The U.S. Drug Enforcement Agency (DEA) will extend telemedicine flexibilities around the prescription of certain controlled medications as it considers stakeholder feedback on proposed rules for post-COVID remote prescribing guardrails. The DEA received over 38,000 comments on its proposed rules, and a record, and is working to find a way to provide Americans with appropriate safeguards for telemedicine access to needed medications. The temporary extension will ease concerns for telehealth and behavioral health sectors, but further revisions are needed to avoid a so-called telehealth cliff that would hinder patient access to care.
The COVID-19 pandemic has caused a dramatic increase in the use of telemedicine, with many patients relying on remote care to access the medications they need. However, this shift has raised concerns about the potential for increased diversion and abuse of controlled substances. As a result, the U.S. Drug Enforcement Agency (DEA) has proposed new rules for remote prescribing of controlled substances that would require patients to have in-person exams, effectively ending the telemedicine flexibilities that have been in place during the pandemic.
The proposed rules have been met with significant opposition from telehealth and behavioral health providers, who argue that they would create significant barriers to care access for many patients. In response, the DEA has received more than 38,000 comments on its proposed telemedicine rules—a record, according to DEA Administrator Anne Milgram.
“We take those comments seriously and are considering them carefully,” the statement said. “We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities while we work to find a way forward to give Americans that access with appropriate safeguards.”
To this end, the DEA has submitted a temporary extension of COVID-19 telemedicine flexibilities for the prescription of controlled medications to the Office of Management and Budget. This extension will provide some relief for the telehealth and behavioral health sectors, which have been waiting anxiously for further details on the DEA’s proposed rulemaking.
While the extension is welcome news, there are still significant concerns about the potential impact of the proposed rules on patient access to care. Many organizations, including the American Telemedicine Association, have called for revisions to the rules to avoid a so-called “telehealth cliff.” They argue that telemedicine has been a critical tool for increasing access to necessary care during the pandemic and that ending these flexibilities would be a step backward for patient care.
In response to the proposed rules, ATA and others have suggested the creation of a registry for telemedicine providers, similar to the existing electronic prescribing of controlled substances system. This would allow pharmacists to easily identify legitimate telemedicine prescribers and prescriptions, providing an additional layer of protection against the diversion and abuse of controlled substances.
