DEA buys time on proposed telehealth rules for controlled drugs

This is. Big, Very Big

Fierce Telehealth reports. 

Facing major backlash to its proposed rules released in February, the Drug Enforcement Administration (DEA) is looking to buy some time to reconsider whether it should enforce stricter limits around the prescribing of controlled substances via telehealth. 

The Biden administration said at the time that the new rule seeks to provide safeguards to prevent online over-prescribing of controlled medications. Teleprescribing has been touted as a robust tool for bringing medications for opioid use disorder (MOUDs) to rural areas in the ongoing treatment of the opioid epidemic. 

The agency received a record 38,000 comments on its proposed telemedicine rules, according to a statement from the DEA Administrator 

Last week, the DEA filed a draft temporary rule with the Office of Management and Budget titled “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications.”

Milgram said further details about the rule will become public after its full publication in the Federal Register.

The DEA issued proposed rules three months ago that would reinstate strict limitations on the virtual prescribing of controlled substances and roll back telehealth flexibilities extended during the COVID-19 pandemic. The proposed rules would once again require patients to be evaluated in person by a doctor to receive prescriptions for some controlled substances (PDF) including stimulants like Adderall and opioids

Provider groups, telehealth advocates, and patients submitted comments largely panning the proposal, arguing that it would create barriers to care. 

Under the proposed rule, Schedule 2 medications or narcotics would require (PDF) an in-person prescription. Schedule 3 or higher medications, including buprenorphine, can be prescribed for 30 days via telehealth but would require an in-person visit before a refill. Non-narcotic drugs like Ambien, Valium, Xanax, and ketamine also fall into this category. If a patient is referred to a provider, an in-person appointment is not required as long as one took place with the referring physician.

If a telemedicine relationship was established during the COVID-19 public health emergency, the DEA will extend the in-person exam waiver for an additional 180 days.

DEA buys time on proposed telehealth rules for controlled drugs