Proposed DEA rule would tighten telehealth prescriptions, according to leak

A proposed telemedicine rule from the Drug Enforcement Administration reportedly would limit the types of medication that can be prescribed if a patient and provider have not had an in initial in-person visit. Although the proposed rule has not been made public, an anonymous source leaked it.

This is just the latest development in a hotly debated issue. The DEA proposed two rules for telehealth controlled substance prescriptions early last year but withdrew them after receiving 38,000 public comments. The new rule, which would set a post-pandemic norm for patients receiving medications through telehealth, was expected to be issued this month, according to the administration’s schedule of regulatory actions.

The unpublished rule reportedly restricts schedule II substances such as Adderall from being prescribed at all unless an in-person visit has occurred. Schedule III-V substances can be prescribed based solely on a telehealth visit. The draft rule reportedly allows providers to do only half of prescribing online, in an effort to prevent misuse and diversion, with the other half done in person.

The draft rule also would require providers to check all 50 states’ prescription drug monitoring programs before prescribing a controlled substance to a patient whom they have not seen before in person. However, there is no national prescription drug registry where prescribers could easily determine if the patient had obtained the medication in another state. Providers said the DEA would need to make this type of national registry available to them to carry out the stipulations of the draft rule.

In response to the leaked information, major telehealth advocacy groups are gathering signatures for letters they will send to congressional leaders and the White House requesting a two-year extension of current rules. The letters reportedly stress that the DEA is out of time to promulgate a rule before the current waiver expires at the end of the year.

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Republicans and Democrats in both chambers have supported opening up telehealth prescriptions of controlled substances. Sen. Mark Warner, D-Va., released a statement after media reports of the restrictions in the forthcoming rule. He wants the DEA to lift some reported restrictions regarding in-person visits.

“As currently reported, the DEA’s proposal provides an even worse solution than the one put forth under the first proposed rule,” he said in a statement. “This arcane approach would represent a significant step back for patients who rely on telemedicine for critical medications and yet another failure by the DEA to establish a meaningful special registration, which Congress has repeatedly directed it to do for over a decade.”