DEA publishes final rule on continuity of care via telemedicine for veterans

On Jan. 17, the Drug Enforcement Administration published a final rule, “Continuity of Care via Telemedicine for Veterans Affairs Patients.” The final rule includes several key provisions.

Telemedicine Prescribing of Controlled Substances

• VA practitioners can prescribe Schedule II–V controlled substances via telemedicine without an in-person medical evaluation, as long as another VA practitioner has previously conducted an in-person evaluation.
• Another DEA final rule, “Expansion of Buprenorphine Treatment via Telemedicine Encounter,” allows indefinite prescribing via telemedicine within the VA system without requiring additional in-person evaluations.

Prescription Drug Monitoring & Safeguards

• VA practitioners must check both state Prescription Drug Monitoring Programs (PDMPs) and the VA’s internal prescription database before issuing prescriptions.
• If PDMP data is unavailable, a 7-day supply limit applies until the data can be reviewed.
• Pharmacy verification of patient identity is required.

Exemption from General Telemedicine Restrictions

• Unlike non-VA practitioners, VA providers do not need a “qualifying telemedicine referral” or an in-person exam to prescribe certain controlled substances.
• This exemption is due to the VA’s integrated health care system, which allows comprehensive patient data access.

Stricter prescription monitoring and compliance requirements may lead to closer scrutiny of prescriptions for sleep medications and may affect continuity of care if PDMP data access issues arise. However, veterans with sleep disorders will benefit from expanded telemedicine access, especially those in rural areas and/or with mobility issues.

This final rule went into effect Feb. 18. Members may send questions about the rule to coding@aasm.org.