Use of Telemedicine While Providing Medication Assisted Treatment (MAT)

Use of Telemedicine While Providing MAT - May 15, 2018
Use of Telemedicine While Providing
Medication Assisted Treatment (MAT)
Under the Ryan Haight Act of 2008, where
controlled substances are prescribed by
means of the Internet, the general
requirement is that the prescribing
Practitioner must have conducted at least
one in-person medical evaluation of the
patient. U.S.C. § 829(e). However, the Act
provides an exception to this
requirement. 21 USC § 829
(e)(3)(A). Specifically, a DEA-registered
Practitioner acting within the United States is exempt from the requirement of an
in-person medical evaluation as a prerequisite to prescribing or otherwise
dispensing controlled substances by means of the Internet if the Practitioner is
engaged in the practice of telemedicine and is acting in accordance with the
requirements of 21 U.S.C. § 802(54).
Under 21 U.S.C. § 802(54)(A),(B), for most (DEA-registered) Practitioners in the
United States, including Qualifying Practitioners and Qualifying Other
Practitioners (“Medication Assisted Treatment Providers”), who are using FDA
approved Schedule III-V controlled substances to treat opioid addiction, the term
“practice of telemedicine” means the practice of medicine in accordance with
applicable Federal and State laws, by a practitioner (other than a pharmacist) who
is at a location remote from the patient, and is communicating with the patient, or
health care professional who is treating the patient using a telecommunications
system referred to in (42 C.F.R. § 410.78(a)(3)) which practice is being
conducted:
A. while the patient is being treated by, and physically located in, a
DEA-registered hospital or clinic registered under 21 U.S.C. § 823(f) of
this title; and by a practitioner
-who is acting in the usual course of professional practice;
-who is acting in accordance with applicable State law; and
-is registered under 21 U.S.C. § 823 (f) with the DEA in the State in which the
patient is located.
OR

B. while the patient is being treated by, and in the physical presence of,
a DEA-registered practitioner
-who is acting in the usual course of professional practice;
-who is acting in accordance with applicable State law; and
-is registered under 21 U.S.C. § 823 (f) with the DEA in the State in which the
patient is located.
Please be advised that the remote Practitioner engaged in the practice of
telemedicine must be registered with the DEA in the state where they are
physically located and in every state where their patient(s) is (are) physically
located. 21 U.S.C. § 822 (e)(1); 21 C.F.R.§ 1301.12 (a); Notice 69478 Federal
Register / Vol. 71, No. 231 / Friday, December 1, 2006.
Also be advised that all records for the prescribing of an FDA approved narcotic
for the treatment of opioid addiction need to be kept in accordance with 21 C.F.R.
§ 1304.03(c), 21 C.F.R. § 1304.21(b), and with all other requirements of 21
C.F.R. Part 1300 to End.
Please note that while this document reflects DEA’s interpretation of the relevant
provisions of the Controlled Substances Act (CSA) and DEA regulations, to the
extent it goes beyond merely reiterating the text of law or regulations, it does not
have the force of law and is not legally binding on registrants. Because this
document is not a regulation that has the force of law, it may be rescinded or
modified at DEA’s discretion.