(a) In general
Subchapter III of chapter 17 of title 38, United States Code, is amended by adding at the end the following new section:
1730D. Prescription, delivery, distribution, and dispensation of controlled substance medications via telemedicine
(a) In general
Notwithstanding sections 102(54) and 309(e) of the Controlled Substances Act ( 21 U.S.C. 802(54) and 829(e)), a covered health care professional may prescribe, deliver, distribute, and dispense a controlled substance if the covered health care professional is using telemedicine through the use of an interactive telecommunications system, including an audio-only telecommunications system when necessary, to prescribe, deliver, distribute, or dispense to a patient eligible to receive hospital care or medical services under this chapter a controlled substance that is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act ( 21 U.S.C. 301 et seq. ), regardless of whether such covered health care professional has conducted an in-person medical examination of such patient, if—
such covered health care professional—
is acting in the usual course of professional practice;
is registered pursuant to section 303(g) of the Controlled Substances Act ( 21 U.S.C. 823(g) ) in any State or is utilizing the registration of a facility of the Department registered pursuant to section 303(f) of such Act ( 21 U.S.C. 823(f) );
has access to medical documentation from an in-person medical evaluation of such patient in the past two years by—
a covered health care professional;
a health care professional who furnished care and services under the Veterans Community Care Program under section 1703 of this title; or
a health care professional of the Department of Defense; and
at the time of the telemedicine visit of the patient—
has reviewed the prescription data of the individual from the electronic health record database of the Department and data from the prescription drug monitoring program for the State in which the patient is located at the time of the telemedicine encounter (if such a program exists) for at least the one-year period preceding the date of the visit or, if less than one year of data is available, for the entire period available; and
provides documentation of—
such substance is delivered, distributed, or dispensed for a legitimate medical purpose.
(b) Authority for limited supply
(1) In general
If the databases and program described in subsection (a)(1)(D) are unavailable or inaccessible at the time of a telemedicine encounter conducted by a covered health care professional, the covered health care professional may not prescribe, deliver, distribute, or dispense more than a seven-day supply of a controlled substance until the covered health care professional is able to review such databases and program.
(2) Databases unavailable or inaccessible
If a database or program required to be reviewed under subsection (a)(1)(D) is unavailable or inaccessible for an extended period, as determined by the Secretary, a covered health care professional may provide additional seven-day supplies of a controlled substance until such database or program is accessible.
(c) Maximum supply
The authority under this section may be used to supply a controlled substance for not more than a six-month period.
(d) Use of authority
The Secretary shall ensure that the authority under this section is used to prevent interruptions to patient care and not as a replacement for routine in-person patient care.
(e) Regulations
(1) In general
The Secretary shall establish in regulations guidelines and a process for the prescription, delivery, distribution, and dispensation of a controlled substance pursuant to subsection (a).
(2) Elements
The Secretary shall ensure the guidelines and process described in paragraph (1)—
do not restrict access of a patient to in-person care; and
provide for the collection and analysis of data to determine if an individual has evidence of a prior in-person medical evaluation by a health care professional described in subsection (a)(1)(C) who would reasonably be expected to have prescribing authority based on their credential or organizational role.
(3) Initiating treatment
(A) In general
The guidelines established by paragraph (1) shall prohibit a covered health care professional from initiating treatment with an opioid medication listed in schedule II or III under section 202 of the Controlled Substances Act ( 21 U.S.C. 812 ) unless the covered health care professional is providing treatment—
for opioid use disorder;
for a patient receiving palliative care or enrolled in hospice care; or
for a patient who is physically located in a medical facility where the patient is receiving in-person care.
(B) Exception
The prohibition under subparagraph (A) shall not apply to renewal or maintenance of a previously prescribed medication described in such subparagraph.
(f) Reporting
(1) In general
Not later than one year after the date of the enactment of the Take Care of America’s Veterans Act , and not less frequently than annually thereafter until the termination date under subsection (g), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report that addresses the use of the authority under this section during the fiscal year preceding the date of submission of the report in each Veterans Integrated Service Network.
(2) Elements
Each report under paragraph (1) shall indicate, at a minimum—
how many patients received prescriptions for controlled substance medications through telemedicine under this section;
which controlled substances are being prescribed under this section and how many prescriptions were written for each such substance;
the number of individuals who received a controlled substance medication that was prescribed, delivered, distributed, or dispensed under this section without evidence of an in-person medical evaluation within the previous two years by a health care professional described in subsection (a)(1)(C); and
the barriers that exist to reviewing prescription drug monitoring programs of States and how often those barriers occur.
(g) Duration
The authority under this section shall terminate on September 30, 2031.
(h) Definitions
In this section:
The terms controlled substance , deliver , dispense , and distribute have the meanings given those terms in section 102 of the Controlled Substances Act ( 21 U.S.C. 802 ).
The term covered health care professional means—
a health care professional who—
is—
is authorized by the Secretary to provide health care under this chapter;
is required to adhere to all standards for quality relating to the provision of health care in accordance with applicable policies of the Department;
has an active, current, full, and unrestricted license, registration, or certification or meets qualification standards set forth by the Secretary within a specified time frame; and
with respect to a health care profession listed under section 7402(b) of this title, has the qualifications for such profession as set forth by the Secretary; and
a health professions trainee who—
is appointed under section 7405 of this title; and
is under the clinical supervision of a health care professional described in subparagraph (A).
(b) Clerical amendment
The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1730C the following new item: