The Temporary Rule is clear about its primary purpose: “The full set of telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID–19 PHE will remain in place through November 11, 2023.” This means that the status quo as it relates to telemedicine flexibility for the prescribing controlled substances will remain in place until November 11, 2023.

2. Why does the Temporary Rule reference a “grace period” until November 11, 2024?

The Temporary Rule provides a “grace period” until November 11, 2024 for patient provider relationships “established” on or before November 11, 2023. This means, according to the Temporary Rule, that “the full set of telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID–19 PHE will continue to be permitted via a one-year grace period through November 11, 2024. In other words, if a patient and a practitioner have established a telemedicine relationship on or before November 11, 2023, the same telemedicine flexibilities that have governed the relationship to that point are permitted until November 11, 2024.”

3. How does the “grace period” impact the necessity of in-person visits?

Based on the language of the Temporary Rule, provided a patient-provider relationship is established by November 11, 2023 (this includes existing patients and any patients that sign up before that date), no in-person visit will be required until November 11, 2024.

4. Does the Temporary Rule impact the ability to prescribe in states where a provider doesn’t have a DEA license?

At least until November 11, 2023, subject to state law, the PHE exception allowing providers to write prescriptions for patients in other states via telemedicine remains in place. As a reminder, here is the guidance issued on March 25, 2020 (which, to be clear, remains in place until November 11, 2023):

[T]o allow practitioners to prescribe controlled substances in states in which they are not registered if the practitioner is registered with DEA in at least one state and has permission under state law to practice using controlled substances in the state where the dispensing occurs. In other words, under this exception, a DEA-registered practitioner is not required to obtain additional registration(s) with DEA in the additional state(s) where the practitioner’s dispensing (including prescribing and administering) occurs if the practitioner is authorized to dispense controlled substances by both the state in which the practitioner is registered with DEA and the state in which the dispensing occurs. Practitioners may utilize this temporary exception via in-person prescribing or prescribing via telemedicine. Id. 802(54)(D). A practitioner using this exception must continue to comply with the laws and regulations of the state in which they are DEA-registered, and the laws and regulations of the state in which they are practicing, if different.

In short, on a Federal level, the Temporary Rule maintains the PHE status quo. In states that do not have conflicting regulations, providers with DEA licenses may prescribe in other states where doing so is permissible under state law.

For Existing Patients
Existing patients who are prescribed a controlled substance before May 10, 2023: The DEA will require a qualified referral on file before November 7, 2023 to continue treatment with controlled medications via telehealth. Patients can also choose to meet one of our providers in-person at one of our multiple locations.

For New Patients
New patients who need controlled substance prescriptions after May 10, 2023: The DEA will require patients who plan to use telemedicine services to manage their prescription to have a qualified referral on file before starting treatment. Patients can also choose to meet one of our providers for an in-person appointment.