DEA Extends Telemedicine Prescription Waiver One More Year

November 20, 2024 ‐ HealthLeaders Media

By Eric Wicklund

Healthcare providers will be able to prescribe scheduled drugs via telemedicine for at least one more year, thanks to a last-minute extension of a pandemic-era waiver by the U.S. Drug Enforcement Administration (DEA).

The announcement late Friday may have been met with relief by advocates, but it’s little more than a stopgap measure. The federal agency has been tasked with creating a special registration process for prescribing via telemedicine since the passage of the Ryan Haight Online Pharmacy Consumer Protection Act in 2008, but has resisted calls from advocates and lawmakers to do so.

Nevertheless, the latest announcement garnered some praise.

“We are pleased to see the DEA act to ensure patient care is not interrupted next month,” Chris Adamec, executive director of the Alliance for Connected Care, which spearheaded a letter signed by more than 300 organizations urging Congress to take action, said in a press release issued Friday. “We look forward to working with the Trump Administration next year to finish the work they started in 2020 through a permanent rulemaking that creates access to comprehensive medical care, including a controlled substance when necessary, through telemedicine.”

“The DEA’s extension of telehealth flexibilities of controlled substances is a lifeline for many mental health and substance use disorder patients,” Debbie Witchey, president and CEO of the Association for Behavioral Health and Wellness (ABHW), said in a separate release. “Buprenorphine, in particular, is very safe and one of the gold standards of care for opioid use disorders (OUD). The option to provide buprenorphine-based treatment via telemedicine will enhance access to care and address health disparities. ABHW strongly supports removing the in-person requirement permanently for tele-prescribing buprenorphine as this requirement hinders access to care.”

Supporters, including many health systems and hospitals, say the ability to prescribe controlled medications via telemedicine is critical to improving treatment and access to care for substance abuse and behavioral health issues, as patients often can’t or are reluctant to seek in-person treatment. They also worry that ending the waiver will disrupt and potentially end treatment for patients who have relied on virtual prescriptions for the past few years.

According to the DEA, the extension “ensure(s) a smooth transition for patients and practitioners that have come to rely on the availability of telemedicine for controlled medication prescriptions.” It also gives the DEA and the Health and Human Services Department (HHS) more time to come up with a final rule, and for providers to be ready for that rule when it goes into effect.

That hasn’t worked out too well in the past.

In 2023, the DEA unveiled a proposal for a final rule, but advocates quickly criticized the proposal as being too complex and restrictive, leading the agency to shelve the plan and extend the waiver. Earlier this year, the DEA floated another draft of a final rule, but a leaked copy of the plan was deemed by supporters to be “a significant blow to the telemedicine industry.”

The one-year extension isn’t a surprise. Those familiar with the process have been anticipating either a one- or two-year continuance for some time. But there’s a growing concern among telehealth advocates that the DEA won’t come up with a final rule that meets their concerns, and that they will have to put extra pressure on either Congress or the White House to bypass the DEA and create a permanent rule that is amendable to everyone.

That may be why advocates like the American Telemedicine Association (ATA) were quick to praise not only the DEA but HHS, Congress and the White House for the waiver.

“As we close out this year and prepare for 2025, we will remain actively engaged with the incoming Trump administration, the DEA, the Department of Health and Human Services (HHS), interagency partners, and other key stakeholders to establish a permanent framework that ensures appropriate and necessary access to care for millions of Americans,” Kyle Zebley, the ATA’s senior vice president of public policy and executive director of ATA Action, the organization’s lobbying arm, said in a press release last week.

“We remain grateful to the Biden Administration, the DEA and other key agencies, and our bipartisan, bicameral Congressional telehealth champions, as well as President-elect Trump and his first Administration, for their staunch support,” he added. “However, our work is far from over. We are buoyed by this important ruling and will continue to pursue permanent access to essential virtual care services on behalf of healthcare providers and the millions of patients who have come to rely on telehealth.”

Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.

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