In recent years, Texas has served as ground zero for a number of the most contentious legal battles surrounding telehealth. This week, State Senator Perry Schwertner, the chairman of the Committee on Health and Human Services, submitted a bill signifying progress for telemedicine and telehealth providers looking to practice in the Lone Star State. The bill, S.B. 1107, would remove one of the toughest hurdles for telemedicine and telehealth practitioners – the face-to-face meeting requirement. Providers would be able to provide services to, and establish physician-patient relationships with, Texas residents through either a synchronous audio-visual interaction or via store-and-forward technology and an audio-only interaction, without ever having to meet the patient in real life. The bill would require the practitioner to use the relevant clinical information required to meet the same standard of care as practitioners providing in-person services.
The bill also would mean changes for the policies of the Texas Medical Board. The legislation signifies that the “telepresenter” requirement, mandating the presence of a healthcare professional when a patient initiates a video consultation, would be eliminated. In addition, the Texas Medical Board, along with the Texas Board of Nursing, the Texas Physician Assistant Board, and the Texas State Board of Pharmacy, would be required to adopt rules defining “valid” prescriptions for telemedicine visits. This would supersede the current, and defunct, policy against telemedicine prescribing, although prescribing abortion drugs would still be prohibited.
The new bill follows the stay recently placed on the litigation between the Texas Medical Board and telehealth company Teladoc. The dispute arose in 2015 when the Texas Medical Board ruled that Texas physicians were prohibited from prescribing to patients without a face-to-face visit. In response, Teladoc filed an antitrust suit and obtained an injunction against enforcement of the rule. The Texas Medical Board then revised the rule, requiring a face-to-face evaluation to establish a physician-patient relationship. Teladoc again filed suit and obtained another injunction. Although the Texas Medical Board filed an appeal, it backed down in October 2016 after the U.S. Department of Justice and the Federal Trade Commission expressed support for Teladoc through amicus briefs. The Texas Medical Board and Teladoc are now rumored to be discussing a settlement.