{ "id": "R45240", "type": "CRS Report", "typeId": "REPORTS", "number": "R45240", "active": true, "source": "EveryCRSReport.com, CRSReports.Congress.gov", "versions": [ { "source": "EveryCRSReport.com", "id": 588362, "date": "2018-12-07", "retrieved": "2019-12-20T20:24:25.345439", "title": "The Special Registration for Telemedicine: In Brief ", "summary": "Suppress:\nIn response to the concerns about the opioid epidemic, the Trump Administration proposed expanding access to telemedicine services such as for the prescribing of medicine used for substance abuse or mental health treatment. Telemedicine is the electronic delivery of a clinical health care service via a technological method. Section 311(h)(1) of the Controlled Substance Act (CSA), which was added by Section 3 of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (Ryan Haight Act; P.L. 110-425), authorized the special registration for telemedicine with the goal of increasing patients\u2019 access to practitioners that can prescribe controlled substances via telemedicine in limited circumstances. Section 802(21) of Title 21, U.S.C. defines a practitioner as \na physician, dentist, veterinarian, scientific investigator, pharmacy, hospital, or other person licensed, registered, or otherwise permitted, by the United States or the jurisdiction in which he practices or does research, to distribute, dispense, conduct research with respect to, administer, or use in teaching or chemical analysis, a controlled substance in the course of professional practice or research.\nThe registration would enable a practitioner to deliver, distribute, dispense, or prescribe via telemedicine a controlled substance to a patient who has not been medically examined in-person by the prescribing practitioner. For example, in the event of an opioid overdose, a patient might need a prescription for an opioid antagonist such as naloxone from a practitioner who has never examined the patient in-person prior to the telemedicine encounter.\nWhile the Ryan Haight Act authorized the special registration for telemedicine, practitioners have not been able to apply for this special registration because the Drug Enforcement Administration (DEA) of the Department of Justice (DOJ) has yet to finalize a rule on the registration\u2019s application process and procedures and the limited circumstances that warrant it. (On April 6, 2009, the DEA stated in an interim final rule that the agency would issue a separate rule regarding the special registration for telemedicine.) Though the Ryan Haight Act required the Attorney General to issue a regulation governing the special registration, the statute did not specify a particular statutory deadline or other required time frame for the rulemaking to be completed. On October 24, 2018, the President signed into law the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271; H.R. 6). Section 3232 amends CSA Section 311(h)(2) to require that not later than one year after P.L. 115-271\u2019s enactment, the Attorney General, in consultation with the Secretary of the Department of Health and Human Services (HHS), promulgate final regulations specifying the limited circumstances in which a special registration for telemedicine may be issued and the procedure for obtaining the registration. According to the fall 2018 Unified Agenda of the Office of Management and Budget (OMB), the DEA plans to publish in the Federal Register a proposed rule on the special registration.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "https://www.crs.gov/Reports/R45240", "sha1": "40a98105af077b05ead2e4274c24671eb3835a60", "filename": "files/20181207_R45240_40a98105af077b05ead2e4274c24671eb3835a60.html", "images": {} }, { "format": "PDF", "encoding": null, "url": "https://www.crs.gov/Reports/pdf/R45240", "sha1": "d2f8e1a6693c4181f2c46db32a29f0595dfb5d03", "filename": "files/20181207_R45240_d2f8e1a6693c4181f2c46db32a29f0595dfb5d03.pdf", "images": {} } ], "topics": [ { "source": "IBCList", "id": 4788, "name": "Health Care Delivery" }, { "source": "IBCList", "id": 4863, "name": "Health & Medical R&D" } ] }, { "source_dir": "crsreports.congress.gov", "title": "The Special Registration for Telemedicine: In Brief ", "retrieved": "2020-09-05T09:15:48.943988", "id": "R45240_4_2018-11-28", "formats": [ { "filename": "files/2018-11-28_R45240_11d3473df8551fd295362b4322c7f4eff26f464f.pdf", "format": "PDF", "url": "https://crsreports.congress.gov/product/pdf/R/R45240/4", "sha1": "11d3473df8551fd295362b4322c7f4eff26f464f" }, { "format": "HTML", "filename": "files/2018-11-28_R45240_11d3473df8551fd295362b4322c7f4eff26f464f.html" } ], "date": "2018-11-28", "summary": null, "source": "CRSReports.Congress.gov", "typeId": "R", "active": true, "sourceLink": "https://crsreports.congress.gov/product/details?prodcode=R45240", "type": "CRS Report" }, { "source": "EveryCRSReport.com", "id": 585025, "date": "2018-06-26", "retrieved": "2018-09-12T22:44:18.687775", "title": "The Special Registration for Telemedicine: In Brief ", "summary": "Suppress:\nIn response to the concerns about the opioid epidemic, the Trump Administration proposed expanding access to telemedicine services such as for the prescribing of medicine used for substance abuse or mental health treatment. Telemedicine is the electronic delivery of a clinical health care service via a technological method. Section 311(h)(1) of the Controlled Substance Act (CSA), which was added by Section 3 of the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (Ryan Haight Act; P.L. 110-425), authorized the special registration for telemedicine with the goal of increasing patients\u2019 access to practitioners that can prescribe controlled substances via telemedicine in limited circumstances. Section 802(21) of Title 21, U.S.C. defines a practitioner as \na physician, dentist, veterinarian, scientific investigator, pharmacy, hospital, or other person licensed, registered, or otherwise permitted, by the United States or the jurisdiction in which he practices or does research, to distribute, dispense, conduct research with respect to, administer, or use in teaching or chemical analysis, a controlled substance in the course of professional practice or research.\nThe registration would enable a practitioner to deliver, distribute, dispense, or prescribe via telemedicine a controlled substance to a patient who has not been medically examined in-person by the prescribing practitioner. For example in the event of an opioid overdose, a patient might need a prescription for an opioid antagonist such as naloxone from a practitioner who has never examined the patient in-person prior to the telemedicine encounter.\nWhile the CSA authorized the special registration for telemedicine, practitioners have not been able to apply for this special registration. The Drug Enforcement Administration (DEA) has yet to finalize a rule on the registration\u2019s application process and procedures and the limited circumstances that warrant it. As a result, Congress is considering the Special Registration for Telemedicine Clarification Act of 2018 (H.R. 5483). H.R. 5483 would require the DEA, in a joint effort with the Secretary of the Department of Health and Human Services (HHS), to issue a rule on the special registration for telemedicine within one year of the enactment of the bill (as amended). On June 12, 2018, the House passed H.R. 5483 under suspension of the rules. On June 13, 2018, the Senate referred the bill to the Senate Health, Education, Labor, and Pensions Committee.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R45240", "sha1": "ab6cfca8d0e9ebac6921b49a3162d3648cb0250b", "filename": "files/20180626_R45240_ab6cfca8d0e9ebac6921b49a3162d3648cb0250b.html", "images": {} }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R45240", "sha1": "7c7f26bfff4a716127b3763f6df0e195a6e0f773", "filename": "files/20180626_R45240_7c7f26bfff4a716127b3763f6df0e195a6e0f773.pdf", "images": {} } ], "topics": [ { "source": "IBCList", "id": 4788, "name": "Health Care Delivery" }, { "source": "IBCList", "id": 4863, "name": "Health & Medical R&D" } ] } ], "topics": [ "Health Policy" ] }