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Telemedicine Association Hopes to Shape DEA Prescribing Regulations


A decade after Congress ordered the DEA to create a special registration for prescribing controlled substances via telemedicine, a new deadline looms.

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As the U.S. Drug Enforcement Administration (DEA) faces a new deadline to implement telemedicine prescribing regulations, the American Telemedicine Association is offering advice.

It’s been nearly a decade since Congress enacted the Ryan Haight Online Pharmacy Consumer Protection Act, which in part restricted the ability of telemedicine providers to prescribe controlled substances through virtual visits. The law included a provision allowing for a “special registration” avenue that would enable certain qualified providers to write prescriptions without an in-person exam. But the DEA has yet to issue the regulations necessary to implement the special registration process.

>> READ: Dark Web Opioid Sales Climb After DEA Painkiller Restriction

Last October, Congress passed the SUPPORT for Patients and Communities Act, which directed the DEA to promulgate final regulations for special registration within one year. Now, the American Telemedicine Association hopes to help shape the rules.

In a January letter to Kathy L. Federico, the DEA’s acting section chief of regulatory drafting and diversion control, American Telemedicine Association CEO Ann Mond Johnson applauded Congress for passing the SUPPORT Act and said her association created a special workgroup that came up with five recommendations for the implementation of the special registration process.

“These suggestions intend to strike the balance between our country’s great need for additional behavioral health resources, commonly accepted clinical practices, the evolving landscape of telemedicine technologies and DEA’s charge to protect the safety and well-being of citizens via drug diversion,” Johnson wrote.

The recommendations ask DEA to update its registration process to:

  • Create a distinction between traditional and telemedicine providers
  • Allow telemedicine registration for both sites and providers
  • Create a public comment period between now and the October 2019 deadline
  • Avoid placing any discipline-specific limitations on special registration
  • Allow telemedicine providers to register for DEA registration numbers in multiple states at the same time

Johnson noted that many parts of the SUPPORT Act were designed to combat the opioid crisis. She said she believes the American Telemedicine Association recommendations will serve that goal as well.

“Activation of the special registration provision will not only allow additional prescribers to use telemedicine to combat the opioid crisis, but also provide the broad range of medical disciplines an avenue to expand access to quality care,” she wrote.

In an article for the National Law Review, attorney Nathaniel M. Lacktman, whose firm participated in the American Telemedicine Association workgroup, said the increased emphasis on controlling opioid addiction comes at a time when the healthcare industry is being substantially remodeled as a result of technology like telemedicine.

Though the law has limited telemedicine prescribing, there is one substantial corner of the healthcare sphere where the limits are not in effect. The original Ryan Haight Act expressly exempted providers employed by or contracted with the Department of Veterans Affairs from the regulations, so long as the prescription is within the scope of the provider’s clinical role and the provider is registered with a state or works in a registered VA facility.

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