A federal judge on Monday rejected the Texas Medical Board's request to jettison a lawsuit filed against it by Teladoc over the board's new restrictions on the practice of telemedicine in the state.
The judge's decision means the case, which has implications for medical boards and telemedicine across the country, will continue to move forward.
Teladoc sued the board in April over a rule that requires physicians to either meet with patients in person before treating them remotely or treat them face-to-face via technology while other providers are physically present with them when treating them for the first time.
Teladoc, which uses technology to facilitate patient-doctor visits, alleges the rule violates antitrust laws because it would restrict the company's ability to compete, resulting in higher prices and less access to doctors for Texans.
Teladoc's chief legal counsel, Adam Vandervoort, called the ruling "a carefully crafted and very well-reasoned decision." The Texas Medical Board did not respond immediately to a request for comment.
In his opinion Monday, U.S. District Judge Robert Pitman, who previously issued a preliminary injunction to block the rule from taking effect, rejected three of the medical board's main arguments for dismissing the case, including that the board should be immune from antitrust liability as a state agency.
The judge rejected that argument based largely on a recent U.S. Supreme Court ruling in North Carolina Dental Board v. FTC. In that ruling, the Supreme Court said that state licensing boards made up of active members of the professions they regulate, such as practicing doctors, are not immune from antitrust laws unless they are actively supervised by the state.
Pitman wrote that for a board to be considered actively supervised, the state supervisor must have power to veto or modify the board's decisions, and supervision of the Texas Medical Board does not meet that requirement.
Nathaniel Lacktman, a partner at Foley & Lardner and the leader of the firm's telemedicine practice, called that part of the judge's opinion the most interesting and potentially significant.
“The judge's rejection of that is a win for Teladoc and certainly should be viewed if not as a cautionary tale, a word of warning or awareness to medical boards in other states that their activities may not be protect by the sovereign immunity doctrine in ways they presumed they would be protected in the last couple decades,” Lacktman said.
The judge's rejection of the board's request to dismiss the case shows that there's merit to Teladoc's arguments, though it doesn't necessarily mean Teladoc will win in the end, Lacktman said.
If Teladoc prevails overall, “it will send a message to other boards of medicine that they cannot implement arbitrary or capricious policies that serve to restrict the practice of medicine in an unfair way just to benefit doctors in their home states,” Lacktman said.