On April 29, Dallas-based Teladoc, Inc., the largest telemedicine service provider in the U.S., filed a federal antitrust lawsuit against the Texas Medical Board over a new Board rule prohibiting physicians from treating patients over the telephone before having met with them face-to-face.

The suit claims that the Board adopted the rule in order to protect Texas physicians from competition from telemedicine providers.  The Board, however, had said it was concerned about the scenario "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 new rule was adopted on April 10 and is scheduled to take effect on June 3.

Under the new rule (found in Chapter 174 here), the “face-to-face” requirement may be satisfied by either an in-person appointment or, in some situations, a video consultation. The Board issued a press release on April 14 that described the permissible types of telemedicine. 

In a Teladoc press release, CEO Jason Gorevic said, “It is clear that the medical board acted only when Teladoc consultations became sufficiently numerous to be perceived as a competitive threat to brick-and-mortar physician practices.” 

Teladoc’s suit claims that the rule would cause “dramatic and irreparable injury” to the company and “effectively put [it] out of business in Texas,” its largest market. Teladoc and the Board had battled in court since 2011 on other issues, including Teladoc physicians’ prescribing drugs after telephone consultations.