DEA Extends Telemedicine Prescribing Flexibilities Through 2026
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Just before the clock struck midnight on the New Year, the DEA issued a long-awaited formal statement clarifying the federal rules for prescribing controlled substances through telemedicine in the coming year.
Since May 2023, the U.S. Drug Enforcement Agency (DEA) has repeatedly extended the COVID-19 telemedicine flexibilities for prescribing controlled substances, which had been set to expire at the end of the federal COVID Public Health Emergency (PHE). The flexibilities affected an important requirement of The Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which requires prescribers to conduct an in-person examination (i.e. in a medical office) to evaluate each new patient at least once before prescribing a controlled substance, such that the initial examination can be conducted through real-time videoconferencing.
On December 31st the DEA issued a Fourth Temporary Extension of the COVID-19 Telemedicine Flexibilities for the Prescription of Controlled Medications, extending the current telemedicine flexibilities through December 31, 2026.
Additionally, the Department of Health and Human Services (HHS) recently extended telehealth flexibilities for Medicare services to January 31, 2026.
The repeated extensions of COVID-era flexibilities for controlled substance prescribing have occurred amid proposals for a permanent rule change for telemedicine prescribing; however, provisions that would still require in-person visits for Schedule II and opioid medications have been met with substantial resistance from the medical community. As the DEA continues to work on a permanent rule change, there is the likelihood that new rules will involve a special telemedicine registration process for controlled substance prescribing.
Currently, prescribers are still able to continue seeing new patients and prescribing controlled substances through real-time videoconferencing, without the need for an in-person medical evaluation- as long as those prescriptions are otherwise legitimate and appropriate, and within the course and scope of the prescriber’s medical practice.
Finally, it is especially important to note that these requirements only address federal law under the Controlled Substance Act. Additionally, controlled substance prescribers must always:
- Ensure that they are properly licensed, or have legal practice authority, in the state in which the patient is physically located at the time of treatment or prescription.
- Be aware of and comply with state laws pertaining to controlled substances.
- Comply with all applicable standards of care, including conducting in-person evaluations when appropriate, even if not specifically required by law.
MIEC will continue to keep our members updated with additional developments on this important topic. For previous updates and more information on controlled substances and telehealth, see:
DEA Extends Covid-19 Telehealth Prescribing Flexibilities for Another Year.