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How the Ryan Haight Act Impacts Telepsychiatry

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Telepsychiatry is a growing field on the cutting edge of the healthcare industry. State and federal laws are working to catch up with this evolving arena, although continued regulatory development is necessary to reflect the realities of telemedicine practice and the evolution of healthcare services. The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (the Ryan Haight Act) was designed to prevent the illegal distribution of controlled substances using the internet, the terms of which create certain complications for telemedicine providers. Read on for an explanation of the Ryan Haight Act and how it affects the practice of telepsychiatry.

The Ryan Haight Act and In-Person Prescriptions

The Ryan Haight Act was enacted by Congress in response to perceived drug trafficking issues proliferating via the internet. The Act imposes a number of restrictions on prescribing and distributing controlled substances, including the requirement that any practitioner who issues a prescription for a controlled substance must first conduct an in-person medical evaluation of the patient.

In 2009, the federal Drug Enforcement Agency (DEA) published an interim final rule intended to clarify certain provisions of the Ryan Haight Act, bring DEA regulations in line with the Act, and request comments on the amendments. In 2018, Congress passed the “SUPPORT for Patients and Communities Act” which, among other things, required the DEA to pass regulations concerning the special registration of practitioners. Telemedicine practitioners who obtain the special registration would be granted an exemption from the in-person requirement for prescribing medicine.

In September of 2020, the DEA finally published a final rule adopting the interim final rule as final and adopting certain technical changes developed in the intervening years. Unfortunately, the DEA did not create the special registration for telemedicine prescribers as promised, and telemedicine practitioners are still waiting for the DEA to act.

Emergency Exemptions in Response to COVID-19 Pandemic

The COVID-19 coronavirus pandemic has contributed to certain telemedicine practices being fast-tracked for regulatory approval. On March 16, 2020, the DEA announced that DEA-registered practitioners can prescribe Schedule II-V controlled substances to patients without first conducting an in-person medical evaluation, so long as the following requirements are met:

  • The prescription is for a legitimate medical purpose
  • The practitioner prescribed the medicine in the usual course of their professional practice
  • Telemedicine was conducted using an audio-visual, real-time, two-way interactive communications system
  • The provider is otherwise acting in accordance with federal and state regulations

The DEA’s announcement operates as an emergency, temporary authorization, meaning that it could expire once the “public health emergency” abates. Telemedicine practitioners should make sure to keep apprised of current and future DEA announcements to maintain compliance with current regulations. Ideally, the DEA will make the in-person requirement exemption for telemedicine providers permanent via its authority under the 2008 and 2018 laws.

If you are a healthcare provider, litigant, or employer who would benefit from a variety of dedicated, professional, and qualified psychiatric care specialists, reach out to Orbit Health to discuss your options for telepsychiatry today.

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