedule or otherwise.'').
---------------------------------------------------------------------------
During the COVID pandemic, the in-person appointment
requirement was temporarily waived, allowing providers to
prescribe controlled substances via telemedicine. These
flexibilities significantly expanded access to needed
medications, especially for veterans in remote areas. On
October 6, 2023, the DEA and the Department of Health and Human
Services (HHS) extended these telemedicine waivers through
December 31, 2025. However, the long-term regulatory
authorization for these flexibilities is uncertain.
According to VA's Office of Rural Health, over 2.7 million
veterans living in rural communities rely on VA's health care
system. These veterans often face long travel times, provider
shortages, and other barriers that make in-person appointments
difficult or impossible. The Committee believes that without a
permanent solution, the expiration of the current waiver would
severely limit access to controlled substance prescriptions for
these veterans, many of whom require medication for pain
management, treatment for mental health disorders, or substance
use disorder treatment.
The Committee recognizes that the in-person prescribing
requirement under current law creates a barrier to treatment
and care for rural veterans. As such, this section, the
Protecting Veteran Access to Telemedicine Services Act of 2025,
would amend chapter 17 of title 38 to permanently authorize VA
health care professionals to prescribe controlled substances to
veterans via telemedicine. The Committee believes this reform
is necessary to ensure continuity of care for veterans, reduce
disparities between rural and urban veteran populations and
modernize VA's delivery of services.
By updating the law to reflect current medical and
technological capabilities, the Committee believes that this
section would safeguard access to critical medications for
veterans in rural areas--protecting health outcomes while
maintaining appropriate safeguards for prescribing controlled
substances to veteran patients.
Hearings
On March 11, 2025, the Subcommittee on Health held a
legislative hearing on H.R. 1107 and other bills pending before
the subcommittee.
The following witnesses testified:
The Honorable Jack Bergman, U.S. House of
Representatives, 1st Congressional District, Michigan;
The Honorable Greg Murphy, U.S. House of
Representatives, 3rd Congressional District, North
Carolina; The Honorable Steve Womack, U.S. House of
Representatives, 3rd Congressional District, Arkansas;
The Honorable Don Bacon, U.S. House of Representatives,
1st Congressional District, Nebraska; The Honorable
Sylvia Garcia, U.S. House of Representatives, 29th
Congressional District, Texas; The Honorable Lauren
Underwood, U.S. House of Representatives, 14th
Congressional District, Illinois; The Honorable Chris
Deluzio, U.S. House of Representatives, 17th
Congressional District, Pennsylvania; Dr. Thomas
O'Toole, Deputy Assistant Under Secretary for Health
for Clinical Services, Quality and Field Operations,
Veterans Health Administration, U.S. Department of
Veterans Affairs; Dr. Antoinette Shappell, Deputy
Assistant Under Secretary for Health for Patient
Services, Veterans Health Administration, U.S.
Department of Veterans Affairs; Dr. Thomas Emmendorfer,
Executive Director, Pharmacy Benefits Management,
Veterans Health Administration, U.S. Department of
Veterans Affairs; Dr. Jeffrey Gold, President,
University of Nebraska System; Ms. Sue Morris,
President, Veterans Trust; Mr. Brian Dempsey, Director
of Government Affairs, Wounded Warrior Project; Mr. Ed
Harries, President, National Association of State
Veterans Homes; Mr. Jon Retzer, Deputy National
Legislative Director, Disabled American Veterans;
The following individuals and organizations submitted
statements for the record:
Veterans Healthcare Policy Institute; Paralyzed
Veterans of America; American Federation of Government
Employees; Representative Murphy; Trajector Medical;
American Association for Marriage and Family Therapy.
Subcommittee Consideration
On March 25, 2025, the Subcommittee on Health met in an
open markup session to consider H.R. 1107. A motion by Ranking
Member Brownley of California to favorably forward H.R. 1107 to
the full Committee on Veterans' Affairs was adopted by voice
vote.
Committee Consideration
On May 6, 2025, the full Committee met in an open markup
session to consider H.R. 1107. During consideration of the
bill, the following amendments were considered:
An amendment to H.R. 1107 was offered by Ranking
Member Takano of California. This amendment would
reinstate all telework agreements for certain
appointees of the Veterans Health Administration (VHA)
who were terminated after January 20, 2025. This
amendment failed by a recorded vote of 11 ayes, 13
noes.
An amendment to H.R. 1107 was offered by
Representative Herb Conaway of New Jersey. This
amendment would reinstate all telework agreements made
between psychiatrists, psychologists, and social
workers at the VHA who were terminated after January
20, 2025. This amendment failed by a recorded vote of
11 ayes, 13 noes.
An amendment to H.R. 1107 was offered by
Representative Delia Ramirez of Illinois. This
amendment would reinstate all telework agreements for
all clinical resource hub employees in a Veterans
Integrated Service Network (VISN) who were terminated
after January 20, 2025. This amendment failed by a
recorded vote of 11 ayes, 13 noes.
An amendment to H.R. 1107 was offered by
Representative Ramirez. This amendment would reinstate
all telework agreements for all clinical contact center
employees in a VISN who were terminated after January
20, 2025. This amendment failed by a recorded vote of
11 ayes, 13 noes.
