United States, Tuesday, 28 January 2025.The DEA has proposed new telemedicine rules for prescribing Schedule II-V drugs, impacting hospice care with special registration requirements and strict recordkeeping standards.
New Registration Framework
On January 17, 2025, the Drug Enforcement Administration (DEA) unveiled comprehensive regulations introducing an Advanced Telemedicine Prescribing (ATP) Registration system [1][5]. This new framework specifically targets the prescription of Schedule II-V controlled substances via telehealth platforms, with registration fees set at 938 for practitioners requiring both ATP and State Telemedicine Registration [1]. The rules, which follow the agency’s temporary COVID-era flexibilities extending through December 2025 [1][2], represent a significant shift in how controlled substances can be prescribed remotely.
Impact on Healthcare Providers
The proposed regulations establish three distinct categories of special registration [6]. Healthcare providers must now obtain specific certifications for Schedule III-V substances, while an advanced registration tier allows qualified specialists to prescribe Schedule II medications [2]. The rules mandate that teleprescribing of Schedule III-V drugs requires audio-video examinations [1], with exceptions only when patients cannot access video capabilities [GPT]. Additionally, practitioners must verify patient identities and maintain detailed records of telemedicine encounters for two years [1].
Industry Response and Concerns
The American Telemedicine Association has expressed significant concerns, characterizing the proposed rules as creating ‘major setbacks’ due to ‘unworkable restrictions’ [4]. A particularly contentious requirement is the mandatory implementation of a nationwide Prescription Drug Monitoring Program (PDMP) check system within three years [1][2]. Healthcare providers must also maintain separate registrations for each state where they practice telemedicine, potentially creating substantial administrative burdens [2][6].
Timeline and Implementation
The DEA is currently seeking public input on these proposed regulations, with comments due by March 18, 2025 [1][2]. While the rules remain unaffected by the recent presidential regulatory freeze [1], implementation timelines may shift pending administrative review [5]. The final rule allowing buprenorphine prescriptions via telemedicine is set to take effect on February 18, 2025 [4], though this date could be extended during the transition period [5].
