Years before the COVID–19 pandemic, the 2008 Ryan Haight Act stated that prescribing practitioners—subject to certain exceptions—may prescribe controlled medications only after conducting an in-person evaluation. As the world shifted at the outset of 2020, the Department of Health & Human Services (HHS) and the Drug Enforcement Administration (DEA) granted temporary exceptions to the 2008 law to help avoid lapses in patient care.
Under these exceptions, providers could prescribe controlled medications via telemedicine appointments even when the prescribing provider had not conducted an in-person medical evaluation of the patient. These telemedicine flexibilities authorized practitioners to prescribe schedule II–V controlled medications via audio-video telemedicine encounters.
On May 10, 2023, the DEA and HHS issued a temporary rule that extended the telemedicine flexibilities regarding the prescribing of controlled medications. In accordance with this rule, if a patient and a practitioner had established a telemedicine relationship on or before Nov. 11, 2023, the same telemedicine flexibilities that had governed the relationship to that point would continue to apply through Nov. 11, 2024.
The DEA held telemedicine listening sessions in September, then further extended these exceptions. As of Nov. 11, the exceptions have been extended to Dec. 31, 2024.
The ACR supports the use of telehealth and extension of regulatory flexibilities to improve access to care and consistency of care. Rheumatic diseases are chronic and debilitating and require continuous follow-up with the rheumatic care team. Telehealth services, including prescribing medications via audio-video visits, has filled a crucial gap during the pandemic and makes it easier for many patients with rheumatic diseases to get the care they need. This is especially true for patients who are immunocompromised, economically disadvantaged patients and patients living in geographic areas with prolonged travel times to see their rheumatologist.