The DEA recently passed a temporary rule, Temporary Extension of COVID19 Telemedicine Flexibilities for Prescription of Controlled Medications, in response comments received from previously proposed rules.
According to the Center for Connected Health Policy, the temporary rule is issued jointly between the DEA and the Substance Abuse and Mental Health Services Administration (SAMHSA) and includes the following:
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.
Additionally, for any practitioner-patient telemedicine relationships that have been or will be established on or before November 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID-19 PHE will continue to be permitted via a one-year grace period through November 11, 2024. In other words, if a patient and a practitioner have established a telemedicine relationship on or before November 11, 2023, the same telemedicine flexibilities that have governed the relationship to that point are permitted until November 11, 2024.
The temporary rule goes into effect on May 12, 2023 (the first day after the PHE expires) and will expire at the end of the day on November 11, 2024. The COVID prescribing flexibilities for telehealth, which include only seeing patients via telehealth and the ability to prescribe buprenorphine based on an audio-only interaction, are only extended for an additional six months under this temporary rule. What that means is that telehealth providers may still prescribe controlled substances during this time without having had an in-person exam with the patient and a patient-provider relationship can be established in this way. However, this is only for six months after the end of the PHE.
If a telehealth provider established a relationship with a patient during the COVID PHE and in the six-month post-PHE grace period, they may continue to prescribe without having met that in-person exam requirement for an additional year (until November 11, 2024). This additional one-year grace period from November 12, 2023 to November 11, 2024 is meant to give practitioners 12 months to meet that in-person exam requirement. 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.
The DEA will approve final regulations for prescribing via telehealth, but this temporary stay will be in place as that is being worked upon. One other item of interest is that the two end dates noted in this temporary rule are in November, which typically is around the time that the Centers for Medicare and Medicaid Services (CMS) finalize their Physician Fee Schedule proposals for the following year. This may be an indication that different federal agencies are trying align their timing on post-PHE policy decisions. For more information, read the DEA’s full temporary rule.
https://public-inspection.federalregister.gov/2023-09936.pdf
