DDAP Issues Alert Detailing NTP Exception, Allows Telehealth for Initial Screening and Physical Exam

The Pennsylvania Department of Drug and Alcohol Programs (DDAP) today issued Licensing Alert 01-2025 to update statewide exceptions granted to narcotic treatment programs (NTP) in September 2024 to expand access to medication for the treatment of opioid use disorder (MOUD). Specifically, this alert expands the exceptions to allow expanded use of telehealth in initial screening and physical examinations consistent with medical practice regulations of the State Board of Medicine.

Effective December 21, 2024, the State Board of Medicine amended its regulation regarding prescribing, administering, and dispensing controlled substances. The updated regulation mirrors federal regulations by allowing regulated practitioners in NTPs to conduct initial physical examinations by telehealth and initiate treatment with buprenorphine or methadone in compliance with federal requirements and requires an in-person physical examination to be completed within 14 days after admission. Therefore, DDAP is also granting an exception to 28 Pa. Code § 715.9(a)(4), which is the rule that requires a face-to-face determination be made as to whether a person has been dependent on a narcotic drug for at least one year prior to starting MOUD, provided that the NTP has a trained person to diagnose the client using medical criteria in accordance with 42 CFR § 8.12(e)(1) and documents the reason for admission for MOUD treatment in the record. DDAP will allow telehealth for the initial screening and medical examination provided that the clinician determines that they can complete an adequate examination through that method, that the mode of telehealth is permissible for the MOUD to be used in accordance with 42 CFR 8.12(f)(2)(v), and that the NTP completes a full in-person physical examination within 14 days of admission in accordance with 42 CFR 8.12(f)(2)(iii).

DDAP first granted statewide exceptions based on 42 CFR part 8 through Licensing Alert 07-2024. Today’s Licensing Alert 01-2025 rescinds and replaces Licensing Alert 07-2024.

Federal regulations continue to require NTPs and clinicians to comply with pertinent state laws and regulations.

To review all of the exceptions DDAP is granting NTPs, read Licensing Alert 01-2025.

There is no need for NTPs to submit exception requests or to inform the DDAP if they are using these exceptions.