The Drug Enforcement Administration and HHS have published a final rule to allow providers to prescribe buprenorphine through telehealth.
In a final rule published Jan. 15, the agency said it would allow providers to prescribe up to a six-month supply of buprenorphine through telehealth, without seeing a patient in person first.
The agency also published a proposed rule Jan. 15 regulating the prescribing of other controlled substances via telehealth. The agency first implemented rules allowing providers to dispense controlled substances through telehealth during the COVID-19 pandemic. Current flexibilities are in place through the end of 2025.
In September, hundreds of healthcare organizations, including the American Psychiatric Association and other mental health groups, urged the DEA to keep flexible telehealth prescribing in place.
Here are five things to know about the final rule and the DEA's proposed regulations:
- The DEA will allow providers to prescribe up to six months of buprenorphine to treat opioid use disorder through telehealth, including audio-only telehealth. After six months, providers can prescribe additional supplies after an in-person evaluation or through other forms of telehealth.
- The rule only applies to prescribers who do not have an existing relationship with a patient before prescribing OUD treatment through telehealth. The rule is effective 15 days after its official publication in the federal register.
- The DEA and HHS are also proposing a three-tier system to regulate the prescription of other controlled substances. The first tier would allow physicians and other qualified clinicians to prescribe schedule III-IV drugs via telehealth. The second would allow only specialized providers, including psychiatrists, to prescribe schedule II drugs through telehealth.
- The third tier would apply to only telemedicine platforms. The DEA proposed requiring platforms to receive approval to prescribe controlled substances.
- The proposed rule comes after provider groups pushed back on guidelines that would have curtailed online prescribing of controlled substances. The American Hospital Association urged the agency to make these substances available through telehealth, but suggested requiring providers to register in order to do so.
The proposed rule is open for comment for 60 days after its official publication in the federal register.