On May 12, 2025, the U.S. District Court for the District of New Jersey entered a decision dismissing a lawsuit filed by a Massachusetts radiation oncologist and a Pennsylvania neurosurgeon, which claimed New Jersey’s licensure requirements to offer healthcare via telemedicine in New Jersey was unconstitutional. The case is MacDonald et al. v. Sabando.  

The plaintiff physicians operate national practices from Massachusetts and Pennsylvania and each treated a patient who subsequently resided in New Jersey. Those patients wished to continue their care with the out-of-state physicians but were unable to do so because neither physician was licensed in the State of New Jersey, a prerequisite to providing telehealth services in New Jersey.

Pursuant to N.J.S.A. 45:1-62(b), any healthcare provider who utilizes telemedicine or engages in telehealth must be licensed, certified, or registered to provide such services in New Jersey.

The plaintiffs’ complaint alleged four constitutional violations: (1) the Dormant Commerce Clause, (2) the Privileges and Immunities Clause, (3) the First Amendment Freedom of Speech, and (4) the Due Process Rights of Individuals.

With regard to the Dormant Commerce Clause, which prohibits in-state economic protectionism from out-of-state competition, the Court rejected the plaintiffs’ arguments, finding that the New Jersey licensure requirements applied equally to both in-state and out-of-state physicians. Thus, the Court would not apply a heightened scrutiny test to its review. Instead, the question was whether the burden on interstate commerce substantially outweighs the benefit. Since New Jersey has a strong interest in regulating the practice of medicine within the State, the Court found this interest to outweigh any burdens alleged by the plaintiffs.

The plaintiffs next argued the Privileges and Immunities Clause, which entitles all citizens of each state to all the privileges and immunities of citizens in the several states. Thus, the Court assessed whether the licensure requirements discriminated against non-residents of New Jersey, finding that the law does not treat in-state and out-of-state physicians any differently in terms of being permitted to provide telehealth services to patients in New Jersey. And, even if the law were to be found to discriminate, the Court stated that “the licensure requirement bears a substantial relationship to the state’s objective and does not impose too heavy a burden on the privileges of nonresidents.”

The plaintiffs’ next argument discussed the First Amendment’s right to freedom of speech and alleged the licensure requirements restricted the physicians’ speech in communicating with their patients. The Court rejected this argument, finding that the statute does not limit an out-of-state physician’s speech based on viewpoint or content. Rather, out-of-state physicians can become licensed in New Jersey and provide telehealth services. The Court further opined that the law takes no interest in what a physician might say, only whether they are licensed in New Jersey.

Finally, the plaintiffs alleged a violation of due process rights by claiming a fundamental right of parents to make decisions concerning the care, custody and control of their children. Thus, they alleged the law limited their ability to do so. The Court, while acknowledging the due process rights of parents, held that the licensure requirement does not implicate a fundamental right, and thus rational-basis review applied. The Court found that standard was met and concluded that the state has a legitimate interest – the health and safety of the public – and the legislature’s decision to require licensure serves that interest.

The Court’s decision to dismiss this lawsuit reinforces New Jersey’s authority to regulate the practice of medicine within its borders, including the means by which out-of-state physicians may offer telehealth services within the State of New Jersey.