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  • Washington Highlights

    DEA Issues Two Proposed Rules on Prescribing Controlled Substances Using Telehealth


    Gayle Lee, Director, Physician Payment & Quality
    For Media Inquiries

    On Feb. 24 the Drug Enforcement Agency (DEA) issued two proposed rules (Telemedicine Controlled Substance Proposed Rule and Telemedicine for Prescribing Buprenorphine Proposed Rule) regarding circumstances when controlled substances may be prescribed without an initial in-person medical examination. During the COVID-19 public health emergency (PHE), the DEA allowed providers to prescribe controlled substances using telehealth; the PHE is scheduled to end May 11.  

    Under the proposed rules, telehealth providers would no longer be able to prescribe Schedule II controlled substances (e.g., Adderall, oxycodone, Ritalin, Vicodin) or Schedule III-V narcotics (with the sole exception of buprenorphine) without an in-person evaluation. Telehealth providers would be able to prescribe a 30-day supply through telemedicine without the initial in-person visit for buprenorphine and nonnarcotic Schedule III-V (e.g., Ambien, Valium, Xanax, ketamine). For a patient to get refills beyond the initial 30-day supply, an in-person visit would be required. If a patient had an initial in-person exam with a practitioner who subsequently referred to a second practitioner, the second practitioner may conduct a telemedicine exam of the patient and prescribe a controlled substance without personally conducting an in-person exam. Both practitioners would need to be DEA registered. The rule proposes record keeping and other requirements. 

    If a telemedicine relationship was established and the patient has already been receiving prescriptions by telemedicine during the COVID-19 PHE, the DEA will extend the in-person exam waiver an additional 180 days. 

    Along with the rule, the DEA issued a chart to assist practitioners, a list of some common controlled substances, and an outline of various telemedicine consultation scenarios. The AAMC plan to submit comments in response to this rule by the March 31 comment deadline. It is anticipated that a final rule will be released soon after the comment deadline.