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As every chronic procrastinator knows, nothing feels better than an extension on a due date.
So we bet it was a big relief for the US Drug Enforcement Administration (DEA) and the Department of Justice (DOJ) to push back the effective date of two new telehealth rules from March 21 to Dec. 31.
The rules would permanently expand some temporary telehealth flexibilities for prescribing buprenorphine—a medication used to treat opioid dependence—and for Department of Veterans Affairs (VA) clinicians to prescribe controlled substances.
These telehealth flexibilities were enacted during the pandemic and are set to expire Dec. 31. But telehealth clinicians have long called for a permanent solution, and these rules—two of three final controlled substances guidelines released on Jan. 16—were part of that solution.
“Unfortunately, the DEA’s decision fosters uncertainty for both healthcare providers and their patients,” Hari Prasad, CEO of mobile patient intake management system Yosi Health, told Healthcare Brew. “Delaying the implementation of these rules signals hesitation at a time when we should be prioritizing access and continuity of care for vets.”
Tell me more. This isn’t the first extension, either. The rules were initially set to take effect on Feb. 18, but were pushed back to March 21 after President Trump took office and issued a regulatory freeze.
Rule one, Expansion of Buprenorphine Treatment via Telemedicine Encounter, would let telehealth providers prescribe the drug for up to six months without an in-person visit. Pre-pandemic, a patient needed to have an in-person medical evaluation to get more than an initial 30-day supply of buprenorphine.
The other rule, Continuity of Care via Telemedicine for Veterans Affairs Patients, would give special prescribing privileges to VA practitioners, allowing them to prescribe controlled substances remotely to patients they have never met in person, as long as that patient has received an in-person medical exam from another VA clinician.
Non-VA providers would have to get special registrations to prescribe Schedule II–V controlled substances—such as hydrocodone, oxycodone, Adderall, or Ritalin—without an in-person visit.
Christopher Adamec, executive director of industry group Alliance for Connected Care, previously told Healthcare Brew he felt these laws didn’t go far enough to expand telehealth access, adding that the buprenorphine rule’s six-month limit means a doctor could be forced to cut off treatment “in a potentially harmful way when the patient needs it most.”
The DOJ said in federal documents that it’s postponing the effective date to address public comments and to add more time to review “any questions of fact, law, and policy that the rules may raise.”