DEA May Propose Substantial Limits to Telemedicine Prescribing

Since June 13, the Office of Management and Budget (OMB) has been reviewing a proposed rule the Drug Enforcement Administration (DEA) submitted on the prescribing of controlled substances via telemedicine without an in-person visit. Ahead of the public health emergency's end in May 2023, the DEA initially proposed requiring patients see a doctor in person after receiving an initial 30-day supply of some drugs via telemedicine: buprenorphine, testosterone, and ketamine for depression. Due to considerable public pushback, DEA did not finalize this first proposed rule and instead extended the current flexibilities until December 31, 2024.

Through advocacy partners and confirmed by reporting in Politico, LeadingAge learned that DEA is likely to make the rule under review at OMB contain new types of restrictions. What is being reported is that the rule will allow no more than half of a provider's prescriptions to be given virtually. Additionally, it would require providers prescribing controlled substances to check the prescription drug monitoring programs in all 50 states to prevent diversion, a task which could be an impossible lift.

LeadingAge submitted comments on this proposed rule requesting hospice, palliative, and skilled nursing patients be omitted from the changes since the loss of access to e-prescribing for controlled substances supporting pain and symptom management could have considerable unintentional consequences. With the extension expiring at the end of the year, we are still waiting for DEA to publish the new proposed rule and to respond via required public comment period before finalizing. We will keep members posted on next steps on this issue.