The termination of the COVID-19 Public Health Emergency has brought immense tension among the public and clinicians concerning the end of telemedicine flexibilities.

But here's the Good News!

The Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) have extended the telemedicine flexibilities for controlled drugs until November.

Before the COVID-19 pandemic, the Ryan Haight Act mandated that practitioners could only prescribe controlled medications to patients after conducting an in-person evaluation — with some exceptions.

When the Department of Health and Human Services (HHS) declared the COVID-19 Public Health Emergency (PHE) on January 31, 2020, the Drug Enforcement Administration (DEA) introduced temporary exemptions to the Ryan Haight Act. These exemptions enabled practitioners to prescribe controlled medications through telemedicine encounters, even without conducting an in-person evaluation.

The primary objective was to ensure uninterrupted care during the crisis. Authorized by the DEA, practitioners could prescribe schedule II-V controlled medications, including schedule III-V narcotic controlled medicines approved by the FDA for opioid use disorder treatment and withdrawal management. Nevertheless, compliance with DEA guidelines and federal and state laws remained mandatory.

However, the exemption allowing prescriptions of controlled medications or buprenorphine without needing an in-person visit was initially planned to end when the federal public health emergency concluded on May 11, 2023.

Fortunately, on May 10, 2023, the DEA and SAMHSA issued a temporary rule that came into effect on May 11, 2023, implementing the following:

• The telemedicine flexibilities for prescribing controlled medications implemented during the COVID-19 PHE will continue until November 11, 2023. That means patients can still receive their prescriptions through telemedicine without needing an in-person visit.
• Patients who have established a telemedicine relationship with their healthcare practitioner on or before November 11, 2023, can enjoy the existing telemedicine flexibilities until November 11, 2024.

The DEA is currently reviewing the comments from clinicians and patients and expects to implement final regulations for telemedicine practices that prioritize public health, safety, and prevention of misuse. The temporary rule aims to ensure the continuity of care, prevent potential backlogs for in-person medical evaluations, and effectively address the critical public health need for buprenorphine access to treat Opioid Use Disorder (OUD). It also allows providers ample time to comply with new standards or safeguards introduced in the final rules.