I recently had the opportunity to speak at the Pennsylvania Bar Institute’s Health Law Institute in Philadelphia on the topic of “Navigating New Frontiers in Physician Practice: Telehealth, Artificial Intelligence, and Contracting.”

Healthcare law is entering a period of rapid change. Telehealth, artificial intelligence, and remote care models are reshaping how physicians deliver care, while legislatures, regulators, and courts are working to adapt older legal frameworks to new technologies. Although the tools are changing quickly, the core legal issues remain familiar: licensure, standard of care, supervision, privacy, and contractual risk.

Below is a recap of the key issues I discussed.

1. Telehealth Is No Longer a Temporary Workaround

Pennsylvania’s Telemedicine Act (Act 42 of 2024) helped move telehealth from a pandemic-era necessity into a more permanent statutory framework. For policies filed on or after March 31, 2025, insurers, Medicaid, and CHIP must cover medically necessary services delivered through telemedicine when those same services would be covered in person.

But the most important legal point is this: the standard of care in a telehealth encounter is the same as it is in person. Telehealth does not reduce a physician’s duty of care. If the technology does not allow for a clinically meaningful evaluation, the physician may need to direct the patient to an in-person visit.

2. Patient Location Still Matters for Licensure

One of the most common telehealth traps is licensure. In most cases, a physician is considered to be practicing medicine where the patient is physically located at the time of the encounter, not where the physician is sitting.

Pennsylvania’s full implementation of the Interstate Medical Licensure Compact (IMLC) in 2025 made multi-state licensure easier, but it did not create a national license. Physicians still need to ensure they are properly licensed in the state where the patient is located. That makes something as simple as confirming patient location at the start of a telehealth visit an important compliance step.

3. Multi-State Practice Also Creates Multi-State Risk

The IMLC expands opportunity, but it also expands exposure. A disciplinary action in a physician’s principal state can trigger reciprocal consequences in other Compact states. For physicians building multi-state telehealth practices, administrative diligence becomes critically important.

4. Remote Practice Does Not Eliminate Supervision Requirements

Telehealth also complicates supervision of Advanced Practice Providers (APP) such as physician assistants and nurse practitioners. Written supervisory or collaborative agreements still matter, but regulators will focus on whether supervision is meaningful in practice. If an APP encounters a complex case during a telehealth visit, there must be a reliable way to escalate that issue to the supervising physician in real time.

5. Artificial Intelligence Does Not Replace Clinical Judgment

AI tools are increasingly being used for documentation, triage, analytics, and decision support. But under Pennsylvania’s existing liability framework, the physician remains responsible for the final clinical decision.

That means AI should be treated as a decision-support tool, not a decision-maker. If a physician follows an AI-generated recommendation that later proves wrong, the legal analysis is likely to focus on whether the physician exercised independent professional judgment. Likewise, ignoring widely adopted AI tools may eventually raise different standard-of-care questions. In both situations, documentation will matter.

6. AI Raises Significant HIPAA and Data Governance Issues

As practices use more AI-driven vendors and digital tools, patient data often passes through multiple third parties. That creates growing compliance concerns around:

• Business Associate Agreements;

• Downstream subcontractors;

• Breach notification responsibilities;

• Secondary use of clinical data; and

• Vendor access to protected health information.

In my view, traditional BAAs are no longer enough in many AI arrangements. Physicians and healthcare organizations should understand how vendors use, store, and potentially train on clinical data before those tools are integrated into practice workflows.

7. Pennsylvania’s Fair Contracting For Health Care Practitioners Act Changed the Non-Compete Landscape

I also discussed Pennsylvania’s Fair Contracting for Health Care Practitioners Act (Act 74 of 2024), which significantly changed how non-competes operate for physicians and some APPs, as previously discussed on this blog (previous article here).

For any physician employment agreement signed after January 1, 2025, non-compete restrictions are limited to one year, and the statute significantly restricts enforcement when the practitioner is terminated by the employer. Telehealth adds another layer of complexity, because traditional radius-based restrictions can be difficult to apply in a remote practice model. As more care moves online, employers may increasingly rely on narrower patient non-solicitation provisions instead of broad geographic restrictions.

Final Takeaway

The central theme of the presentation was simple: technology is changing physician practice quickly, but the legal principles governing physician responsibility remain familiar.

Telehealth, AI, and digital platforms may create new factual scenarios, but they do not eliminate the importance of:

• Licensure;

• Documentation;

• Supervision;

• Privacy compliance; and

• Independent clinical judgment.

For physicians, healthcare organizations, and the attorneys who advise them, the challenge is not just understanding the new technology. It is understanding how longstanding legal rules apply when that technology becomes part of everyday care delivery.