Can you prescribe your patients controlled medications remotely without ever meeting them? These medications include suboxone, buprenorphine, and any DEA schedule II and III drugs. (https://www.dea.gov/druginfo/ds.shtml). It would appear NO under the Federal Ryan Haight Online Pharmacy Protection Act. (https://www.govtrack.us/congress/bills/110/hr6353/text)
The Federal Ryan Haight Online Pharmacy Protection Act is a law that came about in the late 90s with the proliferation of online pharmacies to stem the fraudulent distribution of controlled meds without prescriptions.
It's very restrictive, because there is an absolute requirement for one (1) in-person visit for a controlled med to be prescribed. However, there are seven (7) exceptions and I'll explain the easiest one to allow you prescribe. The easiest exception for when the patient is located at a facility registered with the DEA and is being treated by a DEA-registered provider who is in the physical presence of the patient.
Real Life Example For Illustration
- Patient A is at a mental health clinic that is not registered with the DEA.
- Patient A is in the physical presence of a mental health worker, but is not in the physical presence of a DEA registered provider.
- Psychiatrist B is registered with DEA and treats the patient via telemedicine.
- Physiatrist B’s treatment includes a prescription for a controlled substance.
DEA finds that this issuance of a prescription via telemedicine violates the Ryan Haight Act.
The easy solution is to find a local to your patient DEA registered clinic (ER, Urgent Care, etc) who has a Doc/NP/PA who is registered with the DEA (most prescribers are), and have patient go to that clinic, and in the presence of that DEA registered provider, have your remote visit and prescribe controlled meds.
Not the most elegant solution but there are some proposals for new laws to be come in, however they have not been passed as of writing this article. (http://docs.house.gov/meetings/IF/IF14/20180228/106915/BILLS-115pih-HR___-U16.pdf)
The “Improving Access to Remote Behavioral Health Treatment Act” would allow certain community mental health centers and addiction treatment centers to obtain DEA registration as a clinic, thereby allowing telemedicine providers to prescribe controlled substances to patients present at those sites without the need for an in-person examination. Currently, treatment sites are restricted to DEA-registered hospitals and some very limited other non-hospital clinics.
If you have more questions, please contact my law firm at www.KhatriMedLaw.com or info@KhatriMedLaw.com if you have need more advice on how to stay compliant.