Virginia Telehealth Network

DEA Grants Second Temporary Extension of Telemedicine Flexibilities for Prescribing Controlled Substances

The Drug Enforcement Administration (DEA) recently announced another extension of the temporary telehealth rules for prescribing controlled substances. The first extension was announced earlier this year, just ahead of the end of the Public Health Emergency.

In this blog post, we’ll explore the key points of this extension and the implications for health care providers and patients.

Recap of Interim Rules

On October 6, DEA and HHS announced they are extending the remote prescription of controlled substances flexibilities that existed during the COVID-19 public health emergency through CY2024. The DEA has also signaled its consideration of a separate Special Registration for telemedicine prescribing without requiring an in-person examination.

The interim rules were originally introduced to address the unprecedented challenges posed by the COVID-19 pandemic. They presented health care providers with flexibilities when prescribing controlled substances via telehealth, thereby reducing the need for in-person visits. This was not only a response to pandemic-related restrictions but also an acknowledgment of the growing importance of telemedicine in health care.

The amended interim rule specifically states, “during the period November 12, 2023 through November 11, 2024, a DEA-registered practitioner is authorized to prescribe schedule II–V controlled substances via telemedicine to a patient with whom the practitioner has a telemedicine relationship established via COVID–19 telemedicine prescribing flexibilities without having conducted an in-person medical evaluation of a patient” if the following conditions are met:

  1. The prescription must serve a legitimate medical purpose within the practitioner’s usual course of professional practice.
  2. The prescription must result from a communication between the practitioner and the patient through an interactive telecommunications system.
  3. The practitioner must either be authorized under their registration to prescribe the specific class of controlled substance or be exempt from obtaining a registration to dispense controlled substances.
  4. The prescription must adhere to all other requirements outlined in 21 CFR part 1306.

This extension is a response to ongoing considerations and discussions between the DEA and the Department of Health and Human Services (HHS) regarding revisions to the proposed rules set forth in the March 1, 2023 Notice of Proposed Rulemaking (NPRM).

The extension’s timing aligns with the Telemedicine Listening Sessions that the DEA hosted last month on September 12 and 13. These sessions served as a platform for stakeholders to discuss the impact and implications of telemedicine regulations, especially in the context of controlled substances prescriptions.

Implications of the Extension

  1. Improved Patient Access: The extension of these telehealth rules will continue to ensure that patients, especially those in remote or underserved areas, have access to essential medications without the need for in-person visits.
  2. Convenience and Efficiency: Health care providers can continue to utilize telemedicine as a convenient and efficient way to connect with patients and prescribe controlled substances when necessary.
  3. Regulatory Flexibility: The ongoing discussions between the DEA and HHS suggest that regulations may be fine-tuned to better accommodate the evolving landscape of telemedicine and controlled substance prescriptions.
  4. Ongoing Telemedicine Integration: This extension underscores the growing importance of telemedicine in the health care industry. As health care adapts to the digital age, telehealth will continue to play a crucial role in delivering patient care and managing prescriptions.

The DEA’s extension of pandemic-era telehealth rules for prescribing controlled substances through 2024 reflects the ongoing importance of telemedicine in modern health care.

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