The U.S. Drug Enforcement Administration (DEA) and the U.S. Department of Health and Human Services (HHS) have for the third time extended the full set of telemedicine flexibilities for prescribing controlled substances that were initially adopted during the COVID-19 public health emergency. The current waivers were set to expire on December 31, 2024.

DEA had issued broad waivers during the pandemic to allow for the use of telehealth to prescribe controlled substances even for initial encounters. DEA and HHS will continue to allow DEA-registered practitioners to prescribe schedule II-V controlled substances using telemedicine without having conducted an in-person medical evaluation, with safeguards described below.

• The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice;
• The prescription is issued pursuant to a communication between a practitioner and a patient using an interactive telecommunications system that meets DEA/HHS regulatory standards;  
• The practitioner is: (1) Authorized under their DEA registration to prescribe the basic class of controlled substance specified on the prescription; or (2) Exempt from obtaining a DEA registration to dispense controlled substances under federal law; and
• The prescription is consistent with all other requirements of the rule. 

According to temporary rule, published in the Federal Register, this extension will give the agencies time “to promulgate and finalize regulations that are consistent with public health and safety, and that also effectively mitigate the risk of possible diversion.” The rule will also ensure a smooth transition for physicians and patients who have come to rely on the availability of telemedicine for controlled medication prescriptions, and allow adequate time for providers to come into compliance with any new standards or safeguards eventually adopted in a final set of regulations.

The DEA telehealth flexibilities enjoy strong bipartisan support in Congress in the event Congress needs to step in next year to extend the waivers.   

The California Medical Association (CMA) applauds this extension, which will allow patients to continue to receive safe and effective care via telemedicine. CMA strongly supports a permanent extension of the flexibilities for physicians to prescribe controlled substances via telehealth with certain protections. 

For More Information

• CMA letter to DEA
• Federal Register: Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications