DEA, HHS announce second extension of telehealth flexibilities that started in pandemic

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Telehealth flexibilities for prescribing controlled substances will continue through 2024.

On Oct. 6, the U.S. Department of Health and Human Services (HHS) and the U.S. Drug Enforcement Administration (DEA) in the U.S. Department of Justice announced the continuation of a rule that started during the COVID-19 pandemic. Starting in March 2020, physicians were permitted to prescribe some controlled substances via telehealth without seeing patients in person.

That allowance was to end with the COVID-19 public health emergency (PHE) in May, but the federal regulators continued it until Nov. 11, six months after the end of the PHE. The Oct. 6 announcement extends the exception again through Dec. 31, 2024.

“In order to prevent lapses in care, these exceptions allowed for the prescribing of controlled medications via telemedicine encounters even when the prescribing practitioner had not conducted an in-person medical evaluation of the patient,” said the notice from HHS and DEA.

The provision actually consists of two exceptions, one dealing with controlled substances and on covering buprenorphine. The federal regulators had a public comment period that prompted 38,369 comments before it ended in March this year.

DEA hosted public listening sessions, scheduled for last month, and the announcement said leaders would carefully evaluate all the public comments before promulgating new standards or safeguards by fall 2024.

DEA listed a number of formal reasons for the most current extension. They include addressing “the urgent public health need for continued access to the initiation of buprenorphine as medication for opioid use disorder in the context of the continuing opioid public health crisis,” the announcement said.

If the existing telemedicine flexibilities ended on Nov. 11, there is a chance “it could lead to potential patient harm – due to an inability to access appropriate care – in some instances,” the announcement said.

The American Telemedicine Association (ATA) and its ATA Action committee praised the DEA and HHS for the action.

“We are thrilled that the DEA is taking such a thoughtful and thorough approach to creating the right rules around the prescription of controlled substances. This is a critical issue for millions of individuals and their families, as well as clinicians wanting to provide care to their patients, wherever and whenever they need it,” ATA Senior Vice President Kyle Zebley said in a statement. He also is executive director of ATA Action.

“We have served as the guardians we promised to be for patients benefitting from these services and will continue to work on their behalf to ensure that the final rules do not restrict access to needed telehealth and virtual care services and do not create undue burdens for providers, while preventing diversion,” Zebley said.

Next year could be a “Super Bowl for telehealth,” with other flexibilities first granted to deal with COVID-19, also set to expire. Examples include tax provisions for high deductible health plans and health savings accounts, and in-person or telehealth rules for Medicare, hospice care and the Acute Hospital Care at Home Program, the ATA statement said.

“This is a historic opportunity to make crucial changes to our healthcare system that will appropriately expand access to urgently needed care to some of our most challenged and underserved patient populations,” Zebley said. “This is not rhetoric, it’s real opportunity that we must not squander.”