All we read about is PPACA. But rest assured there are other threats to the benefits business.

One such threat has emerged in the unlikeliest of places — Texas — where a quiet, but pitched, battle rages on over the future of telemedicine.

After the American Medical Association last year released a formal telemedicine policy requiring that physicians meet with patients personally before engaging in any remote diagnosis and/or treatment, the Texas Medical Board decided to follow suit.

“We believe that a patient-physician relationship must be established to ensure proper diagnoses and appropriate follow up care,” AMA President Dr. Robert M. Wah said in a statement at the time. “This new policy establishes a foundation for physicians to utilize telemedicine to help maintain an ongoing relationship with their patients, and as a means to enhance follow-up care, better coordinate care and manage chronic conditions.”

“Now after over a decade of this being offered in Texas and over 8 million members with one vendor I work with and zero malpractice claims, it is being threatened,” worries broker Tanya Boyd. “It makes no sense to me as other states are trying to implement more. I could go on and on about the stories from clients because they’re truly endless.”

As reported by a number of media outlets, including the Texas Tribune, the ruling has been winding its way through state courts as telemedicine companies fight to keep doing business while regulators struggle to tighten their grip on an emerging industry.

“The crux is that at a time of skyrocketing out-of-pocket costs, we need more ways to access care for simpler issues, not less,” freshbenies owner Reid Rasmussen explained. “When other states and the federal government are expanding the appropriate use of telehealth to reduce unnecessary emergency room visits, urgent care center visits, or doctor office visits — now is not the time Texas should be limiting it.”

According to Rasmussen, only two other states — Arkansas and Idaho — have such Draconian limits on telemedicine. And Idaho lawmakers are working on legislation right now to repeal that ban.

But unlike with PPACA, brokers — and anyone else in the business — can help decide this case. The Texas Medical Board will meet in April to finally settle this issue. At least until the courts get involved again.

“The key is that we need to email the Texas Medical Board our disapproval by April 4,” Rasmussen said. “If they don’t hear from us, they’re going to stop allowing it.”