Remote prescribing of drugs and controlled substances must comply with applicable state and federal requirements. The majority of states permit a physician to prescribe following a telehealth examination. To prescribe a controlled substance, providers must also navigate state practice laws, pharmacy board laws, state-controlled substance diversion laws, and federal laws and regulations under the Drug Enforcement agency (DEA). During the COVID-19 PHE, the DEA is allowing DEA registered practitioners to prescribe controlled substances to patients without having conducted an initial in-person medical evaluation, provided certain conditions are met[22]:
- 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.
Additionally, the DEA is allowing practitioners to prescribe buprenorphine to new and existing patients with opioid use disorders via telephone without requiring practitioners to first conduct an examination of the patient in-person or via telehealth.[23]
Sources
Policy Recommendations
- Providers
- Stay apprised of policy changes during a pandemic.
- Keep team informed/trained to stay compliant.
- Policymakers
- Remove barriers to enable remote prescribing via telehealth at federal and state levels.
- Make PHE policies permanent that enable remote prescribing of controlled substances via telehealth without an initial in-person exam.
- Practitioners should be able to prescribe a legend drug based on a telehealth visit, including a controlled substance, if the practitioner is authorized to prescribe such legend drug under applicable state and federal laws and the prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of the practitioner’s professional practice.