Lawmakers calls for extending telemedicine flexibilities, object to proposed DEA rule

Lawmakers on both sides of the aisle in the House and Senate are calling for COVID-era flexibilities on telemedicine services to be extended to ensure access to “necessary and life-saving treatments,” and are speaking out against a proposed rule reportedly being advanced by the DEA that would limit telemedicine prescribing.

Sens. Sheldon Whitehouse (D-R.I.), Lisa Murkowski (R-Alaska), Mark Warner (D-Va.) and Marsha Blackburn (R-Tenn.) led a group of 11 senators in a letter addressed to President Biden, objecting to a reported draft proposed rule from the Drug Enforcement Administration (DEA) to limit telemedicine prescribing.

The proposed rule would reportedly require that no more than half of a prescriber’s prescriptions be given through telemedicine. The rule would also reportedly make prescribing schedule II substances like Adderall virtually impossible, according to a Politico Pro report.

“We appreciated the DEA’s extension of the telemedicine flexibilities through the end of the year while developing this proposal, but are concerned that the new policies would significantly restrict access to necessary and life-saving treatments. These restrictions would be detrimental to patients and a barrier to accessing care,” the senators wrote in their letter.

During the public health emergency of the COVID-19 pandemic, telemedicine flexibilities were introduced to ensure people could continue receiving care. These flexibilities have since been extended twice. Some of these flexibilities have been made permanent, but others are set to expire at the end of this year.

The DEA sent a “Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription” to the Office of Management and Budget last week for regulatory review. It is not yet available to the public.

Among the flexibilities set to expire on Dec. 31 of this year are rules allowing federally qualified health centers and rural health centers to provide non-behavioral telehealth services as well as allowing all Medicare providers to offer telehealth services.

The COVID-era flexibilities have particularly helped expand access to substance abuse care and mental health services.

Reps. Doris Matsui (D-Calif.) and Buddy Carter (R-Ga.) led 18 members of the House in a similar letter addressed to DEA Administrator Anne Milgram.

Under 2008 legislation, the DEA was directed by Congress to develop a special registration for the Telemedicine process, which would have providers who wish to prescribe a controlled substance without an in-person visit register with the DEA. Despite 16 years having passed and more than one legislative directive from Congress, the agency has never established this registration process.

The DEA’s draft proposal reportedly includes plans to create such a process, but the members of Congress expressed concerns that what the agency was proposing is counter to what the legislation intended, citing the apparent exclusion of entire classes of drugs and providers.

“If the reporting is true, the proposed content of the rule seems misaligned with Congressional intent in authorizing such a Special Registration process. Such a rule may unnecessarily risk care for thousands of patients reliant on telemedicine for critical medications,” their letter read.

“We cannot condone such a potential interpretation of the Special Registration requirement,” they added.

The Hill has reached out to the DEA and White House for comment.