Telemedicine Laws for Opioids and Substance Use Disorder Treatment

Continued access to telehealth services, particularly as it relates to medication assisted treatment (MAT) for substance use disorder (SUD), enjoys strong support among patients and clinicians, yet laws continue to trail behind technology as the telehealth industry continues to grow.

In a recent episode of the Mission: Recovery podcast, Foley & Lardner LLP Partner and member of the ATA’s Board of Directors Nathaniel Lacktman and Associate Sunny Levine met with host Maroof Ahmed, M.D., co-founder of Quit Genius, a leading digital addiction clinic for treatment of substance use disorders.

The three discussed the current state of telehealth regulations in the wake of the COVID-19 pandemic and how uncertainty, legislation, and policy changes could impact medication assisted treatment for opioid use disorders in the coming months. They chat about the future of virtual MAT, the importance of ePrescribing for SUD and Opioid Use Disorder (OUD), how virtual MAT could become permanent, and how the public can help influence upcoming decisions on ePrescribing policies.

“The common thread among the digital health entrepreneurs our team works with is a deep-rooted belief the healthcare status quo can be improved, and that technology is a powerful tool to realize that change. The goal is to make healthcare better, more accessible, and less expensive.”

–Nathaniel Lacktman

Levine noted how telemedicine has helped patients cut through some of the obstacles for those seeking treatment by offering increased convenience, an increased capacity for providers, the ability for patients to receive treatment from the privacy of their homes, and an overall access mechanism for patients to get the treatment they need.

Of the recent digital health boom, Levine stated “Telehealth has been around for years, but the ability to utilize digital health technology in areas like substance use disorder treatment — that was something that came about with the COVID-19 pandemic.”

However, with each passing month, it appears the COVID-19 public health emergency (PHE) is more likely to come to an end, and along with it the waivers that have allowed providers in much of the country to write prescriptions for MAT. These waivers are all tied to the federal PHE, which has continued to be extended, but only in 90 day increments. This uncertainty is unsustainable, both for providers and patients.

“Unless permanent regulations and legislation are in play before the end of the Public Health Emergency, there is a potential for a gap. We need to figure out what to do within this gap. Will there be enforcement discretion not to start to seek compliance for clients that have been operating under these waivers? We have counseled our clients to ensure they have contingency plans in place in the event this telehealth cliff becomes a reality,” said Levine.

Entrepreneurs moving into this space should recognize that multi-state telemedicine services, particularly involving SUD treatment, are one of the most highly regulated areas in health care, and health care is already among the most highly regulated industries in our country.

Accordingly, there can be an intimidating amount of work that goes into creating a successful, sustainable digital health company, and there are some shortcuts or hacks that, while tempting, entrepreneurs should be careful to avoid. Companies can move forward swiftly, but responsibly, including in setting up their clinical, compliance, and oversight frameworks in a homogenous operating structure equipped to operate across multiple states. 

“This is a marrying of technology and healthcare. Having one but not the other is deemed failure. Here at QuitGenius, being a physician by background, the reason why I do what I do every day is for our mission: to help 100 million people overcome all forms of substance addiction. Putting the members first, taking that human centered approach, is at the center of everything we do.”

–Maroof Ahmed, M.D.

There is no shortage of aspiring digital health entrepreneurs with significant experience in e-commerce who can create frictionless platforms.  But sometimes the patient-user experience in these platforms fails to digitize the essential elements of the doctor-patient interaction necessary to ensure the standard of care is being met.

In this regard, a solid comprehension of state telemedicine regulations and practice standards can actually be a helpful source of guidance to startups. “Laws often constitute a bridge from where our society is to where we want it to go,” Lacktman added, emphasizing the need for prudent but not suffocating legislation at the state and federal level regulating digital health.

Levine agreed, saying, “We need a push to ensure these regulations keep apace with the scope and clip of technology evolving without losing a lot of the clinical requirements and ensuring that the standard of care is still met.”

Want to Learn More?

• It’s Time To Review Your Online Patient-User Interface: DOJ Issues New Federal Guidance on Telemedicine and Civil Rights Protections
• The Costs and Rewards of Patient Data in the New Era of Telemedicine
• The Federal Telehealth Extension and Evaluation Act: What You Need to Know

For more information on telemedicine, telehealth, virtual care, remote patient monitoring, digital health, and other health innovations, including the team, publications, and representative experience, visit Foley’s Telemedicine & Digital Health Industry Team.