An amendment to H.R. 1107 was offered by
Representative Kelly Morrison of Minnesota. This
amendment would reinstate all telework agreements for
all employees of the Office of Member Services at the
VHA who were terminated after January 20, 2025. This
amendment failed by a recorded vote of 11 ayes, 13
noes.
An amendment to H.R. 1107 was offered by
Representative Morrison. This amendment would reinstate
all telework agreements for all VHA employees
responsible for the coordination of health care for
veterans under the Veterans Community Care Program who
were terminated after January 20, 2025. This amendment
failed by a recorded vote of 11 ayes, 13 noes.
An amendment to H.R. 1107 was offered by
Representative Morrison. This amendment would require
the VA Secretary to report to Congress about the
terminated telework agreements. This amendment failed
by a recorded vote of 11 ayes, 13 noes.
A motion by Representative Jack Bergman of Michigan to
report H.R. 1107 favorably to the House of Representatives was
agreed to by voice vote.
Committee Votes
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, seven recorded votes were taken
on amendments or in connection with ordering H.R. 1107 reported
to the House.
An amendment to H.R. 1107 was offered by Ranking Member
Takano of California. This amendment would reinstate all
telework agreements for certain appointees of the Veterans
Health Administration (VHA) who were terminated after January
20, 2025. This amendment failed by a recorded vote of 11 ayes,
13 noes.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
An amendment to H.R. 1107 was offered by Representative
Herb Conaway of New Jersey. This amendment would reinstate all
telework agreements made between psychiatrists, psychologists,
and social workers at the VHA who were terminated after January
20, 2025. This amendment failed by a recorded vote of 11 ayes,
13 noes.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
An amendment to H.R. 1107 was offered by Representative
Delia Ramirez of Illinois. This amendment would reinstate all
telework agreements for all clinical resource hub employees in
a Veterans Integrated Service Network (VISN) who were
terminated after January 20, 2025. This amendment failed by a
recorded vote of 11 ayes, 13 noes
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
An amendment to H.R. 1107 was offered by Representative
Ramirez. This amendment would reinstate all telework agreements
for all clinical contact center employees in a VISN who were
terminated after January 20, 2025. This amendment failed by a
recorded vote of 11 ayes, 13 noes.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
An amendment to H.R. 1107 was offered by Representative
Kelly Morrison of Minnesota. This amendment would reinstate all
telework agreements for all employees of the Office of Member
Services at the VHA who were terminated after January 20, 2025.
This amendment failed by a recorded vote of 11 ayes, 13 noes.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
An amendment to H.R. 1107 was offered by Representative
Morrison. This amendment would reinstate all telework
agreements for all VHA employees responsible for the
coordination of health care for veterans under the Veterans
Community Care Program who were terminated after January 20,
2025. This amendment failed by a recorded vote of 11 ayes, 13
noes
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
An amendment to H.R. 1107 was offered by Representative
Morrison. This amendment would require the VA Secretary to
report to Congress about the terminated telework agreements.
This amendment failed by a recorded vote of 11 ayes, 13 noes.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Committee Oversight Findings
In compliance with clause 3(c)(1) of rule XIII and clause
(2)(b)(1) of rule X of the Rules of the House of
Representatives, the Committee's oversight findings and
recommendations are reflected in the descriptive portions of
this report.
Statement of General Performance Goals and Objectives
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the Committee's performance
goals and objectives of H.R. 1107 are to preserve access to
essential medications for veterans, particularly those in rural
or underserved areas.
Earmarks and Tax and Tariff Benefits
H.R. 1107 does not contain any Congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of rule XXI of the Rules of the House of
Representatives.
Committee Cost Estimate
The Committee adopts as its own the cost estimate on H.R.
1107 prepared by the Director of the Congressional Budget.
Budget Authority and Congressional Budget Office
Cost Estimate
Pursuant to clause (3)(c)(3) of rule XIII of the Rules of
the House of Representatives, the following is the cost
estimate for H.R. 1107 provided by the Congressional Budget
Office pursuant to section 402 of the Congressional Budget Act
of 1974:
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
H.R. 1107 would permanently authorize certain health care
professionals employed by the Department of Veterans Affairs
(VA) to prescribe, deliver, and dispense controlled substances
to eligible VA patients via telemedicine, regardless of whether
they have conducted an in-person medical examination. VA has
had temporary authority to do so since the start of the COVID-
19 public health emergency. CBO anticipates that implementing
the bill would change how prescriptions for certain controlled
substances are fulfilled but would not significantly change the
number of medications prescribed or dispensed.
Based on the cost of similar regulatory efforts, CBO
estimates that updating VA policies and guidance documents to
reflect the permanent authority in the bill would cost less
than $500,000 over the 2025-2030 period; any related spending
would be subject to the availability of appropriated funds.
The CBO staff contact for this estimate is Noah Callahan.
The estimate was reviewed by Christina Hawley Anthony, Deputy
Director of Budget Analysis.
Phillip L. Swagel,
Director, Congressional Budget Office.
