Free 51-jurisdiction dataset maps compact licensing, telehealth registration, nurse practitioner authority and MSO rules for white-label virtual clinics and digital health startups. Only 14 states offer out-of-state physicians a telehealth registration or telemedicine license.
WILMINGTON, Del., Sept. 27, 2026 /PRNewswire/ — Cuvo Health, the white label telehealth platform operated by Medstra Inc., today published the 2026 State-by-State Virtual Clinic Compliance Report, a dataset covering all 50 states and the District of Columbia that shows how state licensing, practice-ownership and scope-of-practice rules shape where and how a telehealth brand can launch. The report and its full dataset are free to download and cite at https://cuvo.co/blog/virtual-clinic-compliance-report-2026.
Cuvo Health compiled the report from primary sources as of Sept. 27, 2026: the Interstate Medical Licensure Compact Commission, the PA Licensure Compact commission, the American Association of Nurse Practitioners, the National Council of State Boards of Nursing, state statutes and medical board rules, court decisions, and attorney general opinions. Every row in the dataset lists its source.
Key findings
- 41 of 51 jurisdictions issue physician licenses through the Interstate Medical Licensure Compact. Four more (Alaska, Arkansas, New Mexico and Rhode Island) have enacted it but are not issuing licenses yet, and California, Massachusetts, New York, Oregon, South Carolina and Virginia remain outside it.
- Initial compact licensing for one MD across all 41 issuing jurisdictions costs $18,542.50 in state and Commission fees, before renewals, which each state board sets on its own schedule.
- Only 14 states offer an out-of-state physician a telehealth registration or telemedicine license short of full licensure. In 20 jurisdictions, an out-of-state physician may do little more than consult with a physician licensed in the state.
- 19 states enforce a strong corporate practice of medicine prohibition, including six of the ten most populous, 7 apply a limited version, and 7 remain unsettled. Only 18 have no general prohibition, which makes a management services organization with a physician-owned professional entity the conservative structure for a non-physician founder in most of the country.
- Arkansas, California, Massachusetts and New York combine a strong corporate-practice rule, no live compact license and only narrow telehealth exceptions.
- 28 jurisdictions grant nurse practitioners full practice authority, 12 reduce it and 11 restrict it. The APRN Compact has 4 of the 7 states it needs to take effect, and the PA Licensure Compact, with 29 member states, is not yet issuing privileges.
- Oregon SB 951 and California SB 351 now limit how management services organizations and private equity owners may control physician practices, and the California Attorney General settled corporate-practice cases with Aspen Dental and Carbon Health in 2026.
“Every founder we speak with asks how fast they can launch nationally, and the answer depends on 51 separate rulebooks,” said Fen Haines, Vice President, Operations, Cuvo Health. “A national brand needs a licensed prescriber in every patient’s state, an ownership structure that satisfies each state’s corporate-practice rules, and a nurse practitioner model that changes at state lines. We published the dataset so founders can see those rules before they decide how to build.”
The report also covers the federal rules every telehealth platform shares. Under HIPAA, a breach of unsecured protected health information must be reported to affected individuals within 60 days, and breaches of 500 or more people to HHS at the same time. The FTC Health Breach Notification Rule applies the same 60-day window to health apps and services outside HIPAA. Breach readiness has become a practical buying criterion: OpenLoop Health, Inc. filed a data breach notification with the California Attorney General for a Jan. 7, 2026 incident, which HIPAA Journal reported affected up to 716,000 individuals. The report also notes that the DEA’s telemedicine flexibilities for prescribing controlled substances remain in effect through Dec. 31, 2026.
Cuvo Health operates the infrastructure the report describes for the brands on its platform:
- A network of more than 300 board-certified physicians, nurse practitioners and physician assistants licensed across all 50 states, DC and the US territories;
- The management services organization and physician-owned professional entity, built and maintained by Cuvo;
- E-prescribing over the Surescripts network, fulfillment through 17 partner pharmacies, and an API that supports ONC FHIR interoperability standards;
- HIPAA-compliant infrastructure with business associate agreements, SOC 2 Type II on higher tiers, and a documented FTC Health Breach Notification Rule process.
A typical brand launches on Cuvo in under 30 days at a published $25 per completed consult, with 0% medication markup and no revenue share.
The full report, including the 51-row table, methodology and sources, is available at https://cuvo.co/blog/virtual-clinic-compliance-report-2026. The dataset can be downloaded as a CSV at https://cuvo.co/data/cuvo-2026-state-virtual-clinic-compliance.csv and reused with attribution to Cuvo Health. The report is informational and does not constitute legal advice.
About Cuvo Health
Cuvo Health is a white label telehealth platform that operates the licensed clinic behind consumer health brands: licensed providers in all 50 states, pharmacy fulfillment, patient software, and the regulatory compliance structure, so a brand can launch virtual care under its own name. Brands pay a published $25 per completed consult with 0% medication markup and no revenue share. Cuvo Health is operated by Medstra Inc., doing business as Cuvo Health, 901 N Market Street, Suite 100, Wilmington, Delaware 19801. Learn more at https://cuvo.co.
Media Contact
Cuvo Health Media Relations
contact@cuvo.co
(877) 800-3088
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SOURCE Cuvo Health
