The Drug Enforcement Administration (DEA) is seeking approval from the White House to temporarily extend current COVID-19 Public Health Emergency (PHE) flexibilities for prescribing controlled substances via telemedicine.  The DEA, in coordination with the Department of Health and Human Services, submitted a draft temporary rule, the “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications,” to the White House Office of Management and Budget on April 25.

While the specifics of the temporary rule are not yet public, we anticipate a full extension of DEA’s existing PHE flexibilities, which include the waiver of the in-person medical evaluation requirement. Such extension will prevent a “prescribing cliff” following the end of the PHE and will allow providers to continue to prescribe controlled substances, including Schedule II and narcotic controlled substances, to patients via telemedicine without having to conduct a prior in-person medical evaluation of the patient.

“We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities while we work to find a way forward to give Americans that access with appropriate safeguards,” Anne Milgram, the DEA Administrator, said in a statement.

The DEA has yet to announce a decision about its future telemedicine prescribing policies. Still, the temporary extension will serve as a stopgap to ensure continuity of care for patients following the end of the PHE on May 11. The temporary rule will also give the DEA additional time to finalize its recent companion proposals, which were released in February and generated widespread criticism for being regarded as more restrictive than necessary. As drafted, the proposed rules would reinstate strict limitations on the virtual prescribing of controlled substances and would largely roll back the in-person medical evaluation flexibilities extended during the PHE.  Some of the proposals put forth include a 180-day extension of the in-person waiver for patients who were treated and prescribed controlled substances via telemedicine during the PHE, and the ability to prescribe up to a 30-day supply of Schedule III-V, non-narcotic, controlled substances via telemedicine without an in-person visit, among others. The DEA received over 38,000 public comments to the proposals, which the agency said was a record.

Further details regarding the temporary rule will become public after its full publication in the Federal Register at which time we will provide a full update.