With just four months to go until the scheduled expiration of Drug Enforcement Administration flexibilities on virtual prescribing of controlled substances, a long list of hundreds of healthcare stakeholders is calling on Congress and the White House to extend them before "countless patients [are] abandoned, left without lifesaving clinically appropriate care."

Led by the American Telemedicine Association and its ATA Action arm, more than 330 disparate organizations have signed on to an effort urging federal officials to extend pandemic-era allowances for virtual prescribing that "have been a lifeline for countless individuals across the country, ensuring uninterrupted access to essential mental health care, substance use treatment, end-of-life care, and many other crucial treatments during a time when in-person visits were impossible or unsafe."

In separate letters sent to the House and Senate, the groups – including the American College of Physicians, the American Medical Informatics Association, the National Rural Health Association and many others – are calling for a two-year extension of remote prescribing flexibilities for controlled substances in their year-end legislation.

Another letter to the White House asks that the Biden Administration work with the DEA to use existing authorities to extend the flexibilities, buying time for the agency to stand up a special registration pathway that "balances access to medically necessary care with appropriate enforcement."

Meanwhile, another advocacy organization, the Center for Telehealth and e-Health Law, a nonprofit research group focused on the legal and regulatory aspects of digital health, has also written directly to the DEA, imploring it to 1) issue an immediate extension of current telemedicine prescribing waivers, and 2) begin the process of issuing a rule paving the way for a permanent extension of prescribing authority.

"There is no clinical justification for requiring an in-person visit to prescribe controlled substances; this requirement often results in delayed treatment, increased travel burdens, and additional financial costs for patients," said CTeL in its letter to DEA Assistant Administrator Thomas Prevoznik. "We strongly urge the DEA to implement measures that prevent diversion while ensuring telemedicine remains accessible to all – these are not zero-sum principles."

THE LARGER TREND
While the DEA has offered discrete extensions virtual prescribing latitude for controlled substances before, there is concern that the expiration of current flexibilities might be a more challenging proposition.

In particular, CTeL has aired its concerns that the agency is "likely planning to allow these waivers, initially promulgated in 2020 during the onset of the COVID-19 pandemic, to expire without public notice" on December 31. It's urging telehealth and other healthcare stakeholders to make their voices heard by signing on to its letter to the DEA.

The advocacy comes at a pivotal point for telehealth and the policies that govern it.

Two weeks ago, ATA sent another letter urging the Centers for Medicare and Medicaid Services to clarify its own regulations, calling on CMS to extend telehealth flexibilities in the 2025 Physician Fee Schedule, and asking the White House and Congress to make them permanent.

Earlier this week, Healthcare IT News spoke with Matt Wolf, healthcare senior analyst at consulting firm RSM US, who made the case that, without significant regulatory reform, it's likely the United States will see telehealth services stagnate – and perhaps even decline, squandering the virtual care potential that was demonstrated during the pandemic.

ON THE RECORD
"This is a predictable and preventable crisis that is looming come January 1 and we are quickly running out of time to save countless patients from being abandoned, left without lifesaving clinically appropriate care," said ATA Action Executive Director Kyle Zebley in a statement.

"With each day, we are losing precious time the DEA needs to properly develop a rule that appropriately permits and regulates the prescribing of controlled substances through telehealth without jeopardizing the health and safety of Americans, especially those in underserved communities."

Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.