News & Insights

DEA issues 4th extension of telehealth controlled substance flexibilities as debate enters 6th year

January 7, 2026
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On December 31, 2025, the DEA, working jointly with HHS, issued a fourth temporary extension of the COVID-era telemedicine flexibilities that allow clinicians to prescribe Schedule II–V controlled medications via telehealth without first conducting an in-person visit. The rule takes effect January 1, 2026, and extends the current framework through December 31, 2026, preventing an abrupt “telemedicine cliff” for patients who rely on remote care.

As Fierce Healthcare notes, the extension keeps the “status quo” in place because the broader policy debate remains unresolved: how to preserve access while reducing the risk of online diversion and misuse. Under the Ryan Haight Act, remote prescribing of controlled substances generally requires at least one in-person medical evaluation (with limited exceptions), and federal agencies are still working toward a durable long-term approach.

The extension also arrives alongside two finalized policies tied to buprenorphine and Veterans Affairs patient care, giving providers multiple pathways for telemedicine prescribing with different requirements. Federal officials emphasize the goal is continuity of care—especially for rural and underserved patients—while regulators finalize permanent rules that balance access with safeguards against diversion. 

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