- Physicians in the Lone Star state are now barred from prescribing controlled substances via telemedicine, per an Emergency Rule issued Jan. 16 by the Texas Medical Board.
- The rule, which does not apply to mental health services, amends the Texas Administrative Code to state that "online questionnaires or discussions via phone, e-mail, electronic text or chat" are not adequate to establish a valid relationship between doctors and their patients. The rule further states that physicians are required to do in-person exams or face-to-face visits.
- Dallas-based telehealth provider Teladoc responded by filing a lawsuit on Jan. 20 in Travis County Court. The suit charges the board with violations of the Texas Administrative Procedure Act, arguing that the medical board's emergency rule is bogus.
Texas' clampdown on telehealth and Teledoc's subsequent suit are rooted in a long-standing feud that centers on whether doctors should be allowed to prescribe controlled substances without being in the physical presence of patients. Ideologically, this makes sense—Texas has traditionally been recalcitrant towards change, staunchly refusing Medicaid expansion—but it makes less sense financially. According to the Texas Medical Association, Texas has around 43,000 physicians caring for a population of about 23 million, putting them at 45th in the nation in the number of physicians per population. Telemedicine, it is widely agreed, is powerful tool in the fight against a national physician shortage.
Elsewhere, other states are doing the opposite. Just weeks ago New York state passed new legislation that requires telehealth visits be reimbursed at the same rate as in-person visits. In doing so, it became the 22nd state to pass telehealth parity laws.