Telemedicine flexibilities are protecting patients – cities urge DEA to keep them
December 2025
The Big Cities Health Coalition and 181 other organizations sent a letter to the Office of Management and Budget (OMB) and Drug Enforcement Agency (DEA) to swiftly approve a currently pending temporary extension for the telemedicine prescribing of controlled substances rule.
We write to express our deep concern about the impending lapse of the Drug Enforcement Administration (DEA) telemedicine flexibility that has allowed patients to safely access needed medications. We appreciate that a fourth temporary extension is pending and currently under OMB review. We strongly urge you to immediately act to prevent avoidable lapses in treatment and protect continuity of care for millions who rely on these services.
Since expanded by the Trump Administration, telemedicine has proven to be a lifeline by allowing providers to reach patients where they are, reducing delays in treatment, and improving outcomes. We have seen firsthand how technology-enabled care strengthens the provider-patient relationship, increases adherence to treatment plans, and helps patients lead healthier lives. This progress must not be undone.
With only 25 days remaining before these critical telemedicine authorities expire, patients and providers are facing unacceptable uncertainty and the real risk of care disruptions.
Congress has long required DEA to establish a Special Registration process that balances patient access with appropriate safeguards against misuse. Authorized in the 2008 Ryan Haight Act and reinforced by the 2018 SUPPORT Act, this process remains unfulfilled after 17 years. A thoughtful Special Registration framework would give providers the ability to care for patients responsibly while ensuring DEA has the tools it needs to prevent inappropriate prescribing. We urge you to continue to work with Congress on a path forward for permanent access to controlled medications via telehealth.
Any delay in the DEA policymaking will create confusion among patients, cancellations, and abrupt treatment gaps. These flexibilities have been essential for maintaining continuity of care, particularly for those with mental and behavioral health needs, over the past five years.
In the long-term, we encourage DEA to fully engage with stakeholders in a discussion of the policy barriers to patient care and to collect medical provider feedback on safeguards that mitigate real-world risks of diversion.
