DEA extends pandemic telehealth rules for prescribing controlled substances

The Biden administration on Friday extended flexibilities regarding controlled substances to be prescribed via telemedicine. 

The Drug Enforcement Administration (DEA) said in a notice it would allow providers to continue using telemedicine to prescribe certain controlled substances through the end of 2024. 

The temporary rule is meant "to ensure a smooth transition for patients and practitioners that have come to rely on the availability of telemedicine for controlled medication prescriptions, as well as allowing adequate time for providers to come into compliance with any new standards or safeguards," the agency said.

During the COVID-19 public health emergency, the DEA relaxed its restrictions on controlled substance prescriptions. Previously, patients needed at least one in-person visit, but the administration changed the rule to prevent lapses in care.

Controlled substances covered by the rule include stimulant medications for attention-deficit/hyperactivity disorder (ADHD), anxiety medicines or medications for opioid use disorder.

In February, the agency proposed new rules rolling back those flexibilities before the public health emergency declaration ended on May 13. But the DEA faced immediate backlash from doctors and telehealth groups.

In May, just before the emergency expired, the DEA said it would temporarily extend the pandemic’s telehealth flexibilities through Nov. 11. 

The American Telemedicine Association and its lobbying group ATA Action praised the extension, saying the DEA was taking a "thoughtful and thorough approach to creating the right rules." 

But the Health Innovation Alliance, a health technology advocacy group that represents providers, insurers, patients and others, said the DEA is needlessly delaying the inevitable.

"While this extension will help millions of Americans access much-needed medications, an extension is not a permanent rule," the organization said in a statement. "The DEA needs to stop dragging its feet, admit that tele-prescribing is a success, and trust in the medical professionals who are treating patients."

The agency held a listening session last month where a variety of stakeholders, including patients, doctors and industry groups, urged the agency to extend the rules and change its policy to establish a special registration pathway for remote prescribing.

Several lawmakers, including Sens. Mark Warner (D-Va.), John Thune (R-S.D.), Catherine Cortez Masto (D-Nev.) and Shelley Moore Capito (R-W.Va.) also called on the DEA to change course, saying in a letter last month its February proposal would "limit the ability of doctors to prescribe controlled substances without an in-person visit and place unnecessary requirements on care providers."

The latest extension will end on Dec. 31, 2024. DEA said it is working to write new regulations by fall 2024.