The Drug Enforcement Administration (DEA) released a notice of proposed rulemaking, Special Registrations for Telemedicine and Limited State Telemedicine Registrations. The rule would create three types of special registrations that providers could apply for to prescribe controlled substances via telemedicine without an in-person visit. The current proposal would mandate a search of Prescription Drug Monitoring Programs (PDMPs) in all 50 states, regardless of registration type, with a delayed effective date if all PDMPs are available, and would require that practitioners prescribe no more than 50% of Schedule II controlled substances virtually.
The DEA also released a final rule, Expansion of Buprenorphine Treatment via Telemedicine Encounter, that would enable practitioners to prescribe a six-month initial supply of Schedule III-V medications to treat opioid use disorder (OUD) via audio-only telemedicine interaction without a prior in-person evaluation.
Practitioners could then prescribe additional medication via other telemedicine encounters (e.g., real-time, two-way audio-visual) or after an in-person encounter. Providers would also need to complete a review of the PDMP for the state where the patient is located. Requirements for the special registration proposed rule would not apply to clinicians prescribing buprenorphine for OUD.
Lastly, the DEA, in consultation with the Department of Veterans Affairs (VA), released a final rule, Continuity of Care via Telemedicine for Veterans Affairs Patients, which exempts VA practitioners from special registrations requirements. Under the rule, once a patient has received an in-person medical examination from a VA medical practitioner, the provider-patient relationship is extended to all VA practitioners engaging in telemedicine with the patient.
AAPP will continue to monitor developments related to these rules, including actions the Trump administration could take. Past administrations have directed agencies to carry out a regulatory freeze and delay the effective dates of rules, to allow time for the new administration to review regulatory decisions and decide which to revoke or revise.
To learn more about the rules, read the DEA press release.