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CMA fights federal bill that would allow VA to preempt state telemedicine laws



September 16, 2016
Area(s) of Interest: Advocacy Health Information Technology 

The California Medical Association (CMA) and the American Medical Association (AMA) are fighting a provision in the National Defense Authorization Act (NDAA) for fiscal year 2017 that would preempt state telemedicine laws and dismantle accountability mechanisms needed to ensure patient protection.


The NDAA is an annual piece of legislation that primarily authorizes the federal government to spend money for war operations and military base operations. The two houses of Congress passed their own versions of this annual legislation over the summer. The version passed by the U.S. Senate includes language that CMA believes would allow the Veteran's Administration (VA) to preempt state laws governing medical licensure, medical practice, professional liability and reimbursement by altering the applicable state law from where the patient receives the medical services to the location of the physician providing the services.


Because of a multitude of differences between the two bills, a formal conference committee will be convened in September to reconcile the differences. CMA and AMA are working to get this language removed from the final bill.


“Changing the applicable state laws from the location where the patient is located to the state where the health care provider is located for purposes of state licensure, medical liability and reimbursement does not achieve the intended outcome,” CMA and AMA wrote in the letter. “Namely, it would create confusion by altering well-established legal principles and open new conflicts of law questions, degrade important patient protections, and create confusion with regard to payment and coverage. If enacted, section 705(d) would dismantle accountability mechanisms needed to ensure patient protection because (1) state licensing boards where the patient is located would lack authority over practitioners licensed in another state and (2) state boards where the practitioner is licensed would have no authority to conduct investigations in a different state where the patient is located.“


Currently, patients and others may file complaints with the state medical board where medical care is rendered. Altering the applicable law to the state where the provider is located would place the burden solely on the patient to navigate through the complaint filing and investigatory process (once they have identified the state of licensure of the physician and applicable state medical practice laws) across one or more state lines. 


CMA and AMA strongly believe that enhancing access to care through telemedicine must be done so in a manner that ensures patient safety and accountability. New innovations to expand access must be designed to ensure the delivery of safe, quality care where clear lines of accountability are maintained.


To read the letter, click here.

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