DEA Confirms Providers Can Prescribe Controlled Substances Via Telemed

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The Department of Health and Human Services (HHS) and the Drug Enforcement Administration (DEA) have released clarification of United States Code contained in the Controlled Substances Act affecting Telehealth visits. 

 

President Trump in a Tuesday briefing said his administration would "encourage everyone to maximize use of telehealth to limit exposure to the virus."

 

The DEA has clarified that during a Public Health Emergency, which was issued by Secretary Azar of HHS on January 31st, 2020 due to the COVID-19 virus, that controlled substances may be prescribed via telemedicine without first conducting an in-person visit with the patient.  The Ryan Haight Act of 2008 established regulations and prohibited heathcare providers from prescribing controlled substances to patients that they haven’t first examined in-person.  Section 802(54)(D) of the Controlled Substances Act allows for the Ryan Haight Act to be circumvented during a public health emergency which would allow MDToolbox customers to electronically prescribe controlled substances (EPCS) for patients via telemedicine.

 

The DEA has stated three conditions for prescribing controlled substances via telemedicine:

  • The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice
  • The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system.
  • The practitioner is acting in accordance with applicable Federal and State law.

 

Not all States allow for EPCS via telemedicine, prescribers will need to ensure that they are following both their State law as well as the State law where the patient resides prior to prescribing via telemedicine.  Some states that allow for EPCS via telemedicine include Indiana, Michigan, Ohio, Florida, Delaware, New Hampshire, West Virginia, and Connecticut.  Prescribers should contact their State Medical and Pharmacy Boards as well as the State Boards where their patient resides to ensure their compliance.

 

HHS has also issued further clarification on the systems that can be used for a telemedicine visit, they have ensured penalties will not be enforced for using apps such as:

  • Apple FaceTime
  • Facebook Messenger video chat
  • Google Hangouts video
  • Skype

 

This is not an inclusive list and are examples of apps that can be used.  The app must be a private communication means that support both audio and video.  The DEA provided further clarification that public communication apps or streaming services are not to be used such as:

  • Facebook Live
  • Twitch
  • TikTok

 

The DEA has missed several deadlines to establish rules and a waiver system to allow electronic prescribing of controlled substances via telemedicine during a time in which we are not in a Public Health Emergency.  Reducing these road-blocks, as we are seeing with the emergency measures in place due to COVID-19 can help bring healthcare into the 21st century and help reduce stress on our medical system as well as help prevent infections.

 

We at MDToolbox applaud HHS and the DEA for removing the telemedicine restrictions and our team are watching for more regulation changes on a federal level that would allow electronic prescription of controlled substances via a telehealth practitioner.  You will find any policy and regulation updates here in our blog.  MDToolbox looks forward to working with telehealth providers and help provide tools and resources in combating healthcare system strain.  Contact us for more information or to start your free 30 day free trial.

New Legislation Reduces Telehealth Restrictions

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Emergency legislation has just been enacted that will allow for Medicare reimbursement for practices utilizing telemedicine to treat patients at home regardless of where they live.  The Coronavirus Preparedness and Response Supplemental Appropriations Act was introduced on Wednesday March 6th, 2020.  The bill was enacted and became law on the following Friday with near unanimous support in both the House and Senate.  The Act provides $8.3 billion in emergency funding to agencies responding to the Coronavirus outbreak.

 

The emergency funding is to be distributed by the Department of Health and Human Services (HHS) as follows:

  • $3.4 billion for the Office of the Secretary – Public Health and Social Services Emergency Fund (PHSSEF)
  • $1.9 billion for the Centers for Disease Control and Prevention (CDC)
  • $1.6 billion for international response efforts
  • $836 million for the National Institute of Allergy and Infectious Diseases (NIAID),
  • $61 million for the Food and Drug Administration (FDA)
  • $20 million is for the Small Business Administration (SBA)

 

The Act includes a provision entitled the “Telehealth Services During Certain Emergency Periods Act of 2020” which details a waiver removing restrictions on Medicare providers allowing them to offer telehealth services to beneficiaries regardless of whether the beneficiary is in a rural community.  The waiver becomes effective when either the President of the United States or Secretary of HHS declare a public health emergency.  Secretary Azar of HHS declared a public health emergency on January 31st, 2020 which was retroactive to January 27th, 2020.

 

 “To protect public health, the bill will allow Medicare providers to extend telemedicine services to seniors regardless of where they live, at an estimated cost of $500 million,” House Speaker Nancy Pelosi said in a statement released on March 4th.

 

From the demographics of those infected and killed by COVID-19 internationally, the current data available shows that the elderly age group are most affected by the virus.  While the virus has only begun spreading rapidly in the US in the past two weeks, the Act will hopefully be pro-active enough to save lives by giving patients the option to stay home, away from hospitals and doctor offices to be triaged and seen remotely by care providers.

 

China needed to emergently construct temporary hospitals in a matter of days to handle the influx of patients seeking medical attention, the US could likely see a similar rise in hospital visits and admittances.  Further adoption of telehealth could help alleviate some of that strain on the healthcare system, reducing infection by keeping patients at home, allowing providers to see more patients, and by reducing the sheer numbers of people entering healthcare facilities.

 

MDToolbox has positioned itself to cater to both traditional and telehealth providers needing a simple feature-rich electronic prescribing solution that can be implemented in a minimal timeframe.  Our stand-alone electronic prescribing system is streamlined and easy to use with a much more gentle learning curve than larger EMRs.  Most prescribers can be electronically prescribing within 24 hours, minimal downtime before being able to send prescriptions electronically to more than 98% of the pharmacies in the U.S. including mail order pharmacies that can deliver directly to home-quarantined patients.

 

Although the Coronavirus Preparedness Act removes some of the restrictions hindering telemedicine, the DEA has missed several deadlines to establish rules and a waiver system to allow electronic prescribing of controlled substances (EPCS) via telemedicine.  The Ryan Haight Act of 2008 requires an in-person consultation at regular intervals prior to EPCS via telemedicine.  Reducing these road-blocks can help bring healthcare into the 21st century and help reduce stress on our medical system as well as help prevent infections.

 

We at MDToolbox applaud Congress and HHS for removing some of the telemedicine restrictions and our team are watching for more regulation changes on a federal level that would allow electronic prescription of controlled substances via a telehealth practitioner.  You will find any policy updates here in our blog.  MDToolbox looks forward to working with telehealth providers and help provide tools and resources in combating healthcare system strain.  Contact us for more information or to start your free 30 day free trial.