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Bipartisan Senate bill aims to waive telemedicine restrictions for VA docs

By: | Tags: | Comments: 0 | November 24th, 2015

A Senate committee heard testimony Wednesday on a bipartisan bill meant to ease telemedicine licensing requirements and facilitate mental health e-visits for Veterans Affairs healthcare professionals.

Current rules call for physicians using telemedicine to be licensed in the state where the patient resides.

According to bill sponsor Sen. Joni Ernst (R-Iowa), state licensure requirements are waived for the VA if both patient and doctor are in a federal facility during the e-visit. Home e-visits are allowed only if the two parties are in the same state. Ernsts Veterans E-Health and Telemedicine Support Act of 2015 would allow home e-visits regardless of where the VA clinician is located or licensed. This would apply to both VA-employed physicians and those under contract to deliver care outside of VA facilities.

Thats a very important issue, said Dr. Maureen McCarthy, acting VA assistant deputy under secretary for health for patient care services. She added that, under current practice, providers under a national service contract could find it necessary to get licensed in all 50 states.

Some 677,000 veterans received telemedicine services last year including 122,000 who received mental health e-visits in their homes, McCarthy said. She added that this has led to decreased hospital admissions, lower travel costs and fewer missed appointments.

Telehealth care is an innovative and important means to meet the wide-ranging needs of veterans in Iowa and nationwide, including the invisible struggles of mental healthcare,Ernst said in a news release.

The bill is sponsored by lawmakers from mostly rural states. Its main co-sponsor is Sen. Mazie Hirono (D-Hawaii), who says the issue of access is of particular concern to residents of her state.

Hawaii residents often are forced to drive for hours to see their physician or spend thousands of dollars to fly to Oahu and the mainland to seek care from a specialist,Hirono said in a news release. The TELE-MED Act will help to eliminate the financial and physical stress of seeking quality medical care by allowing seniors access to Medicare-participating physicians from the convenience of their home or local doctors office.

The bill had 11 other co-sponsors before the hearing. This was increased during the hearing when the panels ranking Democrat, Sen. Richard Blumenthal of Connecticut, added his name to the roster.

Committee Chairman Johnny Isakson (R-Ga.) praised the bill.

Legislation like this is a godsend, I suspect, and helps us solve a significant problem, Isakson said.

Along with easing licensing restrictions, the bill calls for assessing patient satisfaction with the service, provider satisfaction, frequency of use, wait times and the effect on access to care.

Though McCarthy said the VA is thrilled with the bill, it had some concerns about creating additional reporting requirements – such as provider satisfaction. She added, however, that for the most part, the concerns were over minor details that could be resolved.

The bill has been endorsed by the Veterans of Foreign Wars, Paralyzed Veterans of America, the American Legion, Concerned Veterans for America and the American Telemedicine Association.

The Federation of State Medical Boards adheres to the principle that the practice of medicine occurs in the state where the patient is located, which it says ensures oversight and accountability if a patient is harmed.

In its current form, the proposed VA legislation falls short of ensuring these protections, and it should be amended to strengthen them, said FSMB Chief Advocacy Officer Lisa Robin.

To facilitate telemedicine access to patients in rural or remote areas, the FSMB advocates states join theInterstate Medical Licensure Compactthat was created to streamline the licensing process for doctors practicing in multiple states. So far, 11 states are participating in the compact and legislation to do so has been introduced in nine more, Robin said.

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Nattasha Acevedo, MD

Dr. Acevedo received her medical degree from the Ponce School of Medicine in Puerto Rico and did her neurology residency at Montefiore Medical Center in New York. She went on to do a clinical neurophysiology fellowship at Emory School of Medicine in Atla nta, Georgia and then joined private practice in Fort Myers, Florida. She currently resides in San Juan, Puerto Rico. She likes running, paddle boarding and spending time with family.
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Bernadette Borte, MD

Dr. Borte received her medical degree from St. Matthew’s University School of Medicine in Grand Cayman. She completed her neurology residency at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Her areas of interest include inpatient neurology and acute stroke. When not working, she enjoys spending time outdoors with her family. Dr. Borte joined the TeleSpecialist family in March of 2019.
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Mazen Almidani, MD

