October Monthly Policy Update

Since the COVID pandemic, rules have been enacted to make access to healthcare more convenient (and, when possible, safer).

During the era’s public health emergency, the Drug Enforcement Administration (DEA) relaxed its rules, allowing individuals to receive prescriptions for buprenorphine (and other schedule II narcotics) via a telemedicine visit. No prior in-person physician’s visit was required.

When the public health emergency ended, many advocacy organizations, including Faces & Voices of Recovery, advocated to make the rule permanent. It was effective and there was little risk involved. According to several studies, diversion of the drug was minimal – potential misuse is not a material concern. The DEA chose to extend the prescribing exception for one year.

Now, as that extension nears its end, Faces & Voices has committed to making the rule change permanent. This has always been our goal, and we have advocated to make it a reality.

We have submitted comments to the DEA and have appeared before it in public meetings. Even so, the DEA recently hinted that it was inclined to end the exception and formulate a new rule. The draft proposal would allow no more than half of a provider’s prescriptions to be given virtually.

Last month, Faces & Voices joined a large coalition of telehealth advocates to fight this proposal, which would severely limit access to medications that assist in the treatment of opioid use disorders. We called upon Congress to intervene and make it known to the DEA that such a rule change would be harmful to their constituents.

Toward the end of the month, we received good news. Mostly. The DEA submitted to the White House for review a final rule entitled The Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications. While we would, of course, like to see prescribing via telemedicine become a permanent fixture, the one-year extension gives us more time to work on this effort. More importantly, it means another year of access to life-saving medication for those who need it.

On Buprenorphine: Rep. Paul Tonko of New York, who serves as chair of the Congressional Addiction, Treatment, and Recovery Caucus, is collecting information on prescribing in the wake of the MAT Act, which eliminated the “X-waiver,” a rule that restricted the number of patients a physician may prescribe the drug to.

Along with Rep. Mike Turner of Ohio, the Caucus has sent inquires to dozens of hospitals, insurance plans, pharmacies, pharmacists, and providers to gather information on their existing practices and what plans are in place to eliminate barriers for accessing opioid use disorder medications (MOUD).

Tonko also introduced the BUPE for Recovery Act this month, which would require the Administrator of the DEA to temporarily exempt buprenorphine from the Suspicious Orders Report System (SORS). SORS reporting requirements have led to uncertainty among pharmacies and distributors to stock and dispense buprenorphine, which can prevent individuals suffering from Opioid Use Disorder from receiving timely and effective treatment. This legislation will mitigate the harmful effects of stringent SORS reporting requirements, reducing overdose deaths, saving lives, and improving public health outcomes.