Telehealth providers are receiving a flood of federal relief this week.
As the government reopens its doors, the Drug Enforcement Administration (DEA) also appears ready to issue another temporary extension of pandemic-era prescribing flexibilities.
Medicare telehealth providers will soon start to receive back pay for the last 42 days of the government shutdown. Many Medicare doctors have continued seeing patients via telehealth since Congress let the clock run out on government funding.
The industry is awaiting Centers for Medicare & Medicaid Services guidance on how to proceed with claims processing.
Meanwhile, the DEA posted a notice indicating that it will once again extend prescribing flexibilities for providers that prescribe controlled substances via telehealth. The temporary authority—last extended in November 2024—runs out Dec. 31.
The Department of Justice, which houses the DEA, has not yet provided details for the rule entitled the “Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications.” One lobbyist suggested the rule is likely a clean, one-year extension.
However, the temporary rules, which have been in effect for nearly six years, allow licensed DEA providers to prescribe Schedule 2-5 controlled substances via telehealth without requiring a patient to see the doctor in person.
It's not yet clear how DEA Administrator Terry Cole or Department of Health and Human Services Secretary Robert F. Kennedy Jr., foresee the future of online prescribing. The Make America Healthy Again movement has mixed views on controlled substances, according to an industry lobbyist, who says they have promoted hormone replacement therapy and psychedelics while expressing negative views of attention-deficit/hyperactivity disorder drugs and cannabis.
The extension will at least offer telehealth prescribers a lifeboat to continue operating under the status quo until the agency puts forward a permanent framework.
The DEA under former President Joe Biden struggled with the question of whether to allow Schedule 2 substances like Adderall and oxycodone to continue to be prescribed via telehealth without in-person guardrails.
The DEA’s congressional mandate is to prevent the diversion and abuse of controlled substances, and the agency has worried about the higher potential for the more addictive Schedule 2 substances to be misused if they are easily accessible online.
Days before Trump was sworn in, Biden's DEA released a controversial rule that created three distinct categories of telemedicine providers subject to different levels of scrutiny and slashed access to Schedule 2 controlled substances. That rule never went into effect.
The American Telemedicine Association released an initial reaction to the January rule at the time of its publication. “Early indications suggest the proposed rule includes elements that represent significant operational challenges,” Kyle Zebley, the association's senior vice president of public policy, said at the time.
A former DEA official told Fierce Healthcare at the time that the rule is “very bad for industry as it will basically shut down telemedicine and put a lot of companies out of business.”
The rule is being closely watched by a slew of associations and providers that are advocating for an expansive rule that allows telehealth prescribing of controlled substances to continue without in-person restrictions. They argue that physicians can determine whether a patient needs to be seen in person.