The Drug Enforcement Administration (DEA), in consultation with the Department of Health and Human Services, on Feb. 24, 2023, proposed two rules — the Telemedicine Controlled Substance Proposed Rule and the Telemedicine Buprenorphine Proposed Rule — that would extend many flexible provisions enacted during the COVID-19 public health emergency (PHE) for prescribing controlled substances.
Under the proposed rules, prescriptions for Schedule II medications or narcotics would require an initial in-person visit. Medical practitioners could prescribe a 30-day supply of Schedule III–V non-narcotic controlled medications and a 30-day supply of buprenorphine to treat opioid use disorder without an in-person evaluation or referral from a medical practitioner that has conducted an in-person evaluation. An in-person visit would be required to obtain a subsequent refill prescription in these cases where the original prescription was based on a telehealth visit.
If a provider and patient established a telemedicine relationship during the COVID-19 PHE, the DEA will extend the initial in-person visit requirement an additional 180 days from the final rules’ publication date.
The proposed rules do not affect:
- Telemedicine consultations that do not involve prescribing controlled medications.
- Telemedicine consultations by a provider that has previously conducted an in-person medical examination of a patient.
- Telemedicine consultations and prescriptions from a provider to whom a patient has been referred, as long as the referring provider has conducted an in-person examination.
Comments on both proposed rules are due March 31.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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