On Mar. 31, the AAMC submitted comments to the Drug Enforcement Administration (DEA) in response to two proposed rules regarding prescribing controlled substances by telemedicine, “Expansion of Buprenorphine via Telemedicine Encounter” and “Telemedicine Prescribing of Controlled Substances When the Practitioner and Patient Have Not Had a Prior In-Person Medical Evaluation.”
In the letters, the association highlighted the importance of buprenorphine as a medication for the treatment of opioid use disorder and urged the DEA to remove the proposed in-person visit requirement to prescribe it. Both letters stated that the in-person requirement “does not enhance the DEA’s ability to do its job of limiting drug diversion or pursuing illegal actors.” Instead, the requirement would reduce access to life saving treatment and would disproportionally affect groups that have been historically marginalized or made vulnerable. For other controlled substances, the association urged the DEA to allow for exceptions if the patient cannot be seen in person before prescribing due to their clinical conditions and other factors. The letters also included several additional recommendations in case the DEA moved forward with the in-person visit requirement. This included extending the 180-day grace period for patients who have already received their prescriptions via telemedicine during the COVID-19 public health emergency to one year due to the limited number of in-person visits available.
The AAMC also recommended that the DEA allow greater flexibility and reduce the administrative burden for record-keeping and referrals for prescribing controlled substances via telemedicine. The letters stated that some of these requirements are overly burdensome and would interfere with access to care. For example, “it is impractical for a practitioner from an outside practice to have advanced knowledge of another practitioner’s name and [national provider identifier] to whom they are referring the patient.” The association also recommended additional flexibility for practitioners in group practices when prescribing controlled substances when another practitioner is in the same group practice at the time of the in-person evaluation.
The DEA is expected to issue a final rule soon.