DEA Extends Telemedicine Prescribing, But More Is Needed

Telemedicine reduces barriers to accessing end-of-life care, especially for very sick people and underserved populations, and we will continue working to keep it intact.

Major backlash to rules proposed in February prompted the Drug Enforcement Administration (DEA) to announce at the end of April that it would extend pandemic-era flexibilities that allowed clinicians to virtually — or via “telemedicine” — prescribe controlled medications to patients.

Compassion & Choices and our supporters were among those who submitted a record 38,000 comments opposing the proposed rules, which would have reinstated strict limitations on virtual prescribing, once again requiring patients to be evaluated in person by a doctor first. This requirement would pose heightened difficulties for people who are too ill to travel outside the home and/or underserved communities that lack suitable care providers. As a result, the DEA together with the Department of Health and Human Services drafted the “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications” just two days before the COVID-19 public health emergency expired. The temporary extension will uphold telehealth flexibilities through November 11, 2023. 

“We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities for six months while we work to find a way forward to give Americans that access with appropriate safeguards,” said DEA Administrator Anne Milgram in a statement.

While this extension is good news, there are still challenges, as detailed in a South Florida Sun Sentinel op-ed co-authored by Compassion & Choices President and CEO Kim Callinan and Dr. Michael Fratkin, a palliative care physician, telemedicine pioneer and member of Compassion & Choices’ Healthcare Advisory Council. “The proposed rule does not adequately support patients at the end of life and will substantially impact their access to essential care. An exemption from the in-person exam requirement should be made available to people at the end of life. … From our perspective, the proposed rule is built to regulate other parts of the healthcare system, not patients at the end of life,” wrote Callinan and Fratkin. 

Compassion & Choices will continue monitoring the situation and advocating for a permanent exception to the proposed rule for terminally ill adults.