In response to DEA listening session scheduled for next week regarding updating proposed rules on telehealth
WASHINGTON, DC, SEPTEMBER 6, 2023 – ATA Action officially submitted comprehensive recommendations to the Drug Enforcement Administration (DEA) around how to create a Special Registration process for telemedicine prescribing of controlled substances.
“ATA Action’s comments to DEA’s March 2023 proposed rules specifically detail why in-person mandates restrict access to care and how restricted access to telemedicine will increase patient harm and diversion risk. We appreciate DEA’s efforts to review and incorporate stakeholder feedback on those comments, including considering the creation of a Special Registration process,” noted Kyle Zebley, Executive Director, ATA Action, in the ten-page document submitted to the DEA. “We maintain that in-person requirements are not a clinically appropriate or effective way to limit diversion and our first preference would be to permanently waive the in-person requirement as done during the COVID-19 public health emergency.”
ATA Action urges DEA to consider two principles when regulating telemedicine prescribing of controlled substances: Clinical practice should not be limited by non-clinical decisionmakers, and telehealth is not a type of care, but a modality of care. Rules should take into account the unique nature of the use of technology as a modality without arbitrarily restricting its use.
ATA Action’s recommendations to DEA for a Special Registration process for telemedicine prescribing of controlled substances without a prior in-person visit include seven tenets:
- The Special Registration process should work in conjunction with the existing registration process.
- Telemedicine providers should not be required to maintain local addresses in every state where they practice.
- Special Registration should include the elements DEA needs to monitor for illegitimate practitioners and illegal prescribing practices.
- Special Registration should not be limited to any specific specialty or treatment condition. Schedule II prescribing could involve additional oversight but should not have additional restrictions.
- Dispensers (pharmacies and pharmacists) should be able to identify legitimate prescribers who have a current Special Registration.
- The location of the patient should not require any registration unless otherwise required because controlled substances are dispensed or administered at that site.
- The Special Registration process should not place any arbitrary limits on a clinician’s ability to practice within the scope of their authority.
“We appreciate the ability for stakeholders to comment on proposed rules and the allowance of enough time for DEA to consider such comments. Our thanks to DEA for their efforts to host public listening sessions to hear feedback from stakeholders in order to inform DEA’s regulations on prescribing controlled substances via telemedicine,” added Zebley. “Our recommendations seek to strike the balance between ensuring legitimate prescribers may practice – thereby expanding access to needed healthcare services using the telehealth modality – with preventing diversion. Our recommendations are also designed to fit into DEA’s current infrastructure without creating undue burdens for providers and urge DEA to consider realistic timelines when implementing these new processes.”
- ATA Action Letter to the DEA (September 6): ATA Action Recommendations to DEA on a Special Registration Process
- ATA Action’s Letter to the DEA (March 28): Telemedicine Prescribing of Controlled Substances When the Practitioner and the Patient Have Not Had a Prior In-Person Medical Evaluation
- ATA Action’s Letter to the DEA (March 27): Expansion of Induction of Buprenorphine via Telemedicine Encounter
About ATA Action
ATA Action recognizes that telehealth and virtual care have the potential to transform the healthcare delivery system by improving patient outcomes, enhancing the safety and effectiveness of care, addressing health disparities, and reducing costs. ATA Action is a registered 501c6 entity and an affiliated trade organization of the American Telemedicine Association (ATA).
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