VA prescribers are exempt from DEA’s special telehealth registration
For veterans who have had an in-person visit with Veterans Affairs health care providers, the Drug Enforcement Administration is expanding these provider-patient relationships to all VA practitioners who engage in telemedicine with the patient, DEA said in a statement Friday.
The new final rule, issued jointly by the Department of Justice, the Substance Abuse and Mental Health Services Administration, and the Department of Health and Human Services, says VA telehealth prescribers do not have to participate in a new special registration for controlled substances prescribed in virtual cases. concern.
WHY IT’S IMPORTANT
Because it is a nationally integrated, closed health care system, the VA has “rigorous internal policies and controls that ensure patient safety, continuity of care, and thorough monitoring of prescriptions,” DEA said in its notice of proposed rulemaking.
The new rule, Continuity of Care via Telemedicine for Veterans Affairs Patients, requires VA telehealth prescribers to review and update the patient’s electronic VA health record and review drug monitoring program data for the state in which the VA patient is located at the time of the illness. the telemedicine visit before prescribing a schedule II-V controlled substance.
If the VA EHR or state PDMP data is not available, the physician should limit the prescription to a seven-day supply until he can access both data, the agency said in its report. notification in the Federal Register.
The DEA explained in its notice that structuring the requirements differently for VA and non-VA practitioners increases safety without placing undue restrictions on veterans’ health care delivery model.
Because VA practitioners have access to shared information systems, including an internal prescription database, they can adequately “monitor and manage prescriptions for controlled substances,” the agency said.
“This infrastructure ensures the safety of telemedicine prescribing without the need for an additional layer of registration, as VA practitioners operate within a highly regulated and cohesive system specifically tailored to the needs of veterans,” DEA said.
Effective Feb. 18, the VA exemption from special registration for telehealth prescribers does not apply to community health network providers or others who conduct disability compensation evaluations, the agency said in the notice.
THE BIG TREND
DEA said the goal with three new telehealth rules is to balance access to virtual care for the long term. Temporary waivers from the Ryan Haight Act, enacted and extended in response to the COVID-19 pandemic and recovery, are set to expire this year.
The general rule, on which the agency is accepting public comments, applies “necessary safeguards against the misuse or abuse of controlled substances” in the larger health care industry, DEA said.
Among the administration’s concerns is the practice of visiting multiple health care providers in non-integrated systems to obtain multiple prescriptions, known as “doctor shopping,” which the agency says encourages drug diversion.
However, according to a response statement from the American Telemedicine Association, DEA’s proposed framework for the new dedicated telehealth registry has significant implications for healthcare providers.
“Early indications indicate that the proposed rule contains elements that represent significant operational challenges,” said Kyle Zebley, senior vice president of public policy for the ATA and executive director of ATA Action.
Also on Friday, DEA published the Expansion of treatment with buprenorphine via Telemedicine Encounter. This rule allows providers to prescribe an initial six-month supply for the treatment of opioid use disorder via audio-only telemedicine interaction, without prior in-person evaluation.
“DEA and HHS believe that expanding access to buprenorphine through audio-only telemedicine outweighs the relatively lower risk of abuse and diversion of buprenorphine,” the agency said.
ON THE RECORD
“The proposed expansion of authorized internet prescribing for VA practitioners responds directly to the changing landscape of VA patients’ health care needs, advances in telemedicine, and DEA’s ability to implement safeguards that protect against potential abuse,” it said agency in the communication.
“VA now has improved tools and data systems, including enhanced monitoring of telemedicine practices and centralized systems such as the VA’s internal prescription monitoring database, allowing for more effective oversight than what was available in the past.”
Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.