The coronavirus pandemic affected how healthcare is provided immensely. In the United States, one of the issues the Drug Enforcement Agency (DEA) was forced to address was the need for providers to still meet with their patients and get patients their necessary controlled substance prescriptions, even amidst lockdowns. Therefore, the Controlled Substances Act underwent great changes, allowing telemedicine doctors to prescribe controlled substances via telemedicine without an in-person appointment.
While pandemic restrictions have been slowly lifted over the past few years, individuals who would be high risk for Covid-19 are still proceeding with caution. With the public health emergency ending in May of 2023, the DEA is proposing a revision of prescribing rules. These changes won’t make controlled drugs prescribed by telemedicine inaccessible, but patients and providers alike will possibly have to meet some more stringent requirements.
Telemedicine Exceptions
The key detail that will determine whether the new rules apply is if the patient and provider met in person or had a telemedicine appointment. If the medical appointment has been held in person in the past, providers can continue to prescribe controlled medications without concern for the rule changes or exceptions. On the other hand, if the provider and patient have only met virtually, the sole exceptions to getting controlled substances via telemedicine prescribed are:
- Initial 30-day supplies of Schedule III, IV, or V non-narcotic controlled medications
- Buprenorphine for the treatment of opioid use disorder
Proposed Telemedicine Rules
If the patient and provider met virtually and do not meet these two exceptions, they need to be prepared for the changes on the horizon. First, providers and patients who developed relationships through telemedicine during the pandemic will be required to hold an in-person appointment within 180 days of the new rules being published. This could create an issue for telemedicine relationships that span different states. Patients that meet this criterion need to discuss with their provider the possibility of switching to a local provider or at least visiting with a local provider with a referral to avoid a lapse in prescriptions.
The second greatest area of concern is the location where providers are registered with the DEA to prescribe controlled substances through online distributors. Just being registered in the state where the provider is physically practicing won’t be enough when the new rules are published. Instead, the provider must be registered in both their own state and the states where their patients are physically located. Providers, especially those that practice primarily by telemedicine, need to make arrangements with the DEA in those states or be alerted that they need to find a local prescriber, again, in order to avoid a lapse in prescriptions.
The period for raising questions and concerns about these proposed rules ends on Friday, March 31, 2023. As we await the final publication of these rules, providers need to plan on revisions of their current telemedicine practices.
Revolution Law Group is located in Greensboro, NC, and serves individuals and small businesses throughout the Triad and surrounding areas. To contact us please visit Revolution.law or call 336-333-7907.
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