Dive Brief:

• The Drug Enforcement Administration and the HHS have delayed a final rule expanding telehealth prescriptions of a drug that treats opioid use disorder for a second time.
• The agencies pushed back enforcement of the rule, which allows DEA-registered clinicians to prescribe up to an initial six-month supply of buprenorphine via telehealth without first seeing the patient in person, to Dec. 31.
• They also delayed another regulation that permits providers at the Department of Veterans Affairs to prescribe controlled substances without conducting an in-person evaluation if another VA practitioner had previously completed one. 

Dive Insight: 

Both regulations were finalized in January, just before President Donald Trump assumed office for his second term. The final rules were initially set to go into effect on Feb. 18, but were delayed until March 21 to comply with an executive order that froze agency regulatory work pending review. 

Now, the telehealth rules are on hold again through the end of the year. The delay will give the agency more time to “further review any questions of fact, law, and policy that the rules may raise,” the DEA wrote. 

The suspension also currently won’t affect how providers prescribe controlled substances via telehealth, the agency said.

During the COVID-19 pandemic, regulators implemented exceptions to a law that typically required clinicians to have an in-person appointment with a patient before prescribing controlled substances, like Adderall for ADHD or buprenorphine, to preserve access to care.

Those flexibilities were supposed to expire in 2023 following the end of the public health emergency. But they’ve since been extended multiple times, most recently in November when they were preserved through 2025.

But regulators have made moves to enact permanent policy. Alongside the buprenorphine and VA final rules, the agency proposed a long-awaited regulation that would create a process for prescribing controlled substances via telehealth, as well as add some restrictions to how many Schedule II prescriptions they could offer.

The DEA aruged the proposed regulation aims to protect access while preventing drugs from being dispensed improperly. However, some telehealth advocates and providers said the proposal could be onerous for clinicians to implement. 

Other telehealth policies have faced turmoil in Washington. Flexibilities for telehealth coverage in Medicare were preserved for another six months in March, just weeks before they were set to expire. The reprieve, which followed another short-term extension enacted in December, creates unpredictability and uncertainty for providers, telehealth groups say.