The Drug Enforcement Administration today released rules regulating telemedicine and prescribing controlled substances. These rules, which are now open for public comment for 30 days, will take effect May 11, when the COVID-19 public health emergency (PHE) ends. Providers will have a grace period of 180 days from this date to comply with the new rules.
The DEA was required to create a special registration process for telemedicine prescribers since the Ryan Haight Act was passed in 2008. However, the DEA believes that creating such a process would place a significant administrative burden on providers. The proposed rules do not establish a special registration process, but instead regulate the prescribing of controlled substances via telehealth.
Under the new rules, a provider may prescribe controlled substances via telehealth if they have seen the patient in person, or if another DEA-licensed provider has seen the patient in person and refers them to the telehealth provider for treatment of the same condition. The maximum supply of controlled substances that may be prescribed via telehealth is 30 days for schedule III-V non-narcotics and buprenorphine. Providers must also comply with all state and federal laws related to licensing and DEA registration.
The rules also require all prescriptions to be submitted electronically, for all prescribers to have an NPI, and for all prescriptions to occur from a direct telemedicine interaction with a patient. Additionally, all prescribers must be physically located in the U.S.
The proposed rules regarding buprenorphine, a drug for treating opioid addiction, allow providers to prescribe it via telehealth if they have established a provider-patient relationship, with a maximum supply of 30 days for schedule III-V non-narcotics and buprenorphine. Providers may also prescribe buprenorphine via audio-only telehealth visit in locations where state law permits audio-only prescribing.
While the new rules are more restrictive than pandemic-era policy, they are somewhat less prohibitory than pre-pandemic policy. However, patients who have only established a relationship with their treating clinician via telehealth may lose access to care if they do not see a provider in person who will refer them to their telehealth provider.
The American Telemedicine Association (ATA) said it plans to submit formal comments to the rulemaking process and meet with the agencies and Congress to ensure that the new rules do not harm patient access to care. Read the DEA’s full announcement.
