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Florida Expands Telemedicine Controlled Substance Prescribing

In an exciting decision benefitting Floridians seeking behavioral health treatment, the Florida Board of Medicine has voted to allow controlled substances to be prescribed via telemedicine for the treatment of psychiatric disorders.

Effective March 7, 2016, the rule, part of the Florida Administrative Code r.64B8-9.0141 Standards for Telemedicine Practice, reads as follows:

Controlled substances shall not be prescribed through the use of telemedicine except for the treatment of psychiatric disorders. This provision does not preclude physicians from ordering controlled substances through the use of telemedicine for patients hospitalized in a facility licensed pursuant to Chapter 395, F.S.

The Florida rule is now consistent with remote prescribing rules among a growing number of states embracing telemedicine, including Delaware and New Hampshire.

Previously, the Florida rule did not permit controlled substances to be prescribed through the use of telemedicine in any case. However, in 2015, the Board granted permission to three mental health organizations to prescribe controlled substances through telemedicine. Thanks in part to the successes of these programs, the revised rule now permits this practice without a waiver.

Telemedicine Controlled Substance Prescribing New Rules

The revised rule still continues to ensure that the prescribing of controlled substances is done safely and appropriately. The rule requires a documented patient evaluation, including history and physical examination to establish the diagnosis for which any prescription drug is prescribed as well as a discussion between the physician or physician assistant and the individual regarding treatment options and the risks and benefits of the treatment.

This change in Florida represents positive steps in the growth of telepsychiatry and acknowledgement of regulators that this is an appropriate and effective means of providing care. A number of facilities in Florida and beyond have turned to telepsychiatry as an effective way to access psychiatrists who they may not be able to have on their treatment team in person due to the huge shortage of psychiatrists across the country. Telepsychiatrists can be integrated on an organization’s care team and preform many of the same tasks an onsite provider would do, but do so through secure televideo. Many Florida programs were previously unable to utilize the full benefits of telepsychiatry because of this regulation banning the prescribing of controlled substances through telemedicine.

Controlled substance medications include stimulants, suboxone and benzodiazepines that are all common treatments for behavioral health care issues. Stimulants are the top treatment prescribed to the 11% of children ages 4-17 who are diagnosed with ADHD.1 Before this change, Florida regulation restricted telepsychiatrists from writing stimulant prescriptions for those children making this small regulatory change a large step forward for children’s mental health and access to behavioral health care in general in Florida.

References

1 Center for Disease Control. 2011.

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