DEA Proposes Updated Rules to COVID-19 Telemedicine Flexibilities

On February 24, 2023, the United States Drug Enforcement Agency (DEA) issued a press release announcing its proposal for updated telemedicine flexibility rules. At the start of the COVID-19 pandemic and throughout the government-mandated quarantine, the DEA had allowed physicians to write prescriptions after seeing patients through telemedicine.

Early pandemic allowances allowed patients to see new providers virtually and obtain prescriptions. For many patients, virtual appointments are the only time they have with their provider, meaning they have yet to have an in-person physical examination. However, the new rules would restrict some allowances.

The DEA news release states, “The proposed rules — developed with the US Department of Health and Human Services and in close coordination with the US Department of Veterans Affairs — propose to extend many of the flexibilities adopted during the public health emergency with appropriate safeguards.”

According to the DEA, these updated rules will not affect patients who have telemedicine consultations with a provider with whom they previously had an in-person visit. In addition, individuals who do not get prescribed controlled substances through telemedicine should not experience any changes. The final group of patients unaffected by these updated rules is patients referred for a telemedicine consultation by a provider who has conducted an in-person exam.

However, medical professionals who prescribe controlled substances to patients whom they have never seen for an in-person evaluation will be required to do so. Initial prescriptions for Schedule III–V drugs, including ketamine, anabolic steroids, benzodiazepines, and narcotics, must be written after an in-person medical assessment. After the initial evaluation or one in-person visit, depending on the case, providers would be allowed to write a refill via telemedicine.

“DEA is committed to ensuring that all Americans can access needed medications,” said Anne Milgram, DEA Administrator, in the news release. “The permanent expansion of telemedicine flexibilities would continue greater access to care for patients across the country while ensuring the safety of patients. The DEA is committed to the expansion of telemedicine with guardrails that prevent the online overprescribing of controlled medications that can cause harm.”