DEA Issues Emergency Guidance for Prescribing Controlled Substances via Telemedicine
Given the potential for many individuals to be in quarantine and isolation, as well as the need to divert non-urgent patients away from the clinic setting, many exceptions have been issued by regulatory agencies in the last few days. The United States Drug Enforcement Administration (DEA) has now released guidance related to exceptions to the controlled substance prescription requirements. Under normal (nonpublic health emergency) circumstances, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 requires a prescriber to perform an in-person medical evaluation of a patient before using the internet to prescribe controlled substances for that person—see 21 U.S.C. 829(e).
What Has Changed?
Per DEA guidance, the emergency exception to the federal requirements is as follows.
For as long as the Secretary of the Department of Health and Human Services' designation of a public health emergency remains in effect, DEA-registered practitioners may issue prescriptions for controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided all of the following conditions are met:
- The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of their professional practice.
- The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system.
- The practitioner is acting in accordance with applicable federal and state laws.
As long as the practitioner satisfies all of these requirements, the prescription may be issued using any method of prescribing currently outlined in DEA regulations. Thus, the practitioner may issue a prescription either electronically (for schedules II–V), by calling in an emergency schedule II prescription to a pharmacy, or by calling in a schedule III–V prescription to the pharmacy. This exception will be in place for as long as the public health emergency declaration is in effect.
- The exception to the in-person exam requirement is related to a controlled substance prescription for which a prescriber has not previously performed an in-person medical evaluation. In nonemergency situations, practitioners who have already performed an in-person medical evaluation may issue a prescription for a controlled substance after communicating with the patient via telemedicine.
- Telemedicine communication does require audio and visual communication. This may hamper the ability of some prescribers to issue a prescription if they are not currently set up to perform audio-visual telemedicine.
- It also is important to note, as with many of the coronavirus disease 2019 (COVID-19)-related healthcare regulatory exceptions being issued, that providers must still comply with current state laws. Some states prohibit prescribing controlled substances via telemedicine under all circumstances, while other states allow it with some restrictions.
Visit the DEA COVID-19 information page to learn more about the recent exception details and find state-by-state resources.
As with most topics related to COVID-19, changes are being made rapidly. Please note that this information is current as of the publication date.
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