Earlier this month the Ohio Medical Board passed two rules that enable physicians to issue prescriptions for both controlled and uncontrolled substances to their patients via telemedicine, rather than in-person at the doctor’s office, given they adhere to an extensive list of rules.
Ohio is another of several states to loosen laws regarding telemedicine to allow for further growth of virtual doctor visit platforms. Most states currently allowing the use of telemedicine for both doctors visits and prescribing medication require the patient to first meet the doctor in person, along with other several guidelines. However, in Ohio the physician must only meet the following criteria to prescribe non-controlled medications:
- Authenticate the patient’s location and identity;
- Obtain consent for remote exam treatments;
- With consent, forward medical records to the patient’s providers or refer the patient to a new provider or facility;
- Meet the minimal standard of care needed for the patient’s condition(s);
- Develop a treatment plan that includes documenting the need for the prescription drug and any contraindications to the treatment plan;
- Document in the patient’s record with all medical information, provided care, patient’s consent, and any referrals made to other providers;
- Recommend or provide any necessary follow-up care for the patient;
- Make the medical record of the visit available to the patient; and
- Use “appropriate technology sufficient for the physician to conduct the above as if the medical evaluation occurred during an in-person visit.”
While most states exclude physicians from prescribing controlled substances via telemedicine, Ohio’s new regulation permits prescribing of controlled substances to a patient located remotely from the provider in the following instances:
- The person is an “active patient” of one of the physician’s colleagues, and the substance is being prescribed through an on-call or cross-coverage arrangement;
- At the time of prescribing the patient is at a DEA-registered hospital or clinic;
- The patient is in the physical presence of and being treated by, an Ohio-licensed physician registered with the DEA;
- The practitioner has obtained a DEA special registration for telemedicine;
- The physician is the medical director, hospice physician, or attending physician for a “hospice program” or “institutional facility” licensed in Ohio and in either instance: the patient is enrolled in that hospice program or institutional facility and the prescription is transmitted to the pharmacy consistent with Ohio board of pharmacy rules.
Advocates for telemedicine note regulations from the federal Ryan Haight Act, which severely restrict when and where physicians can prescribe controlled medications. However, encouraged by the American Telemedicine Association, the DEA is expected to amend the Ryan Haight Act to create a special telemedicine registration for healthcare providers.