DEA Extends COVID Telehealth Controlled Substance Prescribing Flexibilities Again

After holding two listening sessions in September, during which the agency heard from stakeholders including practitioners, the Drug Enforcement Agency (DEA) extended the COVID-era telehealth prescribing flexibilities again.  The issue of telehealth prescribing of controlled substances after the end of the public health emergency (PHE) has been on a bit of a rollercoaster ride.

The short version of the story:  DEA issued proposed regulations in March that would have brought telehealth prescribing of controlled substances to an abrupt end.  The provider community sent nearly 40,000 comments to DEA to explain why that was a bad idea.

Days before the end of the PHE in May, the DEA and the Department of Health and Human Services (HHS) issued a temporary rule (First Temporary Rule).  The First Temporary Rule extended all COVID-era telehealth controlled substance prescribing flexibilities through November 11, 2023.  It also granted a one-year grace period for practitioner-patient telehealth relationships established before November 11, 2023.

On October 10, 2023, a month before the end of the flexibilities for new patient relationships, the DEA and HHS issued another temporary rule (Second Temporary Rule).  The Second Temporary Rule extends flexibilities again through December 31, 2024 without regard to the patient’s status as new or existing.

In the Second Temporary Rule, the DEA indicated that it is working on promulgating new standards or safeguards by the fall of 2024.

For a history on the telehealth controlled substance prescribing restrictions under the Ryan Haight Act and the proposed regulations from March 2023, see The DEA’s Proposed Rules on Telehealth Prescribing of Controlled Substance Fall Short of Expectations.  For details on the First Temporary Rule the criteria to take advantage of the flexibilities (which apply to the Second Temporary Rule as well), see Welcomed Last Minute Temporary Rule Extends Flexibilities for Controlled Substance Prescribing.