DEA Telemedicine Rule Changes

DEA Rule Changes to Class 2-5 Substances via Telemedicine

The DEA's Telemedicine Covid Waiver for prescribing class 2 prescriptions is set to expire on 12/31/2024 this year. What does this mean if the DEA doesn't extend the waiver and you are practicing Telemedicine and prescribe Class 2 Substances online?

It means that starting January 1st, 2025, before you will be able to prescribe a Controlled Class 2 Substance to a new patient via Telemedicine, you will have to have an in person evaluation.

The rule for Class 3 - 5 are as follows:

Those telemedicine consultations by a medical practitioner that has:

• never conducted an in-person evaluation of a patient;
• AND that result in the prescribing of a controlled medication.

For these types of consultations, the proposed telemedicine rules would allow medical practitioners to prescribe:

• a 30-day supply of Schedule III-V non-narcotic controlled medications;
• a 30-day supply of buprenorphine for the treatment of opioid use disorder

https://www.dea.gov/press-releases/2023/02/24/dea-announces-proposed-rules-permanent-telemedicine-flexibilities

DEA Rule Changes - DEA Certificate in Each State where Prescribing

In 2020, the DEA issued a rule suspending the requirement that a Prescribing Physician have a DEA Certificate / Number in each State where they are prescribing Class 2 - 5 Substances.

This rule is set to expire on 12/31/2024 under the conditions of the original ruling from 2020.

What this means is that if the DEA does not extend this rule, then Physicians who prescribe Controlled Substances across State Lines will be required to have a DEA Certificate / Number in Each State where their patients are located.

In order to have a DEA in a State, the physician is required to have an actual practice address where they treat patients. Out of State Physicians are going to have a difficult time prescribing across State Lines if this rule is not extended or made permanent. Telemedicine Physicians will have to have a physical practice in each State where they are prescribing. 

" A DEA individual practitioner registration is based on a State license to practice medicine and prescribe controlled substances. DEA relies on State licensing boards to determine whether a practitioner is qualified to dispense, prescribe, or administer controlled substances and to determine which schedules he/she may dispense, prescribe, or administer. State authority to conduct the above-referenced activities only confers rights and privileges within the issuing State. Thus, a DEA registration based on a State license cannot authorize controlled substance dispensing outside the State. See Registration Requirements for Individual Practitioners Operating in a "Locum Tenens" Capacity, 75 FR 55499, 55501 (Oct. 28, 2009); 21 U.S.C. 823(f); 21 CFR 1306.03(a). EO-DEA089, October 21, 2020"

https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-018)(DEA067)%20DEA%20state%20reciprocity%20(final)(Signed).pdf