Rapid technological advances make telehealth a moving target for regulators. This study examines the scope and evolving nature of telehealth statutes (i.e., laws passed by state legislatures) and regulations (i.e., laws promulgated by state executive agencies) in the U.S. Our research aims to understand changes in telehealth laws over time (2008-2015), variations in legal frameworks established across the U.S., and the extent that state laws regulate the primary care delivery through the use of telehealth. We found that the number of states with broadly worded laws that authorize a variety of healthcare professional to provide care via telehealth more than tripled between 2008 and 2015 (from 3 to 10). A legal analysis suggests that enabling regulations on telehealth payment for Medicaid are relatively rare in the eastern U.S. and that laws governing private insurance telehealth payments are more geographically defused. Examining differences in the adoption of telehealth laws by state proportions on rurality and urbanicity indicates that states with large urban populations also see the utility of a regulatory environment supports telehealth as an avenue for increased access to care for rural residents.