Telehealth & MSO
Telemedicine prescribing of controlled medications runs to 31 December 2026
The DEA and HHS issued a fourth temporary extension of the COVID-19 telemedicine flexibilities for prescribing controlled medications, effective 1 January 2026 through 31 December 2026 (Docket DEA-407). It is a temporary rule with a fixed end date, not a permanent framework, and it is the fourth time the date has been moved.
The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 generally requires at least one in-person medical evaluation before a practitioner may prescribe a controlled substance by means of the internet. The flexibilities first adopted during the COVID-19 public health emergency suspend that requirement, and this rule carries them forward for another year.
The extension is a joint action of the Drug Enforcement Administration and the Substance Abuse and Mental Health Services Administration, published on 31 December 2025 and effective from 1 January 2026 through 31 December 2026.
For a telehealth platform this is a date to plan against rather than a settled position. Three previous extensions have each been temporary, and a practice whose model depends on remote prescribing of a controlled medication is depending on a rule with an expiry printed on it.
What changed
The date moved. The flexibilities now run through 31 December 2026 rather than expiring at the end of 2025.
What did not change
Nothing about the underlying framework. This is a temporary rule, the fourth of its kind, and the Ryan Haight in-person evaluation requirement resumes if it is not extended again or replaced.
Who this reaches
Any telehealth practice or platform that prescribes controlled medications remotely. The operative date is 31 December 2026, and the question worth answering before then is what the clinical and contractual model looks like if the flexibilities lapse.
Common questions
Is remote prescribing of controlled substances now permanent?
No. This is a temporary rule effective 1 January 2026 through 31 December 2026. It is the fourth temporary extension, and each has carried a fixed end date. The Ryan Haight Act requirement of an in-person medical evaluation resumes unless the flexibilities are extended again or a permanent rule replaces them.
Which medications does this reach?
Controlled medications, which is a narrower category than prescription drugs generally. Whether a particular product is controlled, and in which schedule, is the first question, because a practice prescribing only non-controlled therapies is not relying on these flexibilities at all.
What should a platform do before the end of 2026?
Identify which parts of the service actually depend on the flexibilities, and what the fallback is: in-person evaluation, a registered practitioner in the patient state, or a change to the formulary. Each has different licensing and staffing consequences, and those take longer to arrange than the notice period is likely to allow.
Does this reach your business?
Every matter turns on its facts. Mr. Sheehan reviews each inquiry himself.