DEA has now allowed the use of Telemedicine for evaluating and initiating treatment for new patients for the duration of the current Health emergency.
… despite the CSA’s limitations on issuing prescriptions for controlled substances by means of the Internet, for the duration of the public health emergency, a practitioner may prescribe a controlled substance to a new patient via telemedicine—using a real-time, two-way, interactive audio-visual communication—without first conducting an in-person examination. See 21 U.S.C. 802(54)(D).
Requirements for enrolment through Telemedicine
- Reliable internet connection / wifi.
- Laptop / Computer / Cell Phone with camera.
- One and half to two hours of uninterrupted time.
- Credit / Debit Card and internet access to make payments.
- Ability to take a photograph or scan and send Driver License or approved ID.
- Ability to read and understand online consent forms and instructions.
To reduce the possibility of Covid-19 viral transmission, currently enrolled patients will also be served through telemedicine till further notice.
Patients do not have to come to the clinic for follow-up unless specifically directed to do so. This will be the policy till the public health emergency is lifted.
Procedure: Patient follow-up during Covid-19 health emergency
- Patients will receive a text message to provide their email address.
- A link to zoom meeting will be sent to patient via email or text message, with appointment date and time. This appointment date and time may be different from the current appointment date and time.
- Zoom meetings require patients to download and install an app to their computer or phone. Other technologies that are available for use are Skype and WhatsApp, and patients can chose any of the three.
- Zoom is the preferred application as patients do not need to have a zoom account to use this facility.
- I plan to offer extended hours upto 7PM, by prior appointment.
- Please make sure that you complete the process at least three days before you run out of medications.
- During this appointment patients will be asked to answer follow up visit questionnaire, and, an audio recording will be made and kept, till it is incorporated into the medical record.
- Patients who do not have access to reliable hi-speed internet suitable for video meeting will complete this process over an audio only phone call to their designated phone on record.
- Prescriptions will be sent to patient’s pharmacy on record, and a text confirmation will be sent to patient after successful transmission.
- Patients will receive an invoice for payment ahead of the appointment, by email or text message with an embedded link that will direct them to their invoice page. Patients are required to pay before the time of service to receive the prompt pay discount. Patients can make the payment using a credit or debit card. The payment gateway is through squareup.com.
- Patients do not need to have a Square account to make a payment.
- Existing patients enrolled in my program who are facing financial difficulty will be provided a prescription irrespective of their ability to pay prior to their current appointment. They will owe this balance to be cleared before their next appointment without any surcharge, and without losing the prompt pay discount.
The clinic will resume its normal operations once 2019 Novel Coronavirus health emergency is lifted.
According to information posted on the DEA website at:
While a prescription for a controlled substance issued by means of the Internet (including telemedicine) must generally be predicated on an in-person medical evaluation (21 U.S.C. 829(e)), the Controlled Substances Act contains certain exceptions to this requirement.
One such exception occurs when the Secretary of Health and Human Services has declared a public health emergency under 42 U.S.C. 247d (section 319 of the Public Health Service Act), as set forth in 21 U.S.C. 802(54)(D).
Secretary Azar declared such a public health emergency with regard to COVID-19 on January 31, 2020 (https://www.hhs.gov/about/news/2020/01/31/secretary-azar-declares-public-health-emergency-us-2019-novel-coronavirus.html).
On March 16, 2020, the Secretary, with the concurrence of the Acting DEA Administrator, designated that the telemedicine allowance under section 802(54)(D) applies to all schedule II-V controlled substances in all areas of the United States.
Accordingly, as of March 16, 2020, and continuing for as long as the Secretary’s designation of a public health emergency remains in effect, DEA-registered practitioners in all areas of the United States may issue prescriptions for all schedule II-V controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided all of the following conditions are met:
- The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice;
- The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system; and
- The practitioner is acting in accordance with applicable Federal and State laws.
Important note: If the prescribing practitioner has previously conducted an in-person medical evaluation of the patient, the practitioner may issue a prescription for a controlled substance after having communicated with the patient via telemedicine, or any other means, regardless of whether a public health emergency has been declared by the Secretary of Health and Human Services, so long as the prescription is issued for a legitimate medical purpose and the practitioner is acting in the usual course of his/her professional practice.
In addition, for the prescription to be valid, the practitioner must comply with applicable Federal and State laws.
This page was last modified on: April 21, 2020