The recent dust-up between Teladoc and the Texas Medical Board isn't the only battle being waged over telephone-based services. The Dallas-based telehealth provider has also stopped service in Idaho and Arkansas over state laws that prohibit the telephone-based telehealth visit as the initial primary point of contact between doctor and patient.

According to an article in Arkansas Business Online, Teladoc suspended service to some 70,000 consumers in Arkansas last November after the Arkansas State Medical Board warned that it would take action against the company's doctors. The company had been doing business in the state since 2008.

“The board has traditionally defined the establishment of a doctor-patient relationship as: an in-person history and a physical,” board attorney Kevin O’Dwyer told Arkansas Business Online.

At issue is whether a phone consultation is good enough to enable a physician to make a diagnosis or issue a prescription. Other telehealth providers have generally steered clear of any confrontation by either declining to do business in certain states or focusing on a video-based telehealth service.

Teladoc CEO Jason Gorevic told the news site he hopes to meet with Arkansas medical officials to explore a solution that would allow Teladoc to resume service in the state. He's looking for the same kind of meeting in Idaho, where Telodoc also suspended its service recently due to state regulations.

The company is taking a more confrontational approach in its home state, filing a lawsuit this month that challenges a recent Texas Medical Board emergency ruling that prohibits a telehealth doctor from dispensing a prescription without first having an in-person or face-to-face meeting with a patient.

According to a 2014 study by the American Telemedicine Association, Alabama, Missouri and Nebraska also prohibit the telehealth visit as a replacement for an in-person visit.

Not every state is a telehealth battleground, however. Earlier this month, New York Gov. Andrew Cuomo signed a bill mandating that telehealth visits be reimbursed by insurers at the same rate as in-person visits, becoming the 22nd state to do so. And in Colorado, the House Health, Insurance and Environment Committee has approved a bill – with no opposition – that would allow telemedicine as the primary point of contact between a doctor and patient in rural counties (those with 150,000 or fewer residents). The proposed bill would also prohibit health insurers from reimbursing providers at a different rate than for in-person visits.

The ATA is steering clear of commenting on Teladoc's battles, but has long criticized states for their reluctance to adopt telehealth standards. Last year, an ATA report card gave 29 states an 'F' for telehealth reimbursement and coverage, while only seven states – Virginia, Tennessee, Maine, New Hampshire, New Mexico, Mississippi and Maryland – scored an 'A.'