Psych Congress NetworkUpdate on Prescribing via Telehealth: Potential Changes in the Drug Enforcement Administration’s Guidelines

As the Ryan Haight Act waivers near expiration, the DEA’s forthcoming rules could reshape telehealth prescribing practices.

The future of prescribing controlled substances via telehealth is hanging in the balance as healthcare providers await new guidelines from the Drug Enforcement Administration (DEA). With the expiration of Ryan Haight Act waivers on November 11, 2023, the DEA’s proposed pathways could either facilitate or further restrict telehealth prescribing, impacting both physicians and patients.

HCN Medical Memo
For physicians engaged in telehealth, the upcoming DEA guidelines could significantly alter the way you prescribe controlled substances to your patients. The proposed pathways, while offering some flexibility, come with their own set of challenges and limitations. It’s crucial to stay updated and possibly participate in the DEA’s listening sessions this fall to voice your concerns and suggestions.

Key Points

• Edward Kaftarian, MD, executive chairman of Orbit Health Telepsychiatry, emphasized the importance of the Ryan Haight Online Consumer Protection Act in preventing “pill mills” but also noted its limitations in telehealth.
• The DEA has extended the current Ryan Haight Act waivers until November 11, 2023, after which old restrictions requiring in-person visits for prescribing controlled substances will resume.
• The DEA proposes three pathways for prescribing controlled substances: in-person visits, short-term prescriptions for Schedule 3-5 substances, and referrals from DEA-registered practitioners.
• Listening sessions are scheduled for Fall 2023, where the DEA will gather public opinions on these proposed rules.

“So if this sounds confusing, it is. And the DEA is conducting listening sessions where the public can make the case for other ways where we can circumvent these really difficult rules around telemedicine and controlled substances.”
– Edward Kaftarian, MD, Executive Chairman, Orbit Health Telepsychiatry

Additional Points:

• The second pathway does not account for ADHD medications, which are Schedule 2 substances.
• The third pathway involves complex documentation requirements, including specific National Provider Identifier (NPI) numbers for both the referring and receiving practitioners.
• There is a strong call for a special registration process for telemedicine, which is currently not in place.

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