Prescribing Pullback: Telehealth Advocates Ask Trump to Withdraw DEA Proposal

“Upon careful review of the DEA’s draft Special Registration for remote prescribing of controlled substances, we have serious concerns about the feasibility of this proposal,” Kyle Zebley, senior vice president of public policy for the American Telemedicine Association (ATA) and executive director of ATA Action, said in a press release issued on January 16—the second such press release issued by the ATA that day on the DEA’s proposal. “As written, the draft framework creates unworkable restrictions and could not be operationalized, which would be a major setback, should this become the final rule. As such, we implore President Trump to make it his urgent priority to withdraw this proposal immediately following his inauguration on January 20.”

“If allowed to become final, this would undo the important work President Trump put in place in 2020 with the waiver of the in-person requirement allowing for the remote prescribing of controlled substances,” Zebley continued. “We stand ready to work with President Trump and his incoming administration to make essential refinements, taking the time necessary and in consultation with key stakeholders, to create an appropriate and effective Special Registration that will protect the American people while allowing patients the care they so urgently need.”

In an analysis of the proposed rule, Nathan Beaver, a partner with the Foley & Lardner law firm, and Marika Miller, an associate with Foley & Lardner and a member of its telemedicine & digital health advisory team, said “widespread frustration” with the DEA’s efforts to craft a special registration over the past year make it unlikely that this proposed rule will be OK’d in its current form.

One of the biggest complaints is the requirement that providers qualifying for a special registration check their patient’s prescription history for the past year in state Prescription Drug Monitoring Programs (PDMPs) before prescribing via telemedicine.

Providers would be required to check PDMPs in the state where the patient is located, the state where the provider is located, and any other PDMPs in states that have reciprocity agreements with either of the first two states. Three years after passage of the proposed DEA rule, that requirement would be expanded so that a provider would have to check PDMPs in every state.

In urging the Trump Administration to withdraw the DEA proposal, Zebley said advocates hope to work with the DEA on a new version of the special registration—something the DEA has avoided doing for years.

“This is often a life-or-death issue and has understandably been a lightning rod for public comment due to the extraordinary stakes involved,” he said in the press release. “The DEA must implement a permanent framework for remote prescribing of controlled substances that strikes the right balance, ensuring necessary access while safeguarding against diversion.”