Warner Tells DEA to Launch Registration for Telehealth Prescriptions

Congress is calling out the US Drug Enforcement Agency for failing to launch a promised – and mandated - program that would allow healthcare providers to use telehealth to prescribe controlled substances.

Senator Mark Warner (D-VA) sent a letter last week to Acting DEA Administrator Uttam Dhillon asking why the “Special Registration to Engage in the Practice of Telemedicine” hadn’t yet been implemented, even though Congress had requested that it be in place by last October.

The connected health platform is seen as a crucial step in helping care providers address the nation’s ongoing opioid abuse epidemic.

“Providers across the country have been frustrated in their inability to provide adequate care as they wait for Congressionally-mandated guidance from your agency to clarify the process whereby health care professionals can legally use telehealth to better treat patients suffering from substance use disorder,” Warner wrote. “The DEA’s failure to promulgate the rule has meant that – despite Congress’ best efforts – many patients suffering from substance use disorders remain unable to access treatment via telehealth. These patients cannot afford to wait and we are concerned the DEA is standing in the way of treatment for individuals that cannot access a provider in person – particularly those in rural and underserved areas.”

The registration was called for in the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which strongly regulated a provider’s ability to prescribe controlled substances. Under the Ryan Haight Act, providers are required to conduct an in-person examination before prescribing or otherwise dispensing controlled substances “by means of the Internet,” except when engaged in the practice of telemedicine. The definition of “practice of telemedicine,” meanwhile, includes seven categories in which a provider could meet the in-person requirement through a virtual care platform – including under a special registration granted by the US Drug Enforcement Agency. But that registration process was never created by the DEA.

With the Special Registration for Telemedicine Act of 2018, which was part of the SUPPORT for Patients and Communities Act signed into law by President Donald Trump in late 2018, the DEA had until October 24, 2019 to set the ground rules for providers with a special registration to prescribe controlled substances.

That deadline passed without action. In November, the Justice Department announced plans to issue a proposed rule to create that registration process. But nothing has happened since then.

“The opioid and addiction epidemic has devastated communities nationwide, with a particularly devastating impact on rural and medically underserved areas,” Warner said in his letter. “According to the Centers for Disease Control and Prevention (CDC), there were more than 70,000 overdose deaths in 2017 – a 9.6 percent increase from 2016.  Furthermore, the CDC cites opioid deaths as 45% higher in rural areas, compared to urban communities.”

“Expanding telehealth services to individuals suffering from substance use disorder can bridge the distance between patients and care and ensure increased access to services they need,” he added.