A widely panned proposal to regulate virtual prescriptions for controlled drugs isn’t going anywhere. It’s time to bring federal regulators and healthcare leaders back to the table.
Healthcare providers are once again pressuring the federal government to improve the process for using telemedicine to prescribe controlled medications.
The effort is spearheaded by the Alliance for Connected Care (ACC), whose executive director, Chris Adamec, recently sent a letter to Terrence Cole, who became administrator of the U.S. Drug Enforcement Administration (DEA) on July 23. The letter, supported by more than 200 health systems and other organizations, urges Cole to take action on a permanent policy before the end of the year.
“We believe the DEA should consider holding a meeting or forum of leading experts and stakeholders to develop long-term policy for this issue,” Adamec wrote. “Past efforts which did not fully engage stakeholders and Congress had unintended consequences – such as the creation of massive, significant new regulatory burdens on … healthcare systems.”
The debate over allowing qualified providers to prescribe controlled drugs is long and complex, dating back to passage of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008. That legislation set restrictions on how drugs could be acquired online, and tasked the DEA with creating a special registration so that healthcare providers could virtually prescribe those drugs. In 2018, President Trump signed the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) Act, which tasked HHS and the Attorney General with creating regulations to enable telemedicine prescriptions.
Despite lobbying by members of Congress, healthcare organizations and telehealth advocates, the DEA dragged its feet on creating a special registration. When the pandemic hit, the agency issued a waiver relaxing restrictions on telemedicine use, including allowing selected providers to virtually prescribe controlled substances without first meeting a patient in person.
The DEA has extended those flexibilities through the end of this year, and this past January floated a proposed rule to create that long-delayed special registration process for prescribing by telemedicine once those flexibilities end. But that proposal was met with strong opposition by telehealth advocates, including the ACC and the American Telemedicine Association (ATA), who called on the Trump Administration to nullify the proposal.
While no action has been taken on the proposed rule, telehealth advocates are pinning their hopes on Cole and hoping that new DEA leadership can jump-start the move toward a registration process that would appeal to both the government and providers.
If no action is taken and the waivers expire, the ACC and fellow advocates say many programs that include virtual prescribing and monitoring will likely collapse, hindering access to care for rural and remote patients.
“Telehealth has been crucial in providing a wide range of important health services for Americans, but even more so for those Americans who live in remote areas and locations with provider shortages,” Adamec wrote in his letter to Cole. “Overly broad restrictions will lead to harsh consequences for many Americans relying on telehealth to access health services.”
Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.
KEY TAKEAWAYS
The healthcare industry has been waiting almost two decades for a special registration process for providers seeking to prescribe controlled medications via telemedicine.
Healthcare leaders are hoping Terrence Cole, who was sworn in as DEA administrator on July 23, can bring both sides to the table to negotiate better regulations.
An easy and equitable process to virtually prescribe controlled drugs is seen as a crucial part of improved and more effective treatments for mental health concerns and substance abuse issues.