AAFP Weighs in on Legislation Adding Telehealth Benefit to TRICARE

The American Academy of Family Practitioners (AAFP), which represents roughly 125,000 family physicians, has expressed concerns about a new telehealth benefit proposed for the TRICARE program.

TRICARE provides health benefits to more than 8 million military personnel, retirees, and their dependents. The Senate version of the National Defense Authorization Act (NDAA) for FY 2017 includes a new telehealth benefit for TRICARE aimed at increasing access to primary care, urgent care, behavioral health care, and specialty care and improving chronic disease management. Congress is currently ironing out differences between the Senate and House versions of the NDAA; a final version of the bill is expected to pass this fall.

In a September 1 letter to Congress, the AAFP praises the addition of the telehealth benefit, but takes issue with language that would effectively “federalize” medical licensure for physicians providing telehealth services. The Senate version of the NDAA defines the location of care in a telehealth visit as the location of the provider, not the patient. This upends longstanding state rules that hold that when the patient and provider are in separate jurisdictions, the law of the patient’s location governs. The AAFP urges Congress to reject this aspect of the proposed legislation.

The AAFP writes, “While this language would indeed ease barriers that hinder the free flow of telehealth services, it also would undermine the existing system of medical licensure, under which each state governs the practice of medicine within its borders. Allowing physicians with a single license to treat TRICARE beneficiaries in any state via telemedicine would create episodes of medical care that the state in which the patient resides cannot readily regulate, if at all. Section 705(d) therefore portends a troubling scenario under which state licensing boards will lack the authority to discipline physicians who are practicing medicine within that state’s borders.”

According to the AAFP, reciprocity compacts for physician licensing like the Interstate Medical Licensure Compact are the better way to go. They ease the burden of becoming licensed in multiple jurisdictions and promote the free flow of telehealth services while safeguarding the state’s role in regulating the practice of medicine. The AAFP contends that this approach better ensures patient safety and physician accountability.

In other news, POLITICO reports that the AAFP’s Congress of Delegates will vote on a telehealth resolution when they meet this week in Orlando. The resolution addresses the lack of guidelines for coordination between direct-to-consumer (DTC) telehealth companies and primary care physicians (PCPs). It calls on companies and payers to take steps to improve coordination.

The resolution states that DTC telehealth companies should require listing of the primary care physician during patient registration and give patients the option to allow the forwarding of telehealth examination findings to the PCP. The resolution also declares that payers should recommend, in some cases, that thorough in-person physical exams are necessary.

Click here to read the AAFP letter to Congress on the TRICARE telehealth benefit legislation.


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