Federal Mandates Statement
Section 423 of the Congressional Budget and Impoundment
Control Act (as amended by Section 101(a)(2) of the Unfunded
Mandate Reform Act, P.L. 104-4), is inapplicable to H.R. 1107.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
1107.
Applicability to Legislative Branch
The Committee finds that H.R. 1107 does not relate to the
terms and conditions of employment or access to public services
or accommodations within the meaning of section 102(b)(3) of
the Congressional Accountability Act.
Statement on Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, the Committee finds that no provision
of H.R. 1107 establishes or reauthorizes a program of the
Federal Government known to be duplicative of another Federal
program, a program that was included in any report from the
Government Accountability Office to Congress pursuant to
section 21 of Public Law 111-139, or a program related to a
program identified in the most recent Catalog of Federal
Domestic Assistance.
Section-by-Section Analysis of the Legislation
Section 1: Short title
Section 1 would establish the short title as the
``Protecting Veteran Access to Telemedicine Services Act of
2025.''
Section 2: Delivery, distribution, and dispensation of controlled
medications by covered Department of Veterans Affairs health
care professionals via telemedicine
Section 2(a) would authorize VA-employed health care
professionals to use telemedicine to deliver, distribute, or
dispense controlled substances to veterans, even if the
provider has not conducted a prior in-person examination. This
authority is subject to existing requirements under section
1730C of title 38 and the Controlled Substances Act [P.L. 91-
513]. To qualify, the prescribing professional must:
1. Be fully licensed, registered, or certified and
authorized to prescribe the controlled substance under
state law;
2. Be acting in the usual course of professional
practice; and
3. Deliver, distribute, or dispense the substance for
a legitimate medical purpose.
Section 2(b) would require the Secretary of Veterans
Affairs to promulgate guidelines and develop a process
governing the telemedicine-based delivery, distribution, and
dispensation of controlled substances under this section.
Section 2(c) would clarify that nothing in the legislation
changes or limits the obligations of VA providers under the
Controlled Substances Act. It preserves the existing legal
framework governing the prescribing of controlled substances.
Section 2(d) would define terms used in the section:
(1) ``Controlled substance,'' ``deliver,''
``dispense,'' and ``distribute'' have the meanings
assigned under section 102 of the Controlled Substances
Act.
(2) ``Covered health care professional'' includes:
VA employees who are authorized to
provide care, not including contractors, who
are fully licensed, registered, or certified
and meet applicable VA standards; and
Health professions trainees
appointed under section 7405 of title 38, when
under the clinical supervision of a qualifying
VA provider.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, existing law in which no change
is proposed is shown in roman):
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italics and existing law in which no change is
proposed is shown in roman):
TITLE 38, UNITED STATES CODE
* * * * * * *
PART II--GENERAL BENEFITS
* * * * * * *
CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE
SUBCHAPTER I--GENERAL
Sec.
1701. Definitions.
* * * * * * *
SUBCHAPTER III--MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND
NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS
* * * * * * *
1730D. Delivery, distribution, and dispensation of controlled
medications via telemedicine.
* * * * * * *
Sec. 1730D. Delivery, distribution, and dispensation of controlled
medications via telemedicine
(a) In General.--Pursuant to section 1730C of this title and
subject to the requirements of title III of the Controlled
Substances Act (21 U.S.C. 801 et seq.), a covered health care
professional may use telemedicine to deliver, distribute, or
dispense to a patient eligible to receive medical treatment
under this chapter a controlled substance that is a
prescription drug as determined under the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 301 et seq.) regardless of whether
such covered health care professional has conducted an in-
person medical examination of such patient if--
(1) such covered health care professional is--
(A) authorized to prescribe the basic class
of such controlled substance under an active,
current, full, and unrestricted State license,
registration, or certification; and
(B) acting in the usual course of
professional practice; and
(2) such substance is delivered, distributed, or
dispensed for a legitimate medical purpose.
(b) Regulations.--The Secretary shall establish in
regulations guidelines and a process for the delivery,
distribution, and dispensation of a controlled substance
pursuant to subsection (a).
(c) Rule of 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.
(d) Definitions.--In this section:
(1) The terms ``controlled substance'', ``deliver'',
``dispense'', and ``distribute'' have the meanings
given such terms in section 102 of the Controlled
Substances Act, respectively.
(2) The term ``covered health care professional''
means--
(A) a health care professional who--
(i) is an employee of the Department
appointed under section 7306, 7401,
7405, 7406, or 7408 of this title or
under title 5;
(ii) is not a contractor of the
Department;
(iii) is authorized by the Secretary
to provide health care under this
chapter;
(iv) is required to adhere to all
standards for quality relating to the
provision of health care in accordance
with applicable policies of the
Department;
(v) has an active, current, full, and
unrestricted license, registration, or
certification or meet qualification
standards set forth by the Secretary
within a specified time frame; and
(vi) with respect to a health care
profession listed under section 7402(b)
of this title, has the qualifications
for such profession as set forth by the
Secretary; and
(B) a health professions trainee who--
(i) is appointed under section 7405
of this title; and
(ii) is under the clinical
supervision of a health care
professional described in subparagraph
(A).
* * * * * * *
[all]