1. Choose a legal structure with healthcare counsel
Many states restrict who can own a medical practice or employ physicians, a doctrine called the corporate practice of medicine. Non-physician founders often separate a management company from a physician-owned practice. Your states decide what you need, so hire counsel with telehealth experience before you sign anything else.
2. Decide what care you will offer
The care model sets the rules you follow. Compounded medications bring in section 503A and state pharmacy law. FDA-approved medications sold through retail pharmacies follow a different path. Controlled substances add DEA rules. Choose the narrowest offer your audience will buy, then expand.
3. Secure prescribers in each state
A prescriber generally needs authority to practice in the state where the patient is located. You can employ clinicians, contract a clinical group or use a network. Our guide to multi-state licensing explains how coverage gets built.
4. Contract a licensed pharmacy
For compounded care, you need a 503A pharmacy licensed in, or registered to ship to, each state you serve. Ask for its licenses, inspection history and how it tests what it makes.
5. Build intake, prescriptions and patient records
You need a clinical intake, a way for prescribers to review it, prescriptions a pharmacy can rely on, and storage for patient data with access controls and logs. Have counsel confirm where HIPAA applies to you and put the right agreements in place with every vendor that touches patient data.
6. Set up payments
Card processors review telehealth and pharmacy merchants closely, so expect underwriting questions about your products, prescribers and pharmacy. A hosted checkout keeps card numbers off your own servers, which narrows your PCI scope.
7. Get your marketing reviewed before you launch
FDA and the FTC both police health claims. FDA sent 30 warning letters to telehealth companies on March 3, 2026 over misleading compounded drug marketing, and the FTC expects substantiation for health claims. Ad platforms add their own rules: Google uses LegitScript certification in its telemedicine policy, and requirements differ by platform and country, so check the current policy before you set a budget.
Can you start without building all of this?
Yes. A white-label platform covers steps 3 to 6 and leaves you the brand and the demand. You still need counsel for step 1 and honest copy for step 7. SourceRX is one such platform, open to approved businesses.
Sources
- FDA, Compounding and the FDA: Questions and Answers
- FTC, Health Products Compliance Guidance
- Foley & Lardner, FDA Targets Telehealth Marketing in 30 New Warning Letters (March 2026)
- LegitScript, Certified but still getting disapproved: telehealth advertising takeaways
- Interstate Medical Licensure Compact Commission
General information, not legal or medical advice. Rules vary by state and change over time, so have healthcare counsel review your plans.