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Legal Case to Impact Future of Telehealth Services in Texas

By Kyle Murphy, PhD

- A legal case in Texas District Court could determine whether the delivery of healthcare using telehealth services remains a viable solution.

The availability of telehealth services in Texas in part of a legal battle

Teladoc, a national telemedicine provider with a significant foothold in Texas, has filed a complaint for a preliminary injunction calling on the Court to prevent the Texas Medical Board from putting into effect a new rule that would require physicians to have face-to-face encounters with new patients prior to writing prescriptions.

The rule — New Rule 190.8 — has an effective date of June 3, 2015, and the potential to put Teladoc out of business in the state just as telehealth has begun to take off, the national telemedicine provider claims.

"Technological advances and growing consumer acceptance are driving exponential growth in the adoption and utilization of telehealth services like Teladoc," the complaint state. "Although Teladoc has been on the forefront of telehealth advocacy since its founding in 2002, payors have only recently started to recognize telehealth as a safe, viable, and inexpensive healthcare option."

Jim Landers of The Dallas Morning News reports that the current legal action is in direct response to an April 10 ruling by the Texas Medical Board, which voted 13-1 in favor of the new rule despite having received 203 out of 206 public comments opposing it.

According to the new rule, Texas physician are still able to treat regular patients using telehealth technology or new patients with remote monitoring devices so long as a nurse or other healthcare professional is present. "Essentially the only scenario prohibited in Texas is one in which a physician treats an unknown patient using telemedicine, without any objective diagnostic data, and no ability to follow up with the patient," the Texas Medical Board stated in a public release earlier this month.

The legal complaint, however, alleges that the Texas Medical Board's motivation for the new rule is financial and unrelated to patient safety.

"The TMB knowingly permitted the operation of telehealth in Texas for many years," it states. "However, starting around 2009, when telehealth providers, and in particular Teladoc, began to expand in scale, the competitive threat to traditional office- and hospital-based physicians became clear.  The TMB began working to stamp out this threat to competing physicians."

In 2014, Teladoc's operations in Texas generated $10 million, close to a quarter of the company's total revenue for the year. What's more, this figure is only likely to increase significant given a growing interest in offering telehealth services according to a Towers Watson survey cited by Teladoc in its complaint that projects 71 percent of employers to offer telehealth by 2017, a 22-percent projected increase over 2014.

On top of threatening its own business interests, Teladoc also cites the negative impact the new rule would have on patient access to care and out-of-pocket costs " to the extent they are forced to travel to a physician’s office, urgent care center, or hospital, as a result of losing the option of treatment through a telehealth consultation." What's more, these patients stand to lose out on the technological improvements in healthcare that are emerging, the claim alleges.

For its part, the Texas Medical Board is standing firm according to The Dallas Morning News.

Read the full legal complaint here.

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