A coalition of provider and consumer organizations is asking policymakers to extend telehealth flexibilities related to virtual prescribing tied to mental health services.
In a letter to the Biden administration and leadership in the US House and Senate, a coalition of more than 330 organizations — including the American Health Care Association / National Center for Assisted Living and LeadingAge — asked Congress to include a two-year extension of pandemic-era remote prescribing flexibilities for controlled substances in an end-of-year legislative package. The group asked the White House to work with the DEA to use existing authorities to extend these flexibilities for two years to give the DEA time to establish a special registration pathways that balance access to care with appropriate enforcement.
The request comes based on anticipation that the DEA will “dramatically” limit virtual prescribing, either through new regulations or by allowing the existing flexibilities to expire at year-end, according to the American Telemedicine Association. Those telehealth flexibilities affect beneficiaries wherever they live — including assisted living communities, nursing homes and residences for individuals with intellectual and developmental disabilities.
“This is a predictable and preventable crisis that is looming come Jan. 1, and we are quickly running out of time to save countless patients from being abandoned, left without lifesaving clinically appropriate care,” Kyle Zebley, ATA senior vice president of public policy and executive director of ATA Action, said in a statement.
AHCA/NCAL said the issue is about safeguarding access to high-quality mental healthcare for vulnerable populations.
“Without the requested telehealth prescribing flexibilities for mental health services extension, the future availability of crucial services, particularly for individuals in AHCA/NCAL member communities in rural and underserved locations, is at serious risk,” AHCA/NCAL wrote in a blog post.
Setting the stage for telehealth flexibilities
In 2008, Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act, requiring the DEA and the Department of Health and Human Services to create permanent rules to allow practitioners to prescribe certain controlled medications via telehealth through a special registration pathway. Almost 40,000 comments were submitted last year when the DEA attempted to draft rules for a permanent framework on remote prescribing of controlled substances, according to the letter. A final rule has yet to be released, although it is said to be under review at the White House’s Office of Management and Budget.
During the COVID-19 pandemic, the DEA allowed registered practitioners to issue prescriptions for certain controlled substances via telemedicine without requiring in-person medical evaluations. Those flexibilities, which were extended through Dec. 31, 2024, ensured uninterrupted access to mental healthcare, substance use treatment, end-of-life care and other treatments.
Access to in-person care during a mental health crisis now is challenged due to a widespread shortage of mental health providers, adding urgency to the need to extend those telehealth flexibility, according to the coalition.
“Telemedicne has proven to be an effective tool in bridging the gap between patients and providers, reducing barriers to care, and supporting those most in need,” the letter to the White House read. “At its pandemic peak, telehealth represented 40% of mental health and substance use outpatient visits, and still remains strong, representing 36% of outpatient visits currently.”
