The US Drug Enforcement Agency will consider relaxing its rules on prescribing controlled substances via telehealth appointments, a move that could ease concerns of long-term care providers administering certain medications common for pain relief and end-of-life.
The agency posted notice on its website Friday that it is willing to consider a special registration process for certain controlled medications that would allow telemedicine prescribing without an in-person medical evaluation. The notice said the agency received more than 38,000 public comments on the initial rulemaking that would have tightened telehealth prescriptions for controlled substances, particularly those used frequently in nursing homes.
“Given the shortage of mental health providers and the increased need for access to prescribers through telehealth, I’m pleased that the DEA is finally looking into establishing a rule to allow specially trained prescribers to continue administering controlled substances virtually without requiring an in-person visit,” Sen. Mark Warner (D-VA) said in a statement, cited by The Hill newspaper.
In April, LeadingAge sent a letter to the DEA asking it to consider some key exemptions for nursing home, hospice, and palliative care patients so their access to controlled medications would not be disrupted or require in-person medical appointments.
“We do not believe prescribing controlled medications using telehealth for hospice patients or residents in long-term care is a high-risk situation that requires the guardrails outlined in DEA’s proposed rule,” wrote Katy Barnett, LeadingAge’s director of Home Care and Hospice Operations and Policy. “This proposed rule has the potential to significantly restrict and even prevent patients from seeing their prescribing clinicians in a timely manner for palliative pain and symptom management by preventing the prescribing of controlled substances via telemedicine.”
Barnett’s letter was dated the final day of the comment period on the initial rulemaking to extend some of the flexibilities that were put into place during the public health emergency for COVID-19. The new rules prohibited patients from receiving 30-day prescriptions for more Schedule II narcotics without at least an initial in-person medical visit. Schedule III-V non-narcotic drugs and buprenorphine, which is used to treat opioid addiction, can still be prescribed without seeing a prescriber in-person.
The agency announced on May 9 just two days before the PHE expired that it would extend flexibilities for controlled substance prescriptions until Nov. 11, 2023.
The DEA’s listening sessions will take place at its headquarters in Arlington, VA, on Sept. 12 and Sept. 13. Members of the public must register to attend in-person by Aug. 21. The agency will allow a limited number of 10-minute presentations by the public.
