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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Veterans’ Telehealth 
and Telemedicine Improvement Act’’. 
SEC. 2. TELECONSULTATION AND TELEMEDICINE. 
(a) TELECONSULTATION AND TELERETINAL IMAG-
ING.— 
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(1) IN GENERAL.—Subchapter I of chapter 17 
of title 38, United States Code, is amended by add-
ing at the end the following new section: 
‘‘§ 1709. Teleconsultation and teleretinal imaging 
‘‘(a) TELECONSULTATION.—(1) The Secretary shall 
carry out a program to increase the use of teleconsulta-
tion, telemedicine, telehealth, and home telehealth by the 
Department. 
‘‘(2) The Secretary shall, in consultation with appro-
priate professional societies, promulgate technical and 
clinical care standards for the use of teleconsultation serv-
ices within facilities of the Department. 
‘‘(b) TELERETINAL IMAGING.—(1) The Secretary 
shall carry out a program to increase the use of teleretinal 
imaging by the Department in each Veterans Integrated 
Services Network. 
‘‘(2) In each fiscal year beginning with fiscal year 
2013 and ending with fiscal year 2018, the Secretary shall 
increase the number of patients enrolled in each teleretinal 
imaging program under paragraph (1) by not less than 
five percent from the number of patients enrolled in each 
respective program in the previous fiscal year. 
‘‘(c) ANNUAL REPORTS.—Not later than March 1 of 
each year, the Secretary shall submit to the Committees 
on Veterans’ Affairs of the Senate and House of Rep-
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resentatives a report on the Department’s implementation 
of telehealth and telemedicine programs, including the 
program of teleconsultation, telemedicine, telehealth, and 
home telehealth under subsection (a) and the program of 
teleretinal imaging under subsection (b). 
‘‘(d) DEFINITIONS.—In this section: 
‘‘(1) The term ‘home telehealth’ includes, but is 
not limited to, the use of telecommunication tech-
nology and information technology to support the 
monitoring, transmission, and interpretation of clin-
ical data derived from patients situated in a home, 
community, or other non-health-care facility setting. 
‘‘(2) The term ‘teleconsultation’ includes, but is 
not limited to, the use by a health care provider of 
telecommunication technology and information tech-
nology to assist another health care provider, at a 
distant site, in their management, assessment, diag-
nosis, and treatment of a patient. 
‘‘(3) The term ‘telehealth’ includes, but is not 
limited to, the use of telecommunication technology 
and information technology to support the provision 
of health care in situations where the patient and 
health care provider are separated by geographic dis-
tance. 
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‘‘(4) The term ‘telemedicine’ includes, but is 
not limited to, the use of telecommunication tech-
nology and information technology to support the 
provision of health care in situations where the pa-
tient and health care provider are separated by geo-
graphic distance and the provider is directly man-
aging the care of the patient. 
‘‘(5) The term ‘teleretinal imaging’ includes, 
but is not limited to, the use of telecommunication 
technology and information technology to support 
the remote assessment of eye conditions.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of chapter 17 of such title is 
amended by inserting after the item related to sec-
tion 1708 the following new item: 
‘‘1709. Teleconsultation and teleretinal imaging.’’. 
(b) TRAINING IN TELEMEDICINE.— 
(1) MEDICAL
RESIDENTS.—The Secretary of 
Veterans Affairs shall require each Department of 
Veterans Affairs facility that is involved in the train-
ing of medical residents to work with each university 
concerned to develop an elective rotation in telemedi-
cine for such residents. 
(2) RURAL
VETERANS.—The Secretary shall 
provide health care professionals of the Department 
with education and training with respect to using 
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telemedicine to provide care to veterans in rural 
areas. 
(c) ENHANCEMENT OF VERA.— 
(1) INCENTIVES FOR PROVISION OF TELECON-
SULTATION, TELERETINAL IMAGING, TELEMEDICINE, 
AND TELEHEALTH SERVICES.—The Secretary shall 
modify the Veterans Equitable Resource Allocation 
system to provide incentives for the use of telecon-
sultation, teleretinal imaging, telemedicine, and tele-
health coordination services. 
(2) INCLUSION
OF
TELEMEDICINE
VISITS
IN 
WORKLOAD REPORTING.—The Secretary shall mod-
ify the Veterans Equitable Resource Allocation sys-
tem to require the inclusion of all telemedicine visits 
in the calculation of facility workload. 
(d) DEFINITIONS.—In this section, the terms ‘‘tele-
consultation’’, ‘‘telehealth’’, ‘‘telemedicine’’, and ‘‘teleret-
inal imaging’’ have the meanings given such terms in sec-
tion 1709(d) of title 38, United States Code, as added by 
subsection (a)(1). 
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SEC. 3. AUTHORITY TO WAIVE COLLECTION OF COPAY-
MENTS FOR TELEHEALTH AND TELEMEDI-
CINE VISITS OF VETERANS. 
(a) IN GENERAL.—Subchapter III of chapter 17 of 
title 38, United States Code, is amended by inserting after 
section 1722A the following new section: 
‘‘§ 1722B. Copayments: waiver of collection of copay-
ments for telehealth and telemedicine 
visits of veterans 
‘‘(a) IN GENERAL.—The Secretary may waive the im-
position or collection of copayments for teleconsultation, 
telemedicine, teleretinal imaging, telehealth, and home 
telehealth visits of veterans under the laws administered 
by the Secretary. 
‘‘(b) DEFINITIONS.—The terms ‘teleconsultation’, 
‘telemedicine’, ‘teleretinal imaging’, ‘telehealth’, and 
‘home telehealth’ have the meanings given such terms in 
section 1709(d) of this title.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of such title is amended 
by inserting after the item relating to section 1722A the 
following new item: 
‘‘1722B. Copayments: waiver of collection of copayments for telehealth and tele-
medicine visits of veterans.’’. 
Æ 
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