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HomeHealth LawNew Florida Regulation Permits Telemedicine Prescribing of Managed Substances | Blogs |...

New Florida Regulation Permits Telemedicine Prescribing of Managed Substances | Blogs | Well being Care Regulation As we speak

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Florida has taken one other step in direction of increasing telemedicine.  On April 6, 2022, Governor Ron DeSantis signed into legislation laws to take away Florida’s prior restrictions on telemedicine prescribing of managed substances. Beforehand, Florida had a basic prohibition on prescribing managed substances through telemedicine, with solely slim exceptions. The brand new legislation (SB 312) eliminates the ban for all managed substances besides Schedule II. Schedule II medicine will be prescribed through telemedicine, however provided that the scientific scenario meets one of many 4 slim exceptions (extra on that beneath). 

The legislation is an enormous win for Florida sufferers with medical situations requiring managed substances as a part of the remedy routine. This consists of, for instance, endocrinology or substance use dysfunction (each of which use Schedule III drugs now permitted underneath the brand new legislation), permitting these sufferers to acquire higher entry to extra fulsome care. The legislation can even permit Florida clinicians to extra simply prescribe refills in reference to their ongoing care administration as a result of the clinician can periodically conduct affected person exams through telemedicine as an alternative of requiring in-person exams even when these exams could be seen as medically pointless. 

Some stimulant drugs generally prescribed in psychiatry are Schedule II medicine, which might probably meet one of many pre-existing exceptions if they’re prescribed for remedy of a psychiatric dysfunction.  Most opioids are Schedule II medicine not allowed underneath this new legislation.

Florida as a Nationwide Chief in Telemedicine Coverage

Effectively earlier than the COVID Public Well being Emergency, Florida policymakers had the foresight to favorably place the Sunshine State with a few of the most forward-thinking telemedicine legal guidelines in the USA.  This imaginative and prescient was mirrored within the Board of Drugs granting waivers to telemedicine suppliers underneath pilot applications courting again to 2014 (e.g., telepsychiatry, asynchronous prescribing, weight problems). The Legislature then created a groundbreaking State-sponsored Telehealth Advisory Council in 2016.  That very same 12 months, the Board of Drugs allowed telemedicine prescribing of managed substances for remedy of psychiatric problems. In 2019, lawmakers enacted a full overhaul of Florida telehealth legal guidelines and created a registration course of to permit out-of-state clinicians to shortly and simply get hold of permission to deal with Florida sufferers through telemedicine. And there’s a rulemaking workshop at present rewriting sure rules to higher accommodate telemedicine fashions. (Learn Foley’s feedback on that rule right here.)

The results of this multi-year effort allowed Florida residents to take pleasure in elevated entry to medical care, together with behavioral well being, whereas nonetheless giving the Division of Well being regulatory oversight on high quality. When the COVID Public Well being Emergency occurred, Florida carried out extra waivers permitting much more broad use of telemedicine, ultimately sunsetting them final 12 months. (Our prior discussions of Florida’s telehealth waivers can be found right hereright here, and right here.)

What’s Florida’s Managed Substance Telemedicine Prescribing Regulation?

The brand new legislation amends Florida’s telehealth statute as follows (new textual content is underlined):

Florida Statutes 456.47 Use of telehealth to offer companies.

(2) PRACTICE STANDARDS.

[…]

(c) A telehealth supplier might not use telehealth to prescribe a managed substance listed in Schedule II of s. 893.03 except the managed substance is prescribed for the next:
1. The remedy of a psychiatric dysfunction;
2. Inpatient remedy at a hospital licensed underneath chapter 20 395;
3. The remedy of a affected person receiving hospice companies as outlined in s. 400.601; or
4. The remedy of a resident of a nursing dwelling facility as outlined in s. 400.021.

The legislation is efficient beginning July 1, 2022.

What About Federal Legal guidelines?

Clinicians ought to proceed to be conscious of prescribing necessities underneath federal legal guidelines, as telemedicine prescribing of managed substances can be ruled by the Ryan Haight Act.  Amongst different issues, the Ryan Haight Act requires a threshold in-person examination between the prescriber and the affected person, though there are seven exceptions for the apply of telemedicine

Florida legislation have to be learn in concord with the Ryan Haight Act necessities, and a prescriber should adjust to each Florida and federal legal guidelines on this regard. Clinicians delivering care through telemedicine, notably throughout a number of states, should perceive and navigate many intersecting state and federal legal guidelines on telemedicine, medical apply, fraud and abuse, and managed substances.

Need to Be taught Extra?

For extra info on telemedicine, telehealth, digital care, distant affected person monitoring, digital well being, and different well being improvements, together with the staff, publications, and consultant expertise, go to Foley’s Telemedicine & Digital Well being Business Group.

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