The Drug Enforcement Administration (DEA) and the U.S. Department of Health and Human Services (HHS) have delayed the finalization of a rule meant to lock in addiction treatment-related telehealth flexibilities first implemented during the COVID-19 pandemic.

On March 20, the agencies released the text of a final rule that pushed back the effective date of another final rule entitled “Expansion of Buprenorphine Treatment via Telemedicine Encounter” to the end of 2025. It was previously slated to go into effect on Feb. 18, 2025. That was until Jan. 20, when the Trump administration announced all pending regulations were on freeze until they were reviewed. 

Following that review, the administration announced a new effective date for the rule of March 21. The DEA and HHS announced the delay the day before the rule was to come into effect. The final rule delaying the expansion of buprenorphine prescription via telehealth was first proposed in March 2023.

The latest delay adds yet another round of can-kicking as the Trump administration seeks to push making a final rule effective further down the road. 

The rule that was set to be finalized in February during the Biden administration was narrower relative to what was proposed in 2023. In short, the final rule, if ever made effective, will require DEA-approve prescribers that have not seen opioid-use-disorder patients in person to search the prescription drug monitoring program (PDMP) of the patient’s state before initiating a buprenorphine prescription. Pharmacies are required to verify the identity of the patient before fulfilling the prescription under the rule. Prescribers may then continue to fill up to a six-month supply of medication before an in-person exam is required. 

The regulation reads, “this regulation does not affect practitioner-patient relationships in cases where an in-person medical evaluation has previously occurred.

“The purpose of this regulation is to prevent lapses of care by continuing some of the telemedicine flexibilities that currently exist for those patients seeking treatment for opioid use disorder.”

The DEA has been on a saga since emerging from the pandemic and the telehealth experiment that it and the government’s reaction to it caused. It has launched several proposed rules related to developing a new telehealth regulatory framework. It has largely opted to give itself more time to develop regulations and delay implementation of final rules. For example, the DEA under Biden issued three extensions for general telehealth flexibilities.

In its final days under the Biden administration, the DEA released the long-sought special registration process for telehealth prescribing of controlled substances. That regulation is still pending review as part of the larger Trump halt on pending regulations.

While directly unrelated, the continuing resolution signed by President Donald Trump on March 15 included provisions that specifically extend flexibilities for starting mental health care via telehealth until the end of the federal fiscal year, Sept. 30, for Medicare patients.