Following the February 27 statement opposing the US Drug Enforcement Administration’s proposed permanent change to the electronic prescribing of controlled drugs, the American Telemedicine Association and the Executive Their ATA action sent their final comment this week in two letters.
WHY IT IMPORTANT
In an effort to prevent drug diversion with telehealth, the DEA has missed the point of the benefits telehealth offers during the pandemic, the ATA said.
In two letters addressing the telemedicine prescribing of controlled substances – Expanding “Prescribing Buprenorphine through telemedicine” and “Telemedical prescribing for controlled substances when a physician and patients who have not had a previous direct medical evaluation” – ATA outlined some of its arguments, requested more time for compliance, and made recommendations to update the proposed rules to maintain compliance. Maintain mechanisms to prevent diversion and at the same time ensure patients do not lose access to needed treatments.
The main concern is when it comes to direct regulation – all patients must see a doctor in person within 30 days or their prescription will be forfeited – to prescribe certain controlled substances, such as buprenorphine, will cause a backlash that harms patients when the rule goes into effect May 11 when the public health emergency ends.
“We are deeply concerned about the time taken to finalize and implement the new process proposed by the DEA,” ATA wrote.
“To ensure that patients do not lose access to essential services through telehealth, we strongly urge the DEA to extend its pandemic flexibility measures now in the period in which the rule is finalized and enforceable, or at least until 2023.”
Nationwide, people with mental health and substance use disorders as well as other vulnerable populations – such as those in palliative or hospice care – rely on Telehealth opportunities are exploding during a pandemic for a number of reasons:
- Lack of suppliers
- live timeout
- Nature of sensitive conditions and privacy needs
- SUDs disrupt social barriers and stigmas
- Unnecessary convenience issues – both rural and urban
“We are concerned that face-to-face requests will exacerbate existing inequalities in the health care system, as it will only serve patients who are likely to see a doctor in person and skip miss the point where telehealth offers to reach previously inaccessible populations,” ATA said.
The ATA is also concerned that the “telemedicine seal” on legitimate prescriptions has led to an increase in over-the-counter denials.
“Clinically, a valid prescription is a valid prescription, and the fact that a prescription is issued through a telemedicine system makes it no less important. Unfortunately, a stamp like This can lead to confusion and frequent denials of valid prescriptions,” ATA said.
The organization pointed to the existing electronic prescribing for controlled substances used to determine the legitimacy of prescriptions.
EPCS ensures that only authorized providers who meet a range of criteria are able to securely transfer controlled substance prescriptions electronically, but pharmacies need to make it clear on the stamps and also lacked instructions, so they made a mistake on the cautious side.
“The special registration process could be an opportunity for pharmacists to more easily identify legitimate telepresidents,” the ATA said.
If the DEA does not exercise its right to waive its request, it recommends authorizing group referrals, rather than a specific named clinician, and removing the requirement for referral providers on the application. electronic medicine.
“If this requirement were upheld, the proposed referral route would not work – or at least be implemented in a non-compliant manner – for most care providers,” the ATA said. health using a standard electronic prescribing platform”.
The DEA’s ability to identify legally operating providers and match those that do not may be governed by a special registration regime, the DEA’s original requirement in the Pharmacy Act. Ryan Haight Online Product 2008.
That registry could also solve the confusion problem for pharmacies.
TREND TO BIGGER WOMAN
Although the DEA has failed to establish a program to ensure that health care providers can successfully prescribe controlled substances through telehealth — similar to EPCS for Direct Providers — The SUPPORT Act gave the agency a second mandate to do so by October 2019.
But that also did not happen, citing the agency citing an administrative burden.
In 2022, Sen. Mark Warner, D-Va urged the Biden Administration to allow physicians to prescribe controlled substances through telehealth as PHE draws to a close.
Warner wrote in May 2021: “The failure of the DEA to address this issue means that the majority of healthcare providers use telehealth to prescribe controlled substances. control and treatment of their patients has been hindered in providing them with the quality care they need.”
While thousands of behavioral health professionals and other providers have voiced concern that permanent rules aimed at preventing drug diversion will harm patients and instead boost the marketplace. blacklist for some drugs, some healthcare providers have questioned the development of prescription drugs during the COVID-19 PHE pandemic and related exemptions.
But even those skeptics say that establishing systematic monitoring of controlled substance prescribing through telehealth is achievable.
Dr Mimi Winsberg, CMO and another co-founder of Brightside Health, said: “We want to work towards the proper prescribing of controlled substances and if we can find a way to regulate it online in a way that can be regulated online. It’s great if it makes sense.” Healthcare IT News in October.
ON PROFILE
“Telehealth enhances accessibility and requires in-person provider meetings within 30 days as a barrier and worst-case scenario impossible,” ATA said in a comment letter.
“Especially for vulnerable populations and those who may not trust the health care system, asking to see a provider in person creates the risk that patients will discontinue care.”
Andrea Fox is the senior editor of Healthcare IT News.
Email: [email protected]
Healthcare IT News is a publication of HIMSS Media.
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