The back-and-forth battle over telemedicine in Texas has taken another turn, with a federal court ruling in favor of Teladoc's practice of connecting doctors with first-time patients by phone.
U.S. District Court Judge Robert Pittman has blocked action taken by the Texas Medical Board in April to prevent doctors from issuing prescriptions or making certain diagnoses to new patients when their first meeting is by telephone. In a battle that has lasted more than four years, the Texas board had revised its telemedicine guidelines to require that physicians have a face-to-face meeting as their first contact with patients.
Pittman issued an injunction against Rule 190.8, which the board had adopted on April 10 and which would have taken effect June 3. Teladoc officials had filed a lawsuit on April 29 against the board, arguing that it was violating federal law, including the Sherman Antitrust Act, by killing its business model.
[See also: Is a phone call good enough for telehealth?]
"Elimination of physicians providing healthcare would … negatively impact not just the competitive physicians, but consumers," Pittman wrote in his ruling, handed down late on May 29.
Pitman also called the board's ruling "a classic anti-trust injury," apparently supporting Teladoc's argument that the board, composed primarily of physicians, was trying to kill the competition. In his ruling, reported in the Dallas/Fort Worth Healthcare Daily, he noted that "at least two circuit courts have recognized destruction of a business model may constitute irreparable injury."
The dispute will now head to a trial.
In a statement issued to The Texas Tribune, Texas Medical Association President Tom Garcia said he was "sorely disappointed" with Pittman's ruling.
"Protecting patient health and safety and improving the quality of patient care are the Texas Medical Board's responsibilities," he said in the statement. "(The) TMA supports the challenged rules and believe they fulfill the board's mission."
Officials at Dallas-based Teladoc, which does some 70 percent of its business via phone and operates in 48 states, noted this is the sixth time in the past four years that the courts have sided with the company in their battle with the Texas Medical Board.
“Not only is telehealth the wave of the future, but Texas physicians have been treating patients without a prior in-person visit for decades,” Jason Gorevic, the company's chief executive officer, said in a press release. “We are happy to be able to continue serving Texas citizens, employers and health plans by enabling them to access high-quality care in a cost-effective manner.”
[See also: Texas takes a bite out of telemedicine]
“With this latest episode behind us, we look forward to delivering the full value of telehealth to the people of Texas indefinitely,” he continued. “In the face of increasing physician shortages and rising healthcare costs, other states across the country have found solutions that embrace telehealth, and all its benefits, while ensuring patient safety. Today’s court ruling allows Texans to continue enjoying these benefits as well.”
In interviews with mHealth News over the past few months, both Gorevic and Henry dePhillips, Teladoc's chief medical officer, stressed that the company’s physicians do more than just talk on the phone with a patient. They have access to the patient's medical records, Gorevic said, and can conduct video visits and connect with specialists if needed – as well as require that the patient have an in-person visit with a doctor if the issue merits more scrutiny.
In arguing against the Texas board's revisions, Teladoc officials leaned heavily on the company's certification by the National Committee for Quality Assurance, as well as customer satisfaction ratings of 95 percent and 92 percent of patient medical issues resolved.
“The medical board claims to be motivated by concerns about patient safety. However, they failed to produce evidence during their rulemaking process to support the position that telehealth poses a patient safety risk," Adam Vandervoort, Teladoc's chief legal officer, said in the press release. "Additionally, the board offered no evidence of any harm done by telehealth during the federal court proceeding in opposition to Teladoc’s request for an injunction.”
See also:
The AMA takes a stand on telemedicine
How a Pacific Northwest Hospital extends its reach to remote patients
