I 

112TH CONGRESS 

2D SESSION H. R. 4023 

To amend title 38, United States Code, to improve the use of teleconsultation, 

teleretinal imaging, telemedicine, and telehealth coordination services for 

the provision of health care to veterans, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 14, 2012 

Ms. HOCHUL (for herself and Mr. ROE of Tennessee) introduced the following 

bill; which was referred to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to improve the 

use of teleconsultation, teleretinal imaging, telemedicine, 

and telehealth coordination services for the provision of 

health care to veterans, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Veterans’ Telehealth 

5 and Telemedicine Improvement Act’’. 

6 SEC. 2. TELECONSULTATION AND TELEMEDICINE. 

7 (a) TELECONSULTATION AND TELERETINAL IMAG8 ING.— 


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1 (1) IN GENERAL.—Subchapter I of chapter 17 

2 of title 38, United States Code, is amended by add3 ing at the end the following new section: 

4 ‘‘§ 1709. Teleconsultation and teleretinal imaging 

5 ‘‘(a) TELECONSULTATION.—(1) The Secretary shall 

6 carry out a program to increase the use of teleconsulta7 tion, telemedicine, telehealth, and home telehealth by the 

8 Department. 

9 ‘‘(2) The Secretary shall, in consultation with appro10 priate professional societies, promulgate technical and 

11 clinical care standards for the use of teleconsultation serv12 ices within facilities of the Department. 

13 ‘‘(b) TELERETINAL IMAGING.—(1) The Secretary 

14 shall carry out a program to increase the use of teleretinal 

15 imaging by the Department in each Veterans Integrated 

16 Services Network. 

17 ‘‘(2) In each fiscal year beginning with fiscal year 

18 2013 and ending with fiscal year 2018, the Secretary shall 

19 increase the number of patients enrolled in each teleretinal 

20 imaging program under paragraph (1) by not less than 

21 five percent from the number of patients enrolled in each 

22 respective program in the previous fiscal year. 

23 ‘‘(c) ANNUAL REPORTS.—Not later than March 1 of 

24 each year, the Secretary shall submit to the Committees 

25 on Veterans’ Affairs of the Senate and House of RepVerDate Mar 15 2010 04:22 Feb 15, 2012 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4023.IH H4023

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1 resentatives a report on the Department’s implementation 

2 of telehealth and telemedicine programs, including the 

3 program of teleconsultation, telemedicine, telehealth, and 

4 home telehealth under subsection (a) and the program of 

5 teleretinal imaging under subsection (b). 

6 ‘‘(d) DEFINITIONS.—In this section: 

7 ‘‘(1) The term ‘home telehealth’ includes, but is 

8 not limited to, the use of telecommunication tech9 nology and information technology to support the 

10 monitoring, transmission, and interpretation of clin11 ical data derived from patients situated in a home, 

12 community, or other non-health-care facility setting. 

13 ‘‘(2) The term ‘teleconsultation’ includes, but is 

14 not limited to, the use by a health care provider of 

15 telecommunication technology and information tech16 nology to assist another health care provider, at a 

17 distant site, in their management, assessment, diag18 nosis, and treatment of a patient. 

19 ‘‘(3) The term ‘telehealth’ includes, but is not 

20 limited to, the use of telecommunication technology 

21 and information technology to support the provision 

22 of health care in situations where the patient and 

23 health care provider are separated by geographic dis24 tance. 


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1 ‘‘(4) The term ‘telemedicine’ includes, but is 

2 not limited to, the use of telecommunication tech3 nology and information technology to support the 

4 provision of health care in situations where the pa5 tient and health care provider are separated by geo6 graphic distance and the provider is directly man7 aging the care of the patient. 

8 ‘‘(5) The term ‘teleretinal imaging’ includes, 

9 but is not limited to, the use of telecommunication 

10 technology and information technology to support 

11 the remote assessment of eye conditions.’’. 

12 (2) CLERICAL AMENDMENT.—The table of sec13 tions at the beginning of chapter 17 of such title is 

14 amended by inserting after the item related to sec15 tion 1708 the following new item: 

‘‘1709. Teleconsultation and teleretinal imaging.’’. 

16 (b) TRAINING IN TELEMEDICINE.— 

17 (1) MEDICAL RESIDENTS.—The Secretary of 

18 Veterans Affairs shall require each Department of 

19 Veterans Affairs facility that is involved in the train20 ing of medical residents to work with each university 

21 concerned to develop an elective rotation in telemedi22 cine for such residents. 

23 (2) RURAL VETERANS.—The Secretary shall 

24 provide health care professionals of the Department 

25 with education and training with respect to using 


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1 telemedicine to provide care to veterans in rural 

2 areas. 

3 (c) ENHANCEMENT OF VERA.— 

4 (1) INCENTIVES FOR PROVISION OF TELECON5 SULTATION, TELERETINAL IMAGING, TELEMEDICINE, 

6 AND TELEHEALTH SERVICES.—The Secretary shall 

7 modify the Veterans Equitable Resource Allocation 

8 system to provide incentives for the use of telecon9 sultation, teleretinal imaging, telemedicine, and tele10 health coordination services. 

11 (2) INCLUSION OF TELEMEDICINE VISITS IN

12 WORKLOAD REPORTING.—The Secretary shall mod13 ify the Veterans Equitable Resource Allocation sys14 tem to require the inclusion of all telemedicine visits 

15 in the calculation of facility workload. 

16 (d) DEFINITIONS.—In this section, the terms ‘‘tele17 consultation’’, ‘‘telehealth’’, ‘‘telemedicine’’, and ‘‘teleret18 inal imaging’’ have the meanings given such terms in sec19 tion 1709(d) of title 38, United States Code, as added by 

20 subsection (a)(1). 


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1 SEC. 3. AUTHORITY TO WAIVE COLLECTION OF COPAY2 MENTS FOR TELEHEALTH AND TELEMEDI3 CINE VISITS OF VETERANS. 

4 (a) IN GENERAL.—Subchapter III of chapter 17 of 

5 title 38, United States Code, is amended by inserting after 

6 section 1722A the following new section: 

7 ‘‘§ 1722B. Copayments: waiver of collection of copay8 ments for telehealth and telemedicine 

9 visits of veterans 

10 ‘‘(a) IN GENERAL.—The Secretary may waive the im11 position or collection of copayments for teleconsultation, 

12 telemedicine, teleretinal imaging, telehealth, and home 

13 telehealth visits of veterans under the laws administered 

14 by the Secretary. 

15 ‘‘(b) DEFINITIONS.—The terms ‘teleconsultation’, 

16 ‘telemedicine’, ‘teleretinal imaging’, ‘telehealth’, and 

17 ‘home telehealth’ have the meanings given such terms in 

18 section 1709(d) of this title.’’. 

19 (b) CLERICAL AMENDMENT.—The table of sections 

20 at the beginning of chapter 17 of such title is amended 

21 by inserting after the item relating to section 1722A the 

22 following new item: 

‘‘1722B. Copayments: waiver of collection of copayments for telehealth and telemedicine visits of veterans.’’. 

Æ 


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