in effect
This is a final rule from the Department of Veterans Affairs updating the regulations that govern how VA-employed health care professionals deliver care through telehealth. It puts into regulation the telehealth authority Congress granted VA in the MISSION Act of 2018 and the 2021 National Defense Authorization Act, and it takes effect November 3, 2025.
VA health care professionals may now deliver telehealth to any veteran anywhere in the United States regardless of which state the provider or patient is physically located in, and conflicting state licensing or practice laws are preempted and have no force on those professionals while they are performing VA duties. The prior regulation required providers to follow the prescribing restrictions of the state where they held their license; the new rule removes that requirement and instead holds providers to federal standards only — chiefly the Controlled Substances Act and VA-specific prescribing policies — when prescribing medications, including controlled substances, via telehealth. A new example is added to the regulation (38 CFR 17.417(b)(4)(viii)) specifically flagging that prescribing a controlled substance to a patient located in a state other than the provider’s state of licensure is a recognized conflict situation covered by the federal preemption. VA also commits in the rule’s preamble that it will provide legal representation to covered health care professionals if a state pursues disciplinary action against them solely because they practiced telehealth within the scope of their VA duties. Trainees and postgraduate employees may participate in telehealth only under clinical supervision by a properly credentialed VA employee.
VA-employed health care professionals — including physicians, nurses, trainees, and postgraduate employees — can now provide telehealth services and prescribe across state lines without needing to comply with the licensing or prescribing rules of the patient’s state, as long as they hold a valid, unrestricted license in any state. Veterans receiving VA health care gain broader access to care because their provider’s physical location no longer limits service delivery. State licensing boards lose the authority to restrict or sanction VA providers solely on the basis of telehealth practice conducted as part of VA employment.