DEA wants to permanently anchor some COVID-era prescription regulations
Two months after delaying the expiration of COVID-era telehealth prescribing rules, the Drug Enforcement Administration (DEA) has released a regulatory framework to keep these rules in place permanently.
During the COVID-19 pandemic, flexibilities were introduced to allow providers to prescribe controlled substances such as Adderall, benzodiazepines, sleep medications and certain painkillers via telehealth visits.
Prior to COVID, prescribing controlled substances required an in-person visit, along with additional limitations.
The new rule authorizes the prescription of controlled substances classified up to Schedule II without the need for an in-person visit. The DEA is also adding buprenorphine to the list of approved substances, a drug that is gaining popularity as a less-addictive alternative to opioids. It is also used to treat opioid addiction.
The framework was published to the Federal Register on Jan. 17 and will go into effect 30 days from then.
Some limitations on prescribing practices are stricter than those put in place under emergency powers during the pandemic. For instance, prescribers must be registered as telehealth providers in each state where they practice. Additionally, providers will be required to check drug monitoring databases before issuing prescriptions.
Once finalized, the new rule will also mandate that telehealth prescriptions for Schedule II substances—those classified as the most potentially dangerous and addictive—make up less than 50% of a provider’s or practice's total telehealth prescriptions.
Perhaps the most complicated aspect is the framework for how providers must register, with different requirements for clinicians prescribing drugs from lower schedules (III to V) and additional requirements based on specialty. Psychiatrists and hospice workers, for example, will face distinct registration demands if they wish to prescribe Schedule II drugs.
The DEA notes that the framework is designed to balance patient safety with maintaining the flexibilities introduced during the COVID-19 pandemic. Many of the new restrictions will be phased in to ideally improve adoption and compliance.
The U.S. Department of Health and Human Services (HHS) worked with the DEA on this new framework. It is possible that the rules, which go into effect mid-February, will change over time as telemedicine groups, providers and healthcare organizations submit feedback.
See the full framework here.