Federal Judge Blocks Texas Rule Restricting Telemedicine

Ken Terry

June 02, 2015

A federal judge has delayed the implementation of the Texas Medical Board's (TMB's) new telemedicine rule that bars Texas physicians from prescribing drugs to patients over the telephone without having seen them first.

Judge Robert Pitman, of the US District Court for the Western District of Texas, last Friday granted an injunction to Teladoc, a telemedicine company, against the enforcement of the TMB's rule, which was to have gone into effect June 3.

The injunction will continue until the federal antitrust lawsuit of Teladoc against the TMB is resolved.

In Pitman's decision, he said that the evidence shows that Teladoc brings benefits to the market by reducing healthcare costs, increasing opportunities for physicians to practice medicine, and expanding patients' access to care. The judge did not find persuasive the TMB's claims about the poor care allegedly provided by telemedicine providers. In addition, he was unmoved by the TMB's allegation that the care provided on the telephone by on-call physicians is somehow superior to that of Teladoc providers because of their on-call status.

With regard to the patient access issue, Pitman wrote, "Elimination of physicians providing health care would thus negatively impact not just the competitor physicians, but consumers, a classic anti-trust injury."

Jason Gorevic, chief executive officer of Teladoc, said in a statement, "Not only is telehealth the wave of the future, but Texas physicians have been treating patients without a prior in- person visit for decades. We are happy to be able to continue serving Texas citizens, employers, and health plans by enabling them to access high-quality care in a cost-effective manner."

The TMB did not issue a statement in response to Judge Pitman's ruling. But Tom Garcia, MD, president of the Texas Medical Association (TMA), told the Texas Tribune he was "sorely disappointed" with the court's decision.

"Protecting patient health and safety and improving the quality of patient care are the Texas Medical Board's responsibilities," Dr Garcia said. "TMA supports the challenged rules and believe they fulfill the board's mission."

Teladoc filed its suit against the TMB in late April. The suit alleges that the TMB acted not because of concern about the safety of remote consultations but because it was concerned about the competitive threat to physicians.

The medical board adopted its new rule on April 10. Previously, the TMB had sent Teladoc a letter saying that the physicians who provided its remote consultations were violating board policy.

The ongoing litigation between the TMB and Teladoc has been viewed as a litmus test for how medical boards across the country may deal with telemedicine going forward. In one important respect, however, state legislatures are increasingly taking this decision out of the hands of medical boards: a majority of states now require healthcare plans to cover remote consults the same way they cover in-person visits to physicians.


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