The U.S. Drug Enforcement Administration (DEA) has announced three new rules aimed at permanently expanding access to telemedicine while enhancing patient protection. These regulations, which build on temporary flexibilities introduced during the COVID-19 public health emergency, focus on ensuring that telemedicine remains an accessible and safe option for patients needing medical care, particularly for the prescription of controlled substances.
One of the key provisions in the new rules allows for greater access to medications like buprenorphine, a drug used to treat opioid use disorder, through telemedicine consultations. Under the new regulation, patients can receive up to a six-month supply of buprenorphine through a phone consultation with a provider, after which an in-person visit would be required for additional prescriptions.
The rules also introduce special registrations for telemedicine providers who prescribe controlled substances. These special registrations will permit healthcare professionals to prescribe Schedule III-V controlled substances via telemedicine without the need for an in-person examination. Additionally, an advanced registration is available for providers of Schedule II medications, but only if they are board-certified in specific medical specialties, such as psychiatry, hospice care, or pediatric care. This new measure aims to increase accessibility while ensuring the safety of these highly regulated medications.
As part of the changes, the DEA will now require online platforms that connect patients with telemedicine providers who prescribe medications to register with the agency. This is in response to concerns about some unscrupulous providers taking advantage of flexible telemedicine rules to prioritize profits over patient safety. Furthermore, the rules will establish a nationwide Prescription Drug Monitoring Program (PDMP) to help track prescriptions and prevent the diversion of controlled substances into illegal markets.
A key provision in the new regulations also addresses veterans’ care. In consultation with the U.S. Department of Veterans Affairs (VA), the DEA has exempted VA practitioners from the new registration requirements. Once a veteran has had an in-person consultation with a VA medical provider, the provider-patient relationship will extend to all VA practitioners offering telemedicine services.
DEA Administrator Anne Milgram emphasized the importance of balancing access to healthcare with patient safety: “We understand the difficulties some patients have accessing medical providers in-person, and we want to ease this burden while also providing safeguards to keep patients safe.”
The new rules are the result of extensive consultations with healthcare professionals, advocates, and patients. The DEA held public listening sessions in September 2023 and reviewed over 38,000 public comments on the original draft rules. The feedback led to significant revisions, ensuring the final rules prioritize patient safety while expanding access to vital healthcare services through telemedicine.
These rules are a significant step forward in maintaining the progress made during the COVID-19 pandemic while addressing the need for stronger safeguards against abuse and medication diversion.
