The New York State Department of Health (NYSDOH) has finalized a rule allowing the prescribing of controlled substances via telemedicine, setting exceptions to the usual requirement for in-person medical evaluations. The rule aligns closely with a withdrawn proposal from the U.S. Drug Enforcement Administration (DEA) and federal regulations currently in place.
The final rule, announced on May 21, 2025, confirms that practitioners generally must conduct an in-person medical exam before prescribing controlled substances. However, it also outlines specific exceptions. These include cases where a consulting or referring practitioner has performed an in-person evaluation within the past 12 months, temporary coverage by another practitioner who has access to the original prescriber, and emergency situations involving a new condition where remote prescribing is allowed under certain safeguards.
This approach mirrors the DEA’s earlier proposal to tighten telemedicine prescribing rules under the Ryan Haight Online Pharmacy Consumer Protection Act. The DEA initially aimed to restore in-person exam requirements for most controlled substance prescriptions but delayed finalizing the rule after significant public feedback. Instead, it extended temporary telehealth prescribing flexibilities, which remain effective today. In January 2025, the DEA issued a new proposal similar to the previous one, but it is uncertain whether it will be finalized before current waivers expire at the end of the year.
Despite federal uncertainty, New York moved forward by adopting a rule that tracks the previously abandoned DEA framework but explicitly allows exceptions based on federal compliance. This means that providers in New York can continue to prescribe controlled substances through telemedicine as long as they follow federal waivers and regulations.
The NYSDOH rule emphasizes that controlled substances may be prescribed remotely only if the practitioner complies with all applicable state and federal laws, including those enforced by the DEA and Department of Justice. This includes medications used to treat opioid use disorder.
Although the rule is finalized, it does not change current practices. Providers should continue following federal telehealth waivers that permit remote prescribing. To stay compliant, healthcare providers are advised to document medical evaluations thoroughly, ensure proper delegation of prescribing authority within their organizations, and stay informed about federal regulatory updates.
Legal experts recommend reviewing internal policies and maintaining clear records to adapt to any future changes in telemedicine prescribing regulations. As the regulatory environment evolves, providers must ensure that their telemedicine practices comply with both state and federal laws.
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