Operations and Implementation

ePoster Presentation

(EP-137) Do You Know Ryan Haight?

Sunday, April 23
5:15 PM - 5:30 PM
Location: Experience Zone - ePosters

Are you challenging federal law? If you or your clinic practice telemedicine and haven't considered the implications of the Ryan Haight Act, you very well might be. In 2008, the Ryan Haight Act was passed to protect consumers from questionable online pharmacy distribution. Though well intended, the Ryan Haight Act inadvertently made many popular models of telemedicine technically illegal.

In 2015, the ATA wrote a letter with recommendations to the DEA advocating for provider-friendly changes to federal controlled substance prescribing rules. The letter included suggestions for how a special registration process could be structured to safely enable the prescribing of certain controlled substances via telepsychiatry. This presentation will review the ATA's recommendations and break down the confusing elements of the Ryan Haight Act into digestible and applicable pieces. The Ryan Haight Act was aptly written to protect individuals from inappropriately prescribed controlled substances, but its current language limits telemedicine, and does not match the way many forms of telemedicine, particularly telepsychiatry, are currently being used in a number of settings.

As it is written, the Ryan Haight Act requires that before a telemedicine encounter can result in the prescribing of a controlled substance, there must be a prior in-person relationship. Otherwise, the consumer must either be located within a DEA registered hospital or clinic or fit into one of six other telemedicine exemptions. Unfortunately, this exemption list does not include a number of locations where telemedicine commonly occurs, including community clinics and correctional facilities, some of the most common applications of telemedicine and telepsychiatry to date.

Another issue with the Ryan Haight Act is that it makes no distinction between classes of controlled substances, and may challenge common applications of controlled substance prescribing like the stimulants often used for child psychiatry.

Though the Ryan Haight Act has been rarely enforced around telemedicine, the rapidly growing telemedicine industry needs regulators to provide clarification and updates to the law so that this form of care can continue to develop and bring much needed access to care to underserved populations.

Interestingly, the text of the Ryan Haight Act of 2008 explicitly recognizes the distinction between valid telemedicine and the sort of internet prescribing practices that the Act intended to target. The Act itself promises to release clarifying language to define and validate appropriate telemedicine prescribing of controlled substances; however that clarifying language has never been released. Thus, the practice of telemedicine industry has grown within a climate of legal ambiguity.

Like many other forms of telemedicine, telepsychiatry must not be abused to provide inappropriate prescriptions, but there is now a very significant body of research, experience and credible guidelines validating that telepsychiatry is an essential tool in the delivery of necessary, timely mental health care. The Ryan Haight Act needs to be modified to accommodate naturally occurring practice shifts, like we are experiencing with the spread of telepsychiatry.

This presentation will be led by a leader in the telemedicine field who has worked closely with the DEA, state medical boards and other telemedicine organizations, including the workgroup that wrote the ATA letter to the DEA, to advocate for appropriate telemedicine and suitable changes to the Ryan Haight Act. Attendees will take away lessons they can use to adhere with the nuances of the Act in their own organization and gain the tools needed for staying up-to-date on the developments of the act to ensure future compliance.

Learning Objectives:

Geoffrey Boyce

Executive Director
InSight Telepsychiatry

Geoffrey Boyce is the Executive Director of the CFG Health Network’s InSight Telepsychiatry. Since 2008, Boyce has advocated for the appropriate use and value of telepsychiatry and has developed unique telemedicine programs within areas of greatest need. Boyce is an active participant in telemedicine advocacy, education and reform initiatives, regularly interacting with state and local healthcare regulators and administrators. Boyce frequently speaks about the potential of telemedicine and the best practices for establishing new programs. Boyce holds an MBA with a focus on entrepreneurship and business planning.

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