Finding a New Paradigm While the limitations of the current framework should be evident, a new fulcrum that balances employer interests, physician interests, and patient interests is not immediately apparent. Telemedicine, in its ability to expand access to healthcare and potentially reduce the costs of delivering care, is truly a disruptive technology, in the laudatory sense of the term, and like other industry disruptions, it is sending ripples through every arcane corner of the industry which will eventually settle into some new normal. In the interregnum, other areas may flare for example, there may be a greater focus on non-solicitation provisions or confidentiality provisions protecting proprietary business information as employers look for ways to shore up their business models. Regardless, it will continue to be an interesting topic to watch for business, employment, and healthcare attorneys, and will undoubtedly consume much time and attention and many billable hours. Dean Lhospital is Associate General Counsel for the University of Virginia Physicians Group, the faculty practice plan affiliated with UVA Health. Previously, he worked in UVA’s School of Medicine and in private practice in Charlottesville. He received his J.D. from George Mason University School of Law, where he was the Editor-in-Chief of the Journal of Law, Economics & Policy . Previous publica-tions have appeared in the Human Rights and Globalization Law Review , The Washington Post , and Virginia Lawyers Weekly . Endnotes 1 This article uses the definition of “telemedicine” provided in Va. Code Ann. § 38.2-3418.16: “[T]he use of electronic technology or media, including interactive audio or video, for the purpose of diagnosing or treating a patient or consulting with other health care providers regarding a patient’s diagnosis or treatment.” 2 Telehealth may see big long-term gains due to COVID-19: 10 observations. https://www.beckershospitalreview.com/telehealth/telehealth-may-see-big-long-term-gains-due-to-covid-19-10-observations.html (accessed November 11, 2020). 3 Billing and reimbursement during the COVID-19 Public Health Emergency, https://telehealth.hhs.gov/providers/billing-and-reimbursement/?section=1,6# private-insurance-coverage-for-telehealth (accessed November 11, 2020). 4 Policy changes during the COVID-19 Public Health Emergency, https:// telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency (accessed November 11, 2020). 5 Lacktman NM, Acosta JN, Levine SJ. 50-State survey of telehealth commercial payer statutes. https://www.foley.com/-/media/files/insights/health-care-law-today/19mc21486-50state-survey-of-telehealth-commercial.pdf (accessed November 11, 2020). 6 See Virginia Code § 38.2-3418.16 (D) providing that “[an] insurer, corporation, or health maintenance organization shall reimburse the treating provider or the consulting provider for the diagnosis, consultation, or treatment of the insured delivered through telemedicine services on the same basis that the insurer, corporation, or health maintenance organization is responsible for coverage for the provision of the same service through face-to-face consultation or contact.” 7 See Va. Code Ann. § 40.1-28.7:8. Available at https://law.lis.virginia.gov/ vacode/title40.1/chapter3/section40.1-28.7:8/ (accessed November 11, 2020). 8 Modern Env'ts, Inc. v. Stinnett , 263 Va. 491, 493, 561 S.E.2d 694, 695 (2002); Simmons v. Miller , 261 Va. 561, 580-81, 544 S.E.2d 666, 678 (2001). Omniplex World Services v. U.S. Inv. , 618 S.E.2d 340, 270 Va. 246 (2005). 9 Simmons v. Miller , 544 S.E.2d 666, 668, 261 Va. 561, 563 (2001); Advanced Marine Enterprises v. PRC Inc., 256 Va. 106, 118, 501 S.E.2d 148, 155 (1998). 10 Blue Ridge Anesthesia v. Gidick, 239 Va. 369, 371-72, 389 S.E.2d 467, 468-69 (1990); Simmons v. Miller, 544 S.E.2d 666, 261 Va. 561 (2001). 11 See American Medical Association Code of Medical Ethics Opinion 11.2.3.1, providing: Competition among physicians is ethically justifiable when it is based on such factors as quality of services, skill, experience, conveniences offered to patients, fees, or credit terms. Covenants-not-to-compete restrict competition, can disrupt continuity of care, and may limit access to care. Physicians should not enter into covenants that: 1. Unreasonably restrict the right of a physician to practice medicine for a specified period of time or in a specified geographic area on termination of a contractual relationship; and 2. Do not make reasonable accommodation for patients’ choice of physician. Physicians in training should not be asked to sign covenants not to compete as a condition of entry into any residency or fellowship program. 12 Blue Ridge Anesthesia v. Gidick , 239 Va. 369, 371-72, 389 S.E.2d 467, 468-69 (1990). Simmons v. Miller , 544 S.E.2d 666, 261 Va. 561 (2001). 13 Virginia Board of Medicine Guidance Document 85-12. Available at https:// www.dhp.virginia.gov/medicine/guidelines/85-12.pdf (accessed November 10, 2020). www.vsb.org THE HEALTH LAW ISSUE | VOL. 69 | FEBRUARY 2021 | VIRGINIA LAWYER 21