The Drug Enforcement Agency (DEA) issued a temporary rule extending the allowance for physicians and practitioners to prescribe controlled medications to new patients based on a relationship solely established through telemedicine (live video or telephone for buprenorphine) until December 31, 2024. The extension will give the DEA time to consider permanent changes to their rules around prescribing controlled substances moving forward.

Key concerns from stakeholders expressed during the listening sessions were related to in-person visit requirements, the 30-day prescribing limit in the initially proposed rules, and adding various reporting requirements, such as notating on prescriptions that they were prescribed via telemedicine. The rule itself lists additional reasons the extension is being issued:

• “Prevent a reduction in access to care for patients who do not yet have an existing telemedicine relationship;
• For relationships established both during the COVID-19 PHE and those established shortly after, prevent backlogs with respect to in-person medical evaluations in the months shortly before and after the expiration of the telemedicine flexibilities;
• Address the urgent public health need for continued access to the initiation of buprenorphine as medication for opioid use disorder in the context of the continuing opioid public health crisis;
• Allow patients, practitioners, pharmacists, service providers, and other stakeholders sufficient time to prepare for the implementation of any future regulations that apply to prescribing of controlled medications via telemedicine; and
• Enable DEA, jointly with HHS, to conduct a thorough evaluation of regulatory alternatives in order to promulgate regulations that most effectively expand access to telemedicine encounters in a manner that is consistent with public health and safety, while also effectively mitigating against the risk of possible diversion.

RCPA will continue its advocacy work in partnering with the National Council on Mental Wellbeing to support the flexibility becoming part of reimagined legislation. Also, RCPA will continue its efforts on the current appeal it has filed with the DEA and OMHSAS to provide regulatory clarification on the licensing classification for those provider members who submitted applications for DEA Site Registration to disseminate Controlled Substances under the titled Act of 1970.

If you have questions, please contact RCPA Policy Director Jim Sharp.