DEA extends pandemic era Telemedicine rules for prescribing controlled substances until Dec 31, 2024
The COVID-19 public health emergency allowed unprecedented flexibilities for the prescribing of controlled substances. These flexibilities were initially extended until Nov 11th, 2023, and have been extended again until Dec 2024.
Key Takeaways:
On May 10, 2023 the DEA posted a temporary extension of COVID-19 telemedicine rules that would expire Nov 11, 2023.
On Oct 6, 2023 the DEA posted another extension of COVID-19 telemedicine rules that will expire Dec 31, 2024.
The DEA states they are "working to promulgate new standards and safeguards by the fall of 2024".
Modyfi will pause in person assessments until after the DEA proposes their new safeguards and standards in Fall 2024.
These rule changes will not impact anyone prescribed mental health medications other than controlled substances.
What are the DEA rules under the COVID-19 pandemic public health emergency?
Prior to the COVID-19 pandemic public health emergency, the prescribing of controlled substances like Adderall, Ritalin, Vyvanse, Armodafinil, Klonopin, Ativan, Xanax, and Valium required an in person assessment.
The public health emergency allowed for the prescribing of controlled substances without an in person assessment. The Biden administration announced on January 30th, 2023 that the end of the pandemic health emergency would be May 11, 2023. Subsequently, the DEA announced on Mar 1, 2023, proposed rules for permanent flexibilities for prescribing controlled substances online that would still involve an in person assessment. Within 30 days of posting these proposed rules the Drug Enforcement Agency (DEA), Health and Human Services (HHS), and Substance Abuse and Mental Health Services (SAMHSA) received 38,369 public comments. The DEA and HHS posted an extension of the original COVID-19 telemedicine rules on May 10, 2023 which were set to expire now on Nov 11, 2023. On Oct 6, 2023 the DEA posted a second extension of COVID-19 telemedicine rules that will expire Dec 31, 2023.
Why are the COVID-19 telemedicine rules being extended?
According to the DEA "the purpose of this Second Temporary Rule, like the one before it, is to ensure a smooth transition for patients and practitioners that have come to rely on the availability of telemedicine for controlled medication prescriptions, as well as allowing adequate time for providers to come into compliance with any new standards or safeguards".
For the initial extension, there were several thousand public comments supporting the extension of the telemedicine flexibities:
“In the absence of an extension, practitioners could be inundated with in-person evaluation requests and backlogs for in-person medical evaluations might result. Along similar lines, practitioner infrastructure might prove inadequate if practitioners were inundated with in-person evaluation requests over a short period of time.”
There were also several comments opposing the initial extension:
“The telemedicine flexibilities that existed during the COVID–19 PHE increased diversion and overprescribing of some controlled medications, particularly as a result of certain telemedicine companies that do not conduct or require bona fide medical evaluations of patients prior to issuance of controlled medication prescriptions.”
What if I have already received an in person assessment?
Modyfi made arrangements beginning in Feb 2023 to see patients at our office in Gaithersburg, MD to satisfy the DEA's proposed requirements for in person assessments after the public health emergency. These in person assessments will remain valid after December 31, 2024 for any patient still under the care of a Modyfi provider. Any patient transferring their care outside of Modyfi will need another in person assessment after Dec 31, 2024, to satisfy this requirement.
Modyfi will pause in person assessments until after the DEA proposes their new safeguards and standards in Fall 2024.
Please CONTACT US with any questions.
