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Jun 17, 2019

The Emergence of Telemedicine in Texas

By: Chad Nelson

Advances in technology are rapidly changing patient access to health care services. Patients now have a multitude of health-based “apps” available on their smart phones to, among others, monitor heart conditions, analyze blood-glucose levels, use artificial intelligence, and consult with doctors remotely.  One such advancement is telemedicine.

Telemedicine involves the use of telecommunications to facilitate a health care provider’s medical care to patients physically located offsite from the provider’s location. The Texas Occupations Code defines telemedicine medical service as “health care service delivered by a physician… to a patient at a different physical location than the physician or health professional using telecommunications or information technology.”[1]

Improvements in technology have increased the quantity and quality of telemedicine services, which is permitting health care providers to see and hear patients in real time through videoconferencing, rather than requiring patients to travel for an in-person visit to a physician’s office or hospital. As an alternative to traditional, in-person health care services, telemedicine not only improves access and availability of medical care, but it can also be a more affordable and efficient option.

Texas law has long supported and encouraged the use of telecommunications to provide health care services in certain contexts.[2] However, in recent years, Texas legislation has reshaped the landscape of telemedicine law to keep up with advances in technology.

Until 2017, Texas law imposed physical encounter requirements for physicians and patients to use telemedicine services. But, in May 2017, Texas Governor Greg Abbott signed into law Senate Bill 1107 (“SB 1107”), which eliminated the blanket requirement for in-person or face-to-face visits to establish a physician-patient relationship. Moreover, the new regulations provided that telemedicine services need not be provided through an established medical site, as the Texas Medical Board previously required. Now, a valid physician-patient relationship can be established through telecommunications without the need for an in-person encounter.

While Texas law has opened the door for increased use of telemedicine services, health care providers also must ensure they are in compliance with other related laws and regulations.  These include, but are not limited to, the False Claims Act, Anti-Kickback Statute, Stark law, and Health Insurance Portability and Accountability Act (HIPAA).  These laws are designed to prevent efforts by health care providers to induce or reward referral of business reimbursable by federal health care programs (such as waiving co-payments) and to prevent health care providers from profiting from referrals of Medicare/Medicaid patients to an entity in which the health care provider has a financial interest.  Also, telemedicine physicians and health care providers still must protect the confidentiality of private patient health care information under HIPAA.

As technology continues to evolve and further developments in health care emerge, rules and regulations must also advance to facilitate change and greater access to health care. If you are using or considering the use of telemedicine in Texas,  contact Cooper & Scully for assistance to ensure compliance with Texas and federal laws and regulations.


[1] Tex. Occ. Code Ann. § 111.001.

[2] See, e.g., Tex. Occ. Code Chapters 111, 151, 153, 562; Tex. Gov’t Code Chapters 531, 533; Tex. Health & Safety Code Chapters 35, 62, 771, 1001; Tex. Ins. Code Chapter 1455; Tex. Admin. Code Chapter 354.