The Drug Enforcement Agency (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) have issued a rule temporarily extending telehealth prescribing flexibility first implemented in response to the COVID-19 pandemic. The new temporary rule is effective the day the Public Health Emergency (PHE) ends (May 11, 2023) and offers several forms of flexibility with respect to prescribing of controlled substances via telehealth.

• The telemedicine flexibility offered during the PHE allowed practitioners to prescribe schedule II-V controlled substances via audio/video telehealth appointments, and FDA-approved, schedule III-V narcotic-controlled medications for treatment of opioid use disorder via audio-only telemedicine appointments, without requiring an in-person medical evaluation.
• Practitioners will have an additional six months, through November 11, 2023, during which they may prescribe controlled substances via telemedicine to any patient without having to conduct an in-person medical evaluation.
• An additional one-year grace period, through November 11, 2024, is applicable to patients and practitioners who established a telemedicine relationship on or before November 11, 2023. The grace period applies only if the practitioner has previously issued a controlled substance prescription to the patient, pursuant to the relief available during the COVID-19 PHE and through November 11, 2023.
• The DEA and SAMHSA had previously proposed rules that would have significantly restricted the prescribing flexibility offered during the PHE. These agencies will be reviewing the large volume of comments received in response to these proposed rules in order to determine if it is possible, from a regulatory perspective, to more permanently expand access to prescribing via telemedicine while addressing public health and safety concerns.