Accessing medical services across the expansive state of Montana can be tough. With a majority of residents marooned in rural areas that can be separated by significant distances or poor road conditions, more people are using telemedicine to meet with their doctors. Accordingly, legislators have introduced a bill to put, as Representative Kirk Wagoner said, “sideboards on the practice of telemedicine in Montana.”

House Bill 389 sets the rules for how doctors and patients can establish first-time relationships, requiring them to meet either in person or through video chat. After that, they can continue on with audio-only, if they choose. Proponents of the bill, including members of the Montana Medical Association, embraced it because it doesn’t specifically prevent the usage of any types of telemedicine after the relationship has been established. But the first-time relationship requirement irked Teladoc, which conducts most of its visits over the phone. The telemedicine company spoken out against the bill, claiming it is not “technology neutral enough”, according to the Great Falls Tribune.

While no immediate action was taken on the Montana bill, Teladoc still has its hands full in Texas, where the never-ending tussle over telemedicine marches on. The stay granted by a federal judge in the case between Teladoc and Texas Medical Board will last until September.

The sparring group of medical and industry leaders first announced they had come to this compromise in February around the same time the American Telemedicine Association put out their state-by-state assessment of telemedicine practices that pegged Texas as the state with the lowest composite score.

Teladoc sued the Texas Medical Board in state court way back in April 2015, alleging that because the board was made up of practicing doctors with a financial interest in squelching telemedicine, the board's passing of anti-telemedicine legislation constituted a violation of antitrust laws. But the medical board filed a motion asking for the suit to be dismissed on the grounds that there is, in fact, state supervision of the medical board which would make it a state agency under law and therefore immune to suit. When the judge denied the motion, the medical board appealed to the Fifth Circuit court. In October, the Texas Medical Board dropped its appeal in its case against Teladoc.

There was also legislative action in telemedicine in Indiana this week. House lawmakers sent a bill to the governor that would expand services across the state to Medicaid patients. While the legislation was prompted by state psychiatrists who say the bill fills a crucial need for those living in rural areas, others are concerned with the bill’s provision to lift a ban on using telemedicine to prescribe controlled substances, such as Ritalin or Adderall.

“I’m very concerned that this would allow somebody out-of-state to prescribe a controlled substance in this state to someone they’ve never laid eyes on,” Representative Ed DeLaney said, according to Indiana Public Media.