DEA Practitioners Manual - Part 13: Telemedicine – Dental Compliance

DEA Practitioners Manual: Telemedicine

The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 significantly altered the landscape of telemedicine in the United States by adding provisions to the Controlled Substances Act (CSA) to prevent the illegal distribution and dispensing of controlled substances via the internet. The Act clarified several definitions and requirements for telemedicine practitioners, including the need for an "in-person medical evaluation" and what constitutes a "valid prescription."

Here's a summary of the key components:

Practice of Telemedicine: Defined as the practice of medicine via telecommunications by a practitioner who is remote from the patient, in compliance with federal and state laws.
In-Person Medical Evaluation: A medical evaluation conducted physically in the presence of the practitioner. Dispensing a controlled substance via the internet without at least one in-person medical evaluation, except in specified circumstances, is a violation.
Valid Prescription: Issued for a legitimate medical purpose by a practitioner who has conducted at least one in-person medical evaluation or by a "covering practitioner."
Covering Practitioner: A practitioner who evaluates the patient at the request of another practitioner who has conducted at least one in-person evaluation within the previous 24 months and is temporarily unavailable to assess the patient.

Exceptions to the In-person Medical Evaluation Requirement

The Act outlines several exceptions where a DEA-registered practitioner in the U.S. is exempt from the in-person medical evaluation requirement:

Treatment in a DEA-registered hospital or clinic: When the patient is physically present in a registered hospital or clinic.
Treatment in the physical presence of a practitioner: When the practitioner is physically present with the patient.
Indian Health Service or tribal organization: Practitioner is an employee or contractor of the IHS or a tribal organization.
Public health emergency: Declared by the Secretary of Health and Human Services.
Special Registration: Obtained from the Administrator.
Department of VA medical emergency: In cases where there is a medical emergency situation involving a VA patient that meets certain conditions.
Other circumstances specified by regulation: Situations determined by regulatory authorities to be consistent with public health and safety.