The Intersection of AI, Digital Health, and the TCPA: What You Need to Know – The National Law Review

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Artificial intelligence (AI) is widely transforming digital health, including by automating certain patient communications. However, as health care companies consider deploying AI-driven chatbots, texting platforms, and virtual assistants, they should not forget about the highly consequential, and highly litigated, Telephone Consumer Protection Act (TCPA).
Many digital health companies mistakenly assume that they only need to consider the Health Insurance Portability and Accountability Act (HIPAA) when considering whether to text or otherwise communicate with patients via various means. HIPAA governs the privacy and security of protected health information. The TCPA, by contrast, protects consumer rights around how and why patients are contacted.
The TCPA has become a key regulatory consideration for any digital health company that uses technology to communicate with patients by telephone or text message. As AI enables more scalable and automated outreach, understanding the TCPA’s boundaries is key to ensuring regulatory compliance and avoiding costly litigation.
The TCPA restricts certain calls and texts made using an “automatic telephone dialing system” (ATDS), as well as prerecorded or artificial voice messages, without prior express consent. When such communications are made for marketing purposes, prior express written consent may be required. Even health care companies that use AI-powered systems to send appointment reminders, refill prompts, or wellness check-ins by telephone or text — as opposed to marketing, user engagement, or upselling services — may fall within the TCPA’s scope, especially if those communications are automated. Note that although the TCPA includes exemptions for certain health care messages, there are numerous parameters for meeting this exception and we urge caution in relying on it.
Even though the Supreme Court’s 2021 decision in Facebook v. Duguid narrowed the definition of an ATDS, TCPA compliance remains a moving target. Further, some states have their own version of the TCPA that may define ATDS or similar technology in a different way. This creates real legal risk even for digital health companies with no robocall or telemarketing intent.
One of the most pressing legal questions, and a focus of plaintiffs’ attorneys, is whether AI-powered voicebots or chatbots qualify as “artificial or prerecorded voice” communications under the TCPA. Although the Federal Communications Commission’s (FCC) 2024 ruling clarified that AI-generated voices fall into this definition, reaffirming that these types of communications are subject to the TCPA’s consent requirements, the legal landscape remains unsettled.
Courts continue to wrestle with how this interpretation applies to emerging technologies like chatbots, especially text-based systems that do not emit sound but still automate patient communication. Some plaintiffs argue that such AI technology, even if it responds dynamically to user input, meets the statutory definition of “artificial voice” because it lacks a live human on the line. If courts agree, this could impose significant restrictions on AI-driven patient engagement tools unless proper consent is obtained.
The FCC’s authority, although influential, does not fully preempt judicial interpretation, and differing court decisions may shape how the TCPA applies to various forms of AI-powered communication. As a result, companies must stay alert to both regulatory guidance and case law developments.
Below are four practical steps to stay on the right side of TCPA compliance in the AI era:
1. Conduct a TCPA Risk Assessment
2. Audit Your Consent Flows
3. Consent is King
4. Monitor Litigation Trends
AI is revolutionizing patient communication, but it can also amplify regulatory exposure. The TCPA remains a favorite tool for class-action lawsuits, and digital health companies should treat it with the same seriousness as they treat their HIPAA compliance.
As AI capabilities grow, the gap between innovation and regulation is widening. Thoughtful contracting, consent design, and legal review can help digital health companies lead with compliance, while still delivering smarter, scalable care.
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Under certain state laws, the following statements may be required on this website and we have included them in order to be in full compliance with these rules. The choice of a lawyer or other professional is an important decision and should not be based solely upon advertisements. Attorney Advertising Notice: Prior results do not guarantee a similar outcome. Statement in compliance with Texas Rules of Professional Conduct. Unless otherwise noted, attorneys are not certified by the Texas Board of Legal Specialization, nor can NLR attest to the accuracy of any notation of Legal Specialization or other Professional Credentials.
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Find Your Next Job !
Artificial intelligence (AI) is widely transforming digital health, including by automating certain patient communications. However, as health care companies consider deploying AI-driven chatbots, texting platforms, and virtual assistants, they should not forget about the highly consequential, and highly litigated, Telephone Consumer Protection Act (TCPA).
Many digital health companies mistakenly assume that they only need to consider the Health Insurance Portability and Accountability Act (HIPAA) when considering whether to text or otherwise communicate with patients via various means. HIPAA governs the privacy and security of protected health information. The TCPA, by contrast, protects consumer rights around how and why patients are contacted.
