For veterans who have an in-person visit with VA providers, the DEA is expanding provider-patient relationships to include all VA practitioners participating in telemedicine with the patient, the DEA said in a statement Friday.
The new final rule was issued jointly by the Department of Justice, Substance Abuse and Mental Health Services Administration, and Department of Health and Human Services, so that telehealth providers in Virginia do not have to participate in a new special registration for controlled substances prescribed by default care.
Why does it matter?
Because it is a closed, nationally integrated health care system, the VA has “strict internal policies and controls that ensure patient safety, continuity of care, and comprehensive oversight of prescriptions,” the VA said in its notice of proposed rulemaking.
The new rule, Continuity of Care via Telemedicine for Veterans Affairs Patients, requires Virginia telehealth prescribers to review and update a Virginia patient’s electronic health record and review Prescription Drug Monitoring Program data for the state in which the Virginia patient is located at the time. of a telemedicine visit before a Schedule II-V controlled substance was prescribed.
If VA EHR data or state PDMP data are not available, the practitioner should limit the prescription to a seven-day supply until he or she has access to both records, the agency said in its report. He notices In the Federal Register.
The DEA explained in its notice that structuring the requirements differently for VA and non-VA practitioners promotes safety without imposing unnecessary restrictions on the veterans’ health care delivery model.
Because VA practitioners have access to shared information systems, including an internal prescription database, they can “appropriately monitor and manage controlled substance prescriptions,” the agency said.
“This infrastructure ensures the integrity of telemedicine prescribing without the need for an additional layer of recording, as victim assistance practitioners work within a highly structured, cohesive system specifically designed to meet the needs of veterans,” the DEA said.
As of February 18, the VA’s exemption from special registration for telehealth providers does not apply to community or other care network providers or conducting disability compensation evaluations, the agency said in the notice.
The biggest trend
The DEA said its goal with three new telehealth rules is to balance access to virtual care in the long term. Temporary waivers for the Ryan Haight Act, issued and expanded in response to and recovery from the COVID-19 pandemic, End of this year.
the General ruleThe agency, which is accepting public comment, is implementing “necessary safeguards against the diversion or abuse of controlled substances” across the larger health care sector, the DEA said.
One of the government’s concerns was the practice of visiting multiple health care providers across non-integrated systems to obtain multiple prescriptions, known as “doctor shopping,” which the agency said leads to drug diversion.
However, according to a reaction statement from the American Telemedicine Association, the DEA’s proposed framework for a new private telehealth registry carries significant implications for providers.
“Early indications are that the proposed rule includes elements that present significant operational challenges,” said Kyle Zepley, senior vice president for public policy at ATA and executive director of ATA Action.
Also on Friday, the DEA posted Expansion of buprenorphine treatment via telemedicine encounter. This rule allows providers to prescribe an initial six-month supply of opioid use disorder treatment via audio-only telemedicine interaction without prior in-person evaluation.
“DEA and HHS believe that expanding access to buprenorphine through audio-only telemedicine outweighs the relatively low risks of buprenorphine misuse and diversion,” the agency said.
registered
“The proposed expansion of authorized Internet prescribing for VA practitioners responds directly to the evolving landscape of VA patients’ health care needs, advances in telemedicine and DEA’s ability to implement safeguards that protect against potential abuse,” the agency said in the notice.
“VA has now improved tools and data systems, including enhanced monitoring of telemedicine practices and centralized systems such as the VA’s internal prescription monitoring database, allowing for more effective monitoring than was available in the past.”
Andrea Fox is a senior editor at Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS media publication.
