Texas telemedicine bill offers compromise for first-time visits, but would ban telemedicine abortions

By Heather Mack
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The latest legislative effort to establish telemedicine guidelines in Texas may finally be what everyone has been waiting for. Senator Charles Schwertner submitted a bill this week created out of months of negotiations between various medical boards, regulatory agencies and industry groups, and it contains a compromise that may finally bring an end to the longtime telemedicine standoff in the Lone Star State.

Senate Bill 1107 puts forth how clinicians can use telehealth platforms to establish doctor-patient relationships, notably eliminating previous requirements that the two must meet in person before telemedicine can be used for certain services. The bill allows doctors and patients to establish a first-time relationship with audio visits, so long has the doctor has medical records or images to buttress their assessment to form a diagnosis or treatment.

The sparring group of medical and industry leaders first announced they had come to this compromise last month, around the same time the American Telemedicine Association put out their state-by-state assessment of telemedicine practices that pegged Texas as the state with the lowest composite score.

The bill is welcome news to telemedicine provider Teladoc, which has been embroiled in legal battles with the Texas Medical Board. Teladoc, which offers remote medical visits, sued the Texas Medical Board in state court way back in April 2015, alleging that because the board was made up of practicing doctors with a financial interest in squelching telemedicine, the board's passing of anti-telemedicine legislation constituted a violation of antitrust laws. But the medical board filed a motion asking for the suit to be dismissed on the grounds that there is, in fact, state supervision of the medical board which would make it a state agency under law and therefore immune to suit. When the judge denied the motion, the medical board appealed to the Fifth Circuit court. In October, the Texas Medical Board dropped its appeal in its case against Teladoc, though the original suit is still ongoing.

On their quarterly earnings call this week, Teladoc President and CEO Jason Gorevic said they were “encouraged” by the bill, and Chief Operating and Financial Officer Mark Hirschhorn noted the obvious financial benefit the legislation presents.

“You know that over the past almost two years now, we have had, on average, over $1 million of our legal costs principally all related to Texas,” Hirschhorn said on the call. “So if those costs were going to be reduced significantly as a result of a legislative action, we would have that pick up in Q3 and Q4.”

With that bit of liberation came some new restrictions, however. Schwertner’s bill explicitly bans the use of telemedicine to prescribe abortion-inducing medication. If this passes without any objection, Texas would be the 20th state with such a ban. However, that may set up parties in the state for a whole new slew of telemedicine lawsuits. Recently, Utah stripped the limitation from their telemedicine bills, and Planned Parenthood settled a lawsuit with Idaho legislators over a similar restriction in that state. The reproductive health nonprofit also won a similar suit in Iowa in 2015