The TCPA has become a key regulatory consideration for any digital health company that uses technology to communicate with patients by telephone or text message. As AI enables more scalable and automated outreach, understanding the TCPA’s boundaries is key to ensuring regulatory compliance and avoiding costly litigation.
The TCPA restricts certain calls and texts made using an “automatic telephone dialing system” (ATDS), as well as prerecorded or artificial voice messages, without prior express consent. When such communications are made for marketing purposes, prior express written consent may be required. Even health care companies that use AI-powered systems to send appointment reminders, refill prompts, or wellness check-ins by telephone or text — as opposed to marketing, user engagement, or upselling services — may fall within the TCPA’s scope, especially if those communications are automated. Note that although the TCPA includes exemptions for certain health care messages, there are numerous parameters for meeting this exception and we urge caution in relying on it.
Even though the Supreme Court’s 2021 decision in Facebook v. Duguid narrowed the definition of an ATDS, TCPA compliance remains a moving target. Further, some states have their own version of the TCPA that may define ATDS or similar technology in a different way. This creates real legal risk even for digital health companies with no robocall or telemarketing intent.
One of the most pressing legal questions, and a focus of plaintiffs’ attorneys, is whether AI-powered voicebots or chatbots qualify as “artificial or prerecorded voice” communications under the TCPA. Although the Federal Communications Commission’s (FCC) 2024 ruling clarified that AI-generated voices fall into this definition, reaffirming that these types of communications are subject to the TCPA’s consent requirements, the legal landscape remains unsettled.
Courts continue to wrestle with how this interpretation applies to emerging technologies like chatbots, especially text-based systems that do not emit sound but still automate patient communication. Some plaintiffs argue that such AI technology, even if it responds dynamically to user input, meets the statutory definition of “artificial voice” because it lacks a live human on the line. If courts agree, this could impose significant restrictions on AI-driven patient engagement tools unless proper consent is obtained.
The FCC’s authority, although influential, does not fully preempt judicial interpretation, and differing court decisions may shape how the TCPA applies to various forms of AI-powered communication. As a result, companies must stay alert to both regulatory guidance and case law developments.
Below are four practical steps to stay on the right side of TCPA compliance in the AI era:
1. Conduct a TCPA Risk Assessment
2. Audit Your Consent Flows
3. Consent is King
4. Monitor Litigation Trends
AI is revolutionizing patient communication, but it can also amplify regulatory exposure. The TCPA remains a favorite tool for class-action lawsuits, and digital health companies should treat it with the same seriousness as they treat their HIPAA compliance.
As AI capabilities grow, the gap between innovation and regulation is widening. Thoughtful contracting, consent design, and legal review can help digital health companies lead with compliance, while still delivering smarter, scalable care.
More Upcoming Events
Sign Up for any (or all) of our 25+ Newsletters
You are responsible for reading, understanding, and agreeing to the National Law Review’s (NLR’s) and the National Law Forum LLC’s Terms of Use and Privacy Policy before using the National Law Review website. The National Law Review is a free-to-use, no-log-in database of legal and business articles. The content and links on www.NatLawReview.com are intended for general information purposes only. Any legal analysis, legislative updates, or other content and links should not be construed as legal or professional advice or a substitute for such advice. No attorney-client or confidential relationship is formed by the transmission of information between you and the National Law Review website or any of the law firms, attorneys, or other professionals or organizations who include content on the National Law Review website. If you require legal or professional advice, kindly contact an attorney or other suitable professional advisor.
Some states have laws and ethical rules regarding solicitation and advertisement practices by attorneys and/or other professionals. The National Law Review is not a law firm nor is www.NatLawReview.com intended to be a referral service for attorneys and/or other professionals. The NLR does not wish, nor does it intend, to solicit the business of anyone or to refer anyone to an attorney or other professional. NLR does not answer legal questions nor will we refer you to an attorney or other professional if you request such information from us.
Under certain state laws, the following statements may be required on this website and we have included them in order to be in full compliance with these rules. The choice of a lawyer or other professional is an important decision and should not be based solely upon advertisements. Attorney Advertising Notice: Prior results do not guarantee a similar outcome. Statement in compliance with Texas Rules of Professional Conduct. Unless otherwise noted, attorneys are not certified by the Texas Board of Legal Specialization, nor can NLR attest to the accuracy of any notation of Legal Specialization or other Professional Credentials.
The National Law Review – National Law Forum LLC 2070 Green Bay Rd., Suite 178, Highland Park, IL 60035 Telephone (708) 357-3317 or toll-free (877) 357-3317. If you would like to contact us via email please click here.
Copyright ©2025 National Law Forum, LLC