Warner on Proposed Special Registration Rule for Telehealth Prescribing

WASHINGTON - U.S. Sen. Mark R. Warner (D-VA), a member of the Senate Finance Committee, today released the statement below on a new proposed rule by the Drug Enforcement Agency (DEA) governing the use of telemedicine to prescribe controlled substances. This proposal follows years of advocacy by Sen. Warner, who has been outspoken about the need to utilize telehealth to help address the dramatic shortage of mental health providers nationwide. In August, Sen. Warner once again called for the establishment of a special registration rule for providers, and blasted a reported proposal that would have significantly affected patients' ability to access certain prescriptions through telemedicine.

"Since 2008, Congress has pushed the DEA to create a special registration that allows specially certified and trained prescribers to safely prescribe controlled substances via telehealth without requiring an in-person visit. Today, I applaud the DEA for listening to lawmakers and taking a huge step forward towards providing permanent certainty for the many patients who rely on telehealth prescribing and have done so for years, thanks to pandemic-era flexibilities. While the proposed tiered approach is generally commensurate with the increased risk of diversion and fraud, I am concerned that some of the proposed guardrails are overly restrictive and do not reflect the legitimate ways telemedicine is safely conducted today. I look forward to working with stakeholders, the DEA, and my colleagues in Congress to review this proposal and ensure that any final rule meets the needs of patients while aligning with commonsense 21^st century health care practices," said. Sen. Warner.

During COVID-19, patients widely adopted telehealth as a convenient and accessible way to get health care services remotely, including mental health and substance use disorder treatment. This was made possible by the COVID-19 Public Health Emergency, which allowed for a number of flexibilities, including utilizing an exception to the in-person medical evaluation requirement under the Ryan Haight Online Pharmacy Consumer Protection Act, legislation regulating the online prescription of controlled substances. Now that the Public Health Emergency has expired and temporary DEA flexibilities are set to expire at the end of 2025, patients will soon lose the ability to reap the benefits of a mature telehealth system whose responsible providers know how to take care of their patients remotely when appropriate.

Since 2008, Congress has directed the DEA to set up a special registration process, another exception process under the Ryan Haight Act, that would permanently allow for quality health care providers to evaluate a patient and prescribe these medications over telehealth safely, as they've done during the pandemic. The new rule proposed by the DEA would allow medical providers to register to prescribe controlled substances through telehealth.

Sen. Warner, a former tech entrepreneur, has been a longtime advocate for increased access to telehealth. He is an original cosponsor of the CONNECT for Health Act, which would expand coverage of telehealth services through Medicare, make COVID-19 telehealth flexibilities permanent, improve health outcomes, and make it easier for patients to safely connect with their doctors. He previously wrote to both the Biden and Trump administrations to urge the DEA to finalize regulations that allow doctors to prescribe controlled substances through telehealth. Sen. Warner also sent a letter to Senate leadership during the height of the COVID-19 crisis, calling for the permanent expansion of access to telehealth services. In September 2023, Sen. Warner led bipartisan partners to share serious concerns about an earlier version of DEA's proposed rule, which would also have seriously curtailed access to prescriptions through telemedicine.

In 2018, Sen. Warner included a provision to expand financial coverage for virtual substance use treatment in the Opioid Crisis Response Act of 2018. In 2003, then-Gov. Warner expanded Medicaid coverage for telemedicine statewide, including evaluation and management visits, a range of individual psychotherapies, the full range of consultations, and some clinical services, including in cardiology and obstetrics. Coverage was also expanded to include non-physician providers. Among other benefits, the telehealth expansion allowed individuals in medically underserved and remote areas of Virginia to access quality specialty care that isn't always available at home.

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