New requirements by the Texas Medical Board (TMB) have made the practice of telemedicine more stringent in Texas. These new rules go into effect on June 3, 2015. As part of these new rules, in order to treat Texas residents through telemedicine, the physician must be licensed to practice in Texas. Also, an in person, face-to-face, meeting must take place before a physician is able to provide health care services to the patient remotely. Specifically, there can be no online questioning through email, text or telephone until the physician has seen the patient face-to-face. Another change made was to the definition of an "established medical site." This can no longer include a patient's home.
There is an ongoing issue as to whether marketers employed as full time, W-2 employees, may be paid based on the volume or value of business that they generate.