DEA Okays Telehealth to Prescribe Opioids Amid COVID-19 Emergency

March 18, 2020 - Telemedicine has found yet another key purpose during the coronavirus public health emergency: the prescribing of controlled substances, such as opioids.

Per new clarification from the US Department of Justice Drug Enforcement Agency (DEA), healthcare professionals can now prescribe a controlled substance to a patient using telehealth technology.

This announcement comes in the wake of the public health emergency declared by HHS Secretary Alex Azar on January 31, 2020.

“While a prescription for a controlled substance issued by means of the Internet (including telemedicine) must generally be predicated on an in-person medical evaluation (21 U.S.C. 829(e)), the Controlled Substances Act contains certain exceptions to this requirement,” the Diversion Control Division wrote in a public statement.

“One such exception occurs when the Secretary of Health and Human Services has declared a public health emergency under 42 U.S.C. 247d (section 319 of the Public Health Service Act), as set forth in 21 U.S.C. 802(54)(D).”

In other words, healthcare professionals are seeing new avenues by which they may prescribe a controlled substance to a patient in need. While previous law required providers to meet with the patient in-person at least once before prescribing a controlled substance, they may now do so via telehealth. HHS and DEA allow this exception because the US entered into a public health emergency earlier this year.

“For as long as the Secretary’s designation of a public health emergency remains in effect, DEA-registered practitioners may issue prescriptions for controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided all of the following conditions are met,” the agency clarified.

Those conditions include:

• The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice
• The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system.
• The practitioner is acting in accordance with applicable Federal and State law.

To be clear, providers have always had the ability to prescribe a controlled substance via telehealth technology, so long as they have conducted an in-person evaluation with the patient previously. This update gets rid of that in-person evaluation requirement because the nation is in an public health emergency.

The DEA Diversion Control Division added that the industry is not facing a drug shortage at this time. These measures are specifically taking into consideration challenges patients may have in accessing a provider who can prescribe them an opioid painkiller or other controlled substance.

“The DEA is unaware of any shortages of controlled substances at this time,” the agency wrote. “DEA is working with the Food and Drug Administration (FDA) on monitoring the supply of controlled substance availability during the COVID-19 Pandemic.”

This step to lean even more so on telehealth is an important one, as healthcare experts become concerned about the transmission of the coronavirus from patient to provider. Telehealth has proven an effective strategy to promote patient access to care while keeping providers safe from COVID-19 transmission.

Medicare, for example, will be leaning on telehealth to expand access to care for beneficiaries, many of whom may be older and experience chronic conditions that make them at higher risk for the coronavirus.

“The Trump Administration is taking swift and bold action to give patients greater access to care through telehealth during the COVID-19 outbreak,” said Seema Verma, administrator of Centers for Medicare and Medicaid Services (CMS) in an earlier release. “These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit the risk of exposure and the spread of this virus. Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries.”

Other healthcare payers across the country have also opened up reimbursement and care access options using telehealth.