With current pandemic-era flexibilities for telemedicine set to expire at the end of 2024, several telehealth groups and major health systems are calling on the U.S. Drug Enforcement Administration to work faster in crafting a new proposed rule regulating the prescribing of controlled substances via telehealth.

The American Telemedicine Association, the Alliance for Connected Care, the Consumer Technology Association, the Partnership to Advance Virtual Care, Allina Health, Johns Hopkins, Mass General Brigham and HIMSS (parent company of Healthcare IT News) were just some of the 200-plus organizations urging the DEA that new rulemaking is crucial.

WHY IT MATTERS

While the letter, addressed to DEA Administrator Anne Milgram, commended the agency for extending telemedicine flexibilities, it was quick to point out that the clock is ticking.

"Now that the first quarter of 2024 has passed, we write to request that DEA expedite the release of a revised proposed rule to permit and regulate the prescribing of controlled substances through telehealth," the organizations said.

Their request that DEA expedite the release of a revised proposed rule to permit and regulate the prescribing of controlled substances through telehealth as soon as possible, they said timeliness is crucial for access to mental health, substance use disorder and other telehealth care.

"Given the complexity of these issues and the significant stakeholder interest (as demonstrated through more than 38,000 public comments received by DEA on proposed rules), DEA must plan to ensure stakeholders have adequate time to provide feedback on any policy proposal," they said.

Beyond the adequate time it would take to create a special registration process for telehealth prescribers, there is the time it would take for healthcare providers, pharmacies and other related services to comply with operational requirements and guardrails.

Clinician shortage, particularly acute in behavioral health, is a major factor in accomplishing the task of a new national drug registration program.

"While we hope the final rulemaking preserves patient access, any policy change that requires patients to seek in-person care would be extremely disruptive due to long scheduling lead times and in-office wait times," the organizations said in the letter.

THE LARGER TREND

In 2023, the DEA extended telehealth prescribing flexibilities and held public listening sessions to discuss the prescribing of controlled substances via telemedicine platforms and potential safeguards to detect diversion as well as to consider a telehealth controlled substance registry.

When senators and others pushed back on the DEA's position, the agency said it needed more comments to pursue a registry further, extending the flexibilities through the end of 2024 on October 6, 2023.

"We’re on the precipice of history. We have the opportunity to resolve a special registration process under this administration that’s been evading multiple administrations for decades," Robert Krayn, CEO and cofounder of Talkiatry, told Healthcare IT News in September.

ON THE RECORD

"If DEA were to create a special registration process for telehealth prescribers, as proposed by DEA and many stakeholders, substantial operational lead-time would be needed to implement the new process and comply with other potential operational requirements and guardrails," said the stakeholders in their letter to Milgram.

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.