Dr. Almidani is board certified in pediatrics by the American Board of Pediatrics and board certified in epilepsy, as well as neurology with special  qualification in child neurology by the American Board of Psychiatry and Neurology.  Dr. Almidani is happily married with 4 children. His oldest son has autism and his daughter has complicated seizures; both were a drive for him to become a neurologist. Dr. Almidani enjoys soccer, running and spending time with his family. He is very involved with his sons’ therapy and helping with daily challenges. He is double board certified in Pediatric and Adult Neurology and Epilepsy. He sees children and adults. He also participates in charities for children in Syria who may be underprivileged and/or affected by the war. Dr. Almidani joined TeleSpecialists in August 2020.
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Amanda Cheshire, MD

Dr. Cheshire received her medical degree from the University of Louisville School of Medicine in Louisville, Kentucky. She completed her neurology residency at the University of Cincinnati Medical Center in Cincinnati, Ohio. She did a fellowship in neurophysiology at the University of Michigan Medical School in Ann Arbor, Michigan. Dr. Cheshire is double board certified in neurology and clinical neurophysiology. She enjoys traveling, reading and music. She currently resides in Viera, Florida.  Dr. Cheshire joined TeleSpecialists in June 2019.
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Jessica Floyd, MD

Dr. Floyd completed her neurology residency at Mayo Clinic in Jacksonville, Florida followed by fellowship training in clinical neurophysiology with focus in EEG and epilepsy at the Medical University of South Carolina in Charleston, South Carolina. She has particular interest in hospital neurology and patient education as well as the blossoming specialty of lifestyle medicine. She strives to take advantage of every encounter with patients and medical staff to empower them to do their own research into how daily thoughts, choices, and habits can add up to create greater and longer-lasting brain and neurologic health for ourselves and our loved ones. She lives in Florence, South Carolina with her awesome husband of 13 plus years and three beautiful children. She is an avid yogi, astrologer, and lover of food and all things neurology! Dr. Floyd joined the TeleSpecialist family in July 2017.
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Nancy Futrell, MD

Dr. Futrell received her medical degree from the University of Utah in Salt Lake City, Utah. She also did her neurology residency at the University of Utah as well as a research fellowship in cerebral vascular disease at Jackson Memorial Hospital in Miami, Florida. She currently resides in Salt Lake City, Utah. She has authored 2 books and 50 peer reviewed papers. 
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Rebecca Jimenez-Sanders, MD

Dr. Jimenez Sanders received her undergraduate degree from Emory University, and her medical degree from the San Juan Bautista School of Medicine in Puerto Rico. She completed her neurology residency at the University of South Florida in Tampa, Florida, where she also did a specialized headache medicine and facial pain fellowship. She currently resides in Tampa, Florida with her husband and her two daughters. She is also fluent in Spanish and Italian languages, and enjoys photography, baking, boating, and biking.
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Cory Lamar, MD

Dr. Lamar received his medical degree from Meharry Medical College in Nashville, Tennessee. He completed his internship and residency at Wake Forest Baptist Health in Winston Salem, North Carolina. Following residency, he completed a clinical fellowship in neurophysiology, with a concentration in epilepsy. He currently resides in Florida and enjoys outdoor activities.
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Clifford Meyers, MD

Dr. Meyers received his medical degree from Brown University in Providence, Rhode Island and his MBA from the Simon School of Business at the University of Rochester in Rochester, New York. He completed his neurology residency at the University of Rochester, where he also did a neurophysiology fellowship. Dr. Meyers resides in Webster, New York with his wife and daughter. When not doing teleneurology, he enjoys playing sports with his wife and daughter.
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Tao Tong, MD

Dr. Tong received her medical degree from the University of Miami School of Medicine in Miami, Florida. She completed her neurology residency at Jackson Memorial Hospital in Miami, Florida, where she also did a neuromuscular/EMG fellowship.  She currently resides in College Station, Texas. Dr. Tong is married with two boys. She enjoys spending time with her family, traveling and reading.
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Shubhangi Chumble, MD

Dr. Chumble attended BJ Medical School. She is a board certified neurologist with a subspeciality interest in sleep medicine. Dr. Chumble did her residency at Howard University in Washington DC and has practiced neurology since 2001 in private and corporate settings. She lives in Melbourne, Florida and loves the sunshine state. Her hobbies include yoga, meditation, cooking , traveling and meeting new people. She also loves to do stained glass, pottery and painting. She joined TeleSpecialists in June 2019.
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