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Veterans Health

Telehealth Capsules - Federal Legislation

Telehealth Capsules - Federal Legislation

Telehealth to Expand in TRICARE; Shown as Viable Treatment Option for PTSD

The recently enacted National Defense Authorization Act for Fiscal Year 2017 will expand the use of telehealth in TRICARE, the federal healthcare program for military personnel and military retirees. Specifically, the law mandates coverage parity for telehealth services with conditions and reimbursement specifications to be defined in upcoming Department of Defense rules. An earlier version of the law contained broad interstate licensure exemptions, which have since been deleted following complaints by the American Academy of Family Physicians, among others.

TRICARE represents an exciting new adopter of telehealth parity, particularly in light of a recent study, to be published in the upcoming February 2017 issue of Behaviour Research and Therapy, showing therapy delivered via telehealth represents a viable treatment option for veterans with post-traumatic stress disorder (PTSD). The study compared the efficacy of home-delivered therapy by videoconference for veterans with PTSD to treatment received at a U.S. Veterans Affairs clinic, finding the home-delivered therapy to be just as effective to treatment at a U.S. VA clinic.  

The study placed veterans with PTSD into two randomly assigned groups. Each group received 10 to 12 therapy sessions to treat the symptoms of PTSD. One group attended therapy sessions at a Veterans Affairs clinic, while the other group consisted of veterans receiving home-delivered therapy via videoconference with a psychiatrist. Researchers found veterans who received home-delivered therapy made similar progress in treating PTSD symptoms as  veterans who received inpatient therapy at a Veterans Affairs clinic.

ECHO Act Signals Continued Commitment to Expansion of Telemedicine

On December 14, President Obama signed the Expanding Capacity for Health Outcomes Act (ECHO Act) into law. The legislation is modeled after University of New Mexico Health Sciences Center’s telehealth initiative “Project ECHO.” Project ECHO uses a “hub-and-spoke” model to connect healthcare specialists with rural healthcare providers and their patient populations using a telehealth platform. Healthcare specialists located at “hub” hospitals conduct virtual clinics and train primary care providers at “spoke” sites, typically located in rural areas. Through the virtual clinics and training, patients can receive care locally at a spoke site, avoiding costly referrals and the need for a patient to travel to the office of a healthcare specialist. 

The ECHO Act requires HHS to study technology-enabled collaborative learning and capacity building models, and the impact of such models on (1) mental and substance use disorders, chronic diseases, prenatal health, pediatric care, pain management, and palliative care; (2) healthcare workforce issues (e.g., shortage of healthcare specialists); (3) public health programs; and (4) delivery of healthcare to rural, medically underserved areas. Donald Berwick, the former administrator of CMS, has stated the model of Project Echo represents a fundamental design shift “from moving the patient to moving the knowledge,” a necessary shift to meet modern healthcare demands. 

The ECHO Act is the latest legislative effort to ensure quality healthcare services to rural communities through the utilization of telehealth. Telehealth will continue to be a point of legislation in upcoming years due to the efficacy and cost-savings associated with the technology.


Disclaimer: The foregoing materials are provided for informational purposes only, and are not to be construed as legal advice. The information relies on limited authority and has not been screened or approved by any governmental agency. Please consult an attorney before applying this guidance to any particular facts or circumstances.