Telehealth and Trainees – an UPDATE

Nov 27, 2018 | Optometry HQ Announcements

This is updated guidance from OGC regarding Telehealth and trainees from the Office of Academic Affairs.

Many of you are concerned about the continuing controversy about whether trainees are covered (in a legal sense) for the provision of telehealth services to Veterans, including telephone care, video telehealth and even home monitoring and management.  I think the controversy has stemmed directly from the Telehealth regulation published in June (see attached) that did NOT include trainee appointment authorities in “covered occupations”, and also required a full and unrestricted license to be covered for federal supremacy in the regulation.  This was a great worry to us and left open the question whether any trainees, whether unlicensed or with training licenses, could or would be sued for the provision of telehealth services across state lines

An update from the Personnel Law Group (Christina Knott) and the Torts Law Group (Doug Bradshaw):

Here are their thoughts.  This may or not be reassuring to you all but it is pretty positive:

1 – Nothing in the telemedicine regulation or MISSION ACT telemedicine section was meant to restrict current practice or limit Veteran care

2 – Adding trainees specifically will be a technical amendment to the regulation and MISSION ACT law that will be finalized in the next year and there is every intention to do so (work is ongoing)

3-  Trainees, supervised by VA practitioners, acting in the scope of their employment as VA employees, would likely be represented by DOJ in an action by a State Licensing Board (SLB) based on provision of telehealth authorized by VA, even though we inadvertently omitted them from the regulation and there is an ambiguity in the statute.  DOJ treats each situation as unique and must find it to be in the interest of the United States to provide representation.

Please send this around to interested colleagues.  Trainees would “likely” be represented by DOJ in an action by a State Licensing Board based on provision of telehealth services authorized by VA.