The federal government will allow some providers to treat patients with opioid use disorder through telehealth.
The Health and Human Services Department and the Substance Abuse and Mental Health Services Administration posted a final rule Wednesday regarding opioid treatment programs. The rule will go into effect on April 2, 60 days after it is published in the Federal Register.
Under the final rule, opioid treatment programs can initiate buprenorphine treatment via audio-only and audio-visual telehealth. The rule also allows programs to initiate methadone treatment for some patients with audio-visual telehealth. After evaluations for either medication, the opioid treatment program practitioner will review the examination results and order the drugs as indicated, the rule says.
The final rule effectively makes permanent temporary flexibilities SAMHSA issued in spring 2020, the agency said in a fact sheet published Thursday. In the document, SAMHSA cited research demonstrating COVID-19-era flexibilities facilitated access to treatment, while reducing barriers and stigma.
The rule does not apply to pharmacies or providers not working in certified opioid treatment programs, according to the fact sheet. Individual states may have or may enact regulations more restrictive than SAMHSA’s final rule, the fact sheet said.
Jeremy Sherer, a partner and co-chair of the digital health practice at law firm Hooper, Lundy & Bookman, said the rule is fairly narrow in scope compared with pending Drug Enforcement Administration regulations regarding the prescription of controlled substances via telehealth.
“The final rule has no impact on the DEA’s decision regarding controlled substances prescribing more broadly, which is expected by the end of 2024. However, from an industry perspective, it’s encouraging to see SAMHSA—within the Department of Health and Human Services—making permanent COVID-era telehealth policies that have safely expanded access to care via telehealth," Sherer said in a statement.
In May 2023, the DEA extended flexibilities that allowed telehealth companies to remotely prescribe certain controlled substances, including buprenorphine, without an in-person visit until November 2023. The temporary order was subsequently extended again in October until Dec. 31, 2024.
The DEA's original proposed rule, published February 2023, would have allowed Schedule III-V substances like codeine, Xanax and Ambien to be prescribed over telehealth for only an initial 30-day dose. After the 30 days, patients would need to see a doctor once to get a refill. Schedule II substances like Vicodin, OxyContin, Adderall and Ritalin would have gone back to fully requiring an in-person visit before getting prescribed virtually.