Prescribing Controlled Substances via Telemedicine - What you need to know Post-Pandemic

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MAY 2023 STATUS UPDATE:    On May 9, 2023 the DEA has announced a temporary extension of the Public Health Emergency ruling that allowed electronic prescribing of controlled substances via telemedicine encounters.  The flexibilities allowed during the COVID-19 pandemic were set to expire on May 11, 2023.   With this new extension, telemedicine healthcare providers can continue to see their patients and prescribe medications without first needing an in person encounter for most medications. The extension has been set for 6 additional months while the DEA reviews feedback they received on their February proposed ruling for new regulations with telemedicine prescribing post-pandemic.


For more information see the DEA press release at:




On April 11, the Biden Administration signed a bill ending the pandemic emergency. After three years, the federal public health emergency (PHE) will expire May 11, 2023.


Three years ago when the emergency was declared, several rules that affected healthcare were changed.  One of the biggest ones in e-prescribing was the Ryan Haight Act which stated Controlled Substances could not be prescribed via telemedicine.  With the new PHE emergency declared, this rule was temporarily paused, controlled substances could now be prescribed via telemedicine without an in person encounter prior to.


The Drug Enforcement Administration (DEA) has proposed a new ruling (Ryan Haight Act Amendment) which would allow limited controlled substance prescribing via telemedicine only visits but it is only proposed – it has not passed yet.  If this ruling does not pass, on May 11, 2023 telemedicine only encounters/visits no longer can prescribe controlled substances again. If it does pass then it is likely a limited set of controlled substances will be able to be prescribed via telemedicine.


Details on the Proposed Ruling:


In late February, the DEA announced a set of proposed rules that would both include and roll back some of the flexibilities allowed during the pandemic for the prescribing of controlled substances via telemedicine. Prior to the PHE, in most cases prescribing of controlled substances via telemedicine was not allowed. A prior in person visit was required for schedule 2-5 prescribing.


The proposed new rule which is currently being voted on would restrict Schedule 2 drugs via telemedicine again.    However, for many Schedule 3-5 drugs, patients would be able to receive an initial 30-day prescription via telehealth. But after the initial fill, patients will need an in-person visit to get a refill.  The proposed rule was open for comments during March and many medical associations and providers have commented they think it should be longer than 30 days, some even saying 6 months or a years worth before needing an in person visit.  The main push is because of Schedule 3-5 drugs that treat controlled substance addiction.  Many believe giving patients easier access to medicines that treat substance abuse is helping fight the addiction problem in the U.S.


The proposed ruling also contain several other new rules including the requirements for “record keeping” (prescribers would need to be able to produce a list of all patients and medications prescribed via telemedicine on demand if requested by DEA investigation) as well as all prescriptions prescribed by telemedicine would need to include a note that the prescription was prescribed by a telemedicine encounter.


MDToolbox already has the ability to produce reports as well as the ability to include the required note (pharmacy note field) as well as other small enhancements are being considered as we await the final ruling.   Another update will be published after the DEA final ruling announcement.   To start e-prescribing via telemedicine contact us today to get your free 30 day no-obligation trial.



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