IHS Policy to Expand Telemedicine

The Indian Health Service (IHS) https://www.ihs.gov has released their new “Internet Eligible Controlled Substance Provider Designation Policy” designed to increase access to treatments for  opioid use disorders to help American Indians and Alaska Natives living in rural or remote areas.

Medication Assisted Treatment (MAT) is the use of medications in combination with counseling and behavioral therapies to treat substance use disorders. To prescribe buprenorphine, a medication used for treatment, providers must have additional training and special authorization from the Drug Enforcement Agency (DEA).

As a result, it is sometimes difficult in rural and remote locations to access a provider with the necessary training and approval to prescribe buprenorphine in an outpatient or office-based setting.

The new IHS policy enables IHS, tribal, and urban Indian organization healthcare providers to apply to be designated by IHS as “Internet Eligible Controlled Substance Providers”. The new policy will enable providers to prescribe controlled substances for Medication Assisted Treatment (MAT) via telemedicine.

The DEA https://www.dea.gov and HHS https://www.hhs.gov have recently offered clarification surrounding the requirements of the “Ryan Haight Online Pharmacy Consumer Protection Act” of 2008. This Act generally requires healthcare providers to conduct an in-person medical evaluation before prescribing MAT through telemedicine.

The recent IHS policy change clarifies exceptions to the in-person evaluation requirement for patients treated in a DEA-registered facility or in the presence of a DEA-registered practitioner. The new policy expands access to the full spectrum of treatment options for opioid use disorders via telemedicine to individuals in rural and remote areas.

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