Two days before a proposed rule change by the Drug Enforcement Administration (DEA) regulating the prescribing of controlled substances via telemedicine was set to take effect, the agency issued a temporary rule to extend COVID-era telehealth prescribing flexibilities for another six months, through November 11, 2023.
Apparently, the DEA was listening. The agency received some 38,000 comments during the 30-day feedback period, which the DEA said was a record number. Given the reprieve, it’s logical to assume that the comments succeeded in persuading the DEA to maintain – at least for now – many flexibilities surrounding the prescribing of drugs by way of telehealth, changes that were put in place during the Public Health Emergency (PHE).
“Providers across the Commonwealth have been preparing for a new era in health care: the post-PHE transition,” said Mara Servaites, VTN Executive Director. “With continued uncertainty regarding some tele-prescribing rules proposed by the DEA, we’re relieved to see the last-minute extension of flexibilities issued this week so that providers and patients have more time to prepare for any future changes.”
What You Need to Know
- The temporary rule goes into effect May 12, 2023 and expires at the end of the day on November 11, 2023.
- The full set of telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID-19 PHE will remain in place through November 11, 2023.
- If a provider-patient telemedicine relation is established on or before November 11, 2023, the full set of COVID-19 PHE telemedicine flexibilities regarding prescription of controlled medications will continue to be permitted via a one-year grace period through November 11, 2024.
- For new patients having an initial visit after November 11, 2023, there will likely be additional requirements forthcoming pending the DEA’s release of a final rule.
- For more information, read the DEA’s full temporary rule.
When the extended flexibilities end, industry experts anticipate a full extension of the DEA’s existing proposed rules.
Permanent Rules to Come
In February, the DEA had proposed making permanent some of the accommodations enacted during the pandemic but discontinuing others. One proposed rule, for example, would no longer allow telehealth providers to prescribe controlled substances if the patient never had an in-person examination (with some exceptions). According to DEA Administrator Anne Milgram, the agency wants to move forward in a way that “give[s] Americans access [but] with appropriate safeguards.”
Based on public statements from the DEA, the agency is seeking to find a workable balance between concerns over the potential abuse of tele-prescriptions and the need for continued access to medically necessary medications via telehealth.
And so, the DEA will now go about determining just what those safeguards should be on a more permanent basis. We should know more later this fall prior to the new November 11 expiration date.
In the meantime, telemedicine providers who prescribe controlled substances can continue operating as they have been over the past few years. That means that providers may extend prescriptions for patients that had been receiving them for an additional 180 days without an in-person exam. And as has been the case, any prescription beyond a 30-day supply will require an in-person visit.
To stay informed about the DEA’s proposed rule, the end of the PHE, and other legislative updates impacting telehealth usage in the Commonwealth, sign up for VTN updates.