The telehealth cliff: Congress must act now to ensure access to mental health, SUD Care  


As America emerges from the pandemic, it has change into frightfully clear the extent to which the pandemic has exacerbated an already deepening psychological well being and substance use disaster. In line with the Substance Abuse and Psychological Well being Companies Administration (SAMHSA), roughly one in 5 adults, or 50 million individuals in america, suffered from a psychological sickness in 2020, and 40 million People suffered from substance use dysfunction.  

Sadly, the disaster continues to develop worse as a result of many People lack entry to psychological and behavioral well being companies.  Over 150 million People dwell in psychological well being supplier scarcity areas. In consequence, many individuals are merely not receiving care. 

In response, Congress and the federal authorities have embraced telehealth as an answer to this extreme lack of entry to therapy for psychological well being sickness or substance use dysfunction. Telehealth removes obstacles like distance, value, and staffing shortages and permits suppliers to supply companies to people who could not in any other case have entry.     

One particular space the place entry was improved is the results of waivers granted by the Drug Enforcement Company (DEA) through the pandemic. These waivers enable certified clinicians to prescribe some managed medicine used particularly to deal with substance use dysfunction after performing a telehealth examination.  This waiver has been in place for greater than two years, and analysis has proven that it has offered important advantages to sufferers.  A research revealed within the Journal of the American Medical Affiliation concluded that “use of telehealth through the pandemic was related to improved retention in care and diminished odds of medically handled overdose …”

Sadly, the way forward for telehealth stays unsure. If Congress doesn’t act by the top of the yr, these necessary telehealth flexibilities will expire when the Public Well being Emergency ends, leaving 1000’s of sufferers with out entry to psychological well being and substance use dysfunction remedies. There are two methods Congress can keep away from this “telehealth cliff” in time. 

Congress may cross laws just like the invoice I launched, the bipartisan “Telehealth Response for E-prescribing Habit Remedy Companies Act (also referred to as the TREATS Act, H.R. 1647)” that will protect DEA telehealth prescribing waivers.   

Alternatively, Congress may lengthen the DEA’s telehealth prescribing waiver for at the least one yr after the Public Well being Emergency ends.  Two present legal guidelines direct the DEA to determine a Particular Registration for suppliers to prescribe managed substances by way of telehealth — (1) the Ryan Haight On-line Pharmacy Client Safety Act of 2008 (Ryan Haight Act) and (2) the SUPPORT for Sufferers and Communities Act of 2018 (SUPPORT Act).   

Lastly, after a protracted delay, the DEA submitted a proposed rulemaking to the Workplace of Administration and Price range (OMB) in March 2022 the place it stays in the present day. With the Public Well being Emergency anticipated to finish in 2023, Congress may briefly protect DEA’s present telehealth waivers by way of a one-year extension, permitting the rulemaking course of to be accomplished.    

There may be broad assist throughout the medical group for sustaining entry to managed substance prescribing by way of telehealth. In November 2022, the American Medical Affiliation, American Psychiatric Affiliation, and greater than 100 different well being care organizations referred to as on the DEA and DOJ to make this waiver everlasting, and over 370 well being care organizations requested Congress in September to increase the waivers after the Public Well being Emergency. 

Congress ought to act now to protect suppliers’ potential to prescribe managed substances by way of telehealth to make sure that sufferers don’t lose entry to important psychological and behavioral well being remedies when the pandemic ends.   

David B. McKinley, P.E. has proudly represented West Virginia’s 1st District since 2011. He at the moment serves as rating member of the Atmosphere Subcommittee on the Home Vitality & Commerce Committee. McKinley has fought to protect well being, security, and entry to look after his constituents of West Virginia and all People through the opioid disaster.