Last year, we published this blog post about a case filed in the U.S. District Court for the District of New Jersey by two out-of-state physicians alleging that New Jersey’s telehealth licensure requirements were unlawful because they violated the physicians’ freedom of speech by preventing them from communicating with New Jersey residents without a valid in-state or telehealth license. That case was argued and ultimately dismissed by the District Court on May 12, 2025.

Thereafter, the physicians appealed the matter to the U.S. Court of Appeals for the Third Circuit, arguing that the District Court ruled incorrectly and seeking a reversal of the dismissal of their case.
The federal appellate panel in Philadelphia is now tasked with balancing the physicians’ free speech rights and New Jersey’s authority to regulate the practice of medicine. The panel is focused on the key question of how “treatment” should be defined and why a physician’s telemedicine conversation with a patient should not be considered part of the patient’s treatment. The physicians argued that the conversations are merely speech about treatment because you cannot treat cancer by talking. New Jersey’s Attorney General’s Office argued that telemedicine conversations are part of the treatment process and therefore professional conduct that can be regulated.

It remains to be seen how the Third Circuit will rule on the appeal, but the legal precedent and constitutional framework are likely to heavily favor preserving the authority of states to regulate the practice of medicine, which would mean affirming the District Court’s dismissal.

Even if the dismissal is upheld, this case underscores the ongoing push for healthcare across state lines and the efforts of providers to expand their ability to offer services to patients. These efforts will continue to be balanced against states’ obligations to ensure sufficient oversight to protect their residents and regulate the profession. While it is unlikely that the courts will ever eliminate the ability of states to require licenses and oversee the practice of medicine, the various compacts and interstate agreements allowing for telemedicine licenses across state lines are almost certain to continue to expand.