USA Trends and Developments Contributed by: Nadia de la Houssaye, Allison Bell, Emily Degan Vorhoff and Keiana Palmer, Jones Walker LLP
Reproductive Telehealth: State Versus Federal Stalemates Continue In the wake of the US Supreme Court’s 2022 rul- ing in Dobbs v Jackson Women’s Health Organi- zation, the landscape for reproductive telehealth remains highly fragmented. States continue to enact contradictory laws regarding access to abortion and other reproductive health servic- es, creating significant challenges for telehealth providers operating across multiple jurisdictions. Recent shifts in federal enforcement priorities have introduced additional complexity to this already challenging environment. With reduced OCR oversight capacity, concerns have emerged about the enforcement of privacy protections for individuals seeking reproductive healthcare through digital platforms. Telehealth providers of reproductive healthcare services must navigate not only the varying state laws regarding the services themselves but also complex questions about data privacy, prescrib- ing authority and insurance coverage. This regu- latory complexity has led some providers to limit their geographic footprint, potentially reducing access to care for individuals in more restrictive states. The legal status of medication abortion via tel- ehealth remains particularly contentious. States remain divided, with approximately half allowing telehealth medication abortions and the other half either expressly or effectively banning this form of treatment. The Supreme Court’s 2024 decision in FDA v Alliance for Hippocratic Medi- cine preserved access to mifepristone in states where abortion is legal, but did not resolve the underlying tensions between state and federal authority in this area. In 2025, a federal district court judge in Texas ruled that three states – Idaho, Kansas and Missouri – have standing to
they continue to risk violations of state corporate practice of medicine prohibitions. This is a particularly pressing concern given that digital health research, development and imple- mentation typically requires substantial financial resources, often only available through the types of private equity investments described above. Approximately three quarters of physicians in the USA are now salaried employees, and half of all physician practices are owned by a hospital or corporate entity. By their very nature, telemedicine and digital health typically transcend jurisdictional bound- aries. As a result, compliance with ownership, employment and other obligations in one state may not ensure compliance in another. This diversity of rules and exceptions continues to limit the formation, development and use of tel- emedicine alternatives for fear of creating legal exposure. The ongoing wave of hospital mergers, driven by the need for scalability and financial sustain- ability in an environment of low reimbursements, further complicates this picture. While consoli- dation may enable the investment in technology infrastructure necessary for digital health innova- tion, it also raises antitrust concerns and ques- tions about access to care, particularly in rural or underserved areas. Until state legislatures modernise their approach to account for new methods of delivering care and the financial and operational arrangements that support such methods, telemedicine provid- ers and healthcare entities will need to maintain rigorous compliance programmes that address the varying requirements across multiple juris- dictions.
171 CHAMBERS.COM
Powered by FlippingBook