COVID-Era Telehealth Prescribing Extended Again

The Drug Enforcement Administration and Health and Human Services ended an impasse over the virtual prescribing of controlled substances that threatened access to drugs like Adderall by extending pandemic-era flexibilities through the end of 2025.

Why it matters: Keeping the status quo leaves the question of whether to make controlled substances available without an in-person doctor’s visit for the Trump administration to decide.

The latest: The agencies on Friday issued a final rule that marks the third temporary extension of telemedicine prescribing flexibilities that date to the COVID-19 pandemic and were due to expire at the end of this year.

  • Some patients have been grappling with shortages of Adderall and other amphetamines like Vyvanse used for attention-deficit/hyperactivity disorder. Behavioral health providers say access would be even tighter if old limits on telehealth prescribing were restored.

Health providers including the American Psychiatric Association and the Association of American Cancer Institutes had lobbied for a two-year extension and pressed Congress to get involved.

  • But the issue has been complicated for much of this year by a dispute between DEA and HHS over a DEA proposal that would have excluded Schedule II controlled substances, made providers write 50% of controlled substance prescriptions in person and set other requirements.
  • Patients and behavioral health experts are concerned restrictive proposals will disrupt care and access to treatment.
  • The DEA is concerned about the possible diversion and misuse of the substances. Testosterone is included in the cohort, as a steroid classified as a Schedule III controlled substance.

While virtual prescribing of controlled substances is temporary addressed, Congress has yet to act on a separate set of pandemic-era telehealth flexibilities for Medicare that are due to expire at year’s end.

 

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