Big movement on Telehealth prescribing of controlled substances.

On August 25, the DEA sent its final rule — Special Registrations for Telemedicine and Limited State Telemedicine Registrations — to the White House for review. That's the last step before a rule can actually publish, so this is the clearest sign yet that a permanent framework is coming, with publication expected around November.

Here's why it matters: since the pandemic, Telehealth prescribing of Schedule II-V controlled substances has run entirely on temporary extensions. The current one runs through December 31, 2026. Without this rule finalizing (or another extension), that prescribing pathway is set to expire on January 1, 2027.

What the rule would create — a three-tier registration system:

• A standard Telemedicine Prescribing Registration for Schedule III-V substances
• An Advanced registration for specialists like psychiatrists and hospice physicians, covering Schedule II-V
• A Telemedicine Platform Registration for online platforms that dispense Schedule II-V substances

This has been a fight worth watching: the original proposal drew over 40,000 public comments, and advocacy groups like the Alliance for Connected Care pushed back hard on provisions like in-person visit mandates that would undercut the convenience Telehealth is built on. The American Telemedicine Association called this week's OMB submission "a major step toward a permanent federal framework" — while still flagging those same concerns.

Not sure how this affects your practice specifically? Book a quick call with me and we'll walk through what it means for how you're prescribing and operating today.

Sources:

• ​DEA seeks to finalize framework for e-prescribing of controlled substances — Healthcare IT News​
• ​DEA Prescribing of Controlled Substances — Alliance for Connected Care​
• ​Special Registrations for Telemedicine and Limited State Telemedicine Registrations — Federal Register​

Thanks for reading,

-Dan

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