DEA and Telemedicine Prescribing

[SoulinNeed]

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Unlikely. I’m expecting it to return but possibly add more loopholes.

I don't see how it can't. It will have been six years by the end of 2025. I don't think it'll be "permanently extended", but it'll just be extended again. 200-300 companies requested it be extended, including Amazon, Google, and other major stakeholders. We'll see, but I don't see how it can just not be extended again.

 

[milesed]

https://www.dea.gov/press-releases/2025/01/16/dea-announces-three-new-telemedicine-rules-continue-open-access

 

[clausewitz2]

https://www.dea.gov/press-releases/2025/01/16/dea-announces-three-new-telemedicine-rules-continue-open-access

"The second of the two proposed requirements, under proposed 21 CFR 1306.45(c), would require that the average number of special registration prescriptions for Schedule II controlled substances constitutes less than 50 percent of the total number of Schedule II prescriptions issued by the clinician special registrant in their telemedicine and non-telemedicine practice in a calendar month."

So we'd have to keep a log of all our schedule II prescriptions and have the fun of telling people "actually you'll have to come in next appointment because the math says I have to do more in-person prescribing this month." Good times.

EDIT: Less noxious but also you have to now take a screenshot of someone holding up their government issued photo ID, I do love being a cop

 

[clausewitz2]

It gets better:

"Proposed 21 CFR 1304.61 would require that individual special registrants and platform special registrants report annual data on the total number of new patients in each state for which they issued at least one special registration prescription for a Schedule II controlled substance or certain Schedule III-V controlled substances, including Ketamine, Tramadol, and any depressant constituting a benzodiazepine; the total number of special registration prescriptions for Schedule II controlled substances issued by the special registrant, in aggregate and across all states; and the total number of special registration prescriptions for certain Schedule III-V controlled substances, including Ketamine, Tramadol, and any depressant constituting a benzodiazepines (including their salts, isomers, and salt of isomers), which were issued by the special registrant, in aggregate and across all states."

EDIT: It is nice that psychiatrists are presumptively eligible for special registration status rather than having to mother-may-I the DEA for the privilege.

 

[FlowRate]

"The second of the two proposed requirements, under proposed 21 CFR 1306.45(c), would require that the average number of special registration prescriptions for Schedule II controlled substances constitutes less than 50 percent of the total number of Schedule II prescriptions issued by the clinician special registrant in their telemedicine and non-telemedicine practice in a calendar month."

So we'd have to keep a log of all our schedule II prescriptions and have the fun of telling people "actually you'll have to come in next appointment because the math says I have to do more in-person prescribing this month." Good times.

EDIT: Less noxious but also you have to now take a screenshot of someone holding up their government issued photo ID, I do love being a cop

Yeah, they kept a lot of the heavy-handed data-gathering requirements from previously rejected versions of their proposals.

Plus you get to spend an extra $935 every 3 years for the privilege of continuing to to telemed prescribing. Assuming you just want to prescribe in one state.

 

[clausewitz2]

Yeah, they kept a lot of the heavy-handed data-gathering requirements from previously rejected versions of their proposals.

Of course. They're a law enforcement agency. Their concern above all else is to make it as easy as possible to prosecute people for violating the rules that they create.

 

[SoulinNeed]

It's obvious the DEA doesn't want any telemed prescribing, but they can't say that outright because it goes against congressional law, congressional law that has already allowed telemed prescribing of CS over and over again. At this point, Congress needs to step in and put an end to this yearly DEA fearmongering. The current rules are due to stay in place through 2025. That'll be almost six years.

 

[clausewitz2]

It's obvious the DEA doesn't want any telemed prescribing, but they can't say that outright because it goes against congressional law, congressional law that has already allowed telemed prescribing of CS over and over again. At this point, Congress needs to step in and put an end to this yearly DEA fearmongering. The current rules are due to stay in place through 2025. That'll be almost six years.

Congress actually instructed the DEA about a decade ago to develop a system for registration to allow remote prescribing of controlled substances, they have taken their sweet time.