Congress Should Include Addiction Treatment Access in Telehealth Legislation

The U.S. House Committee on Energy and Commerce on May 16 advanced numerous health-related bills, including legislation that would extend for two years the pandemic-era flexibilities that allow Medicare payment for telehealth services. These flexibilities, currently set to expire at the end of 2024, have been, and will continue to be, critical for connecting Medicare beneficiaries to essential health care services.

But Congress can and should do more than ensure that health care providers are paid for telehealth services. Lawmakers also must make certain that all patients—including individuals with opioid use disorder (OUD)—have access to remote care. Enacting H.R. 5163/S. 3193, the bipartisan Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act, would go a long way toward making sure that happens.

Over the past four years, more people than ever have accessed OUD treatment, in part because of the COVID-19 telehealth flexibilities that allowed patients across the country to remotely receive prescriptions for buprenorphine, a Food and Drug Administration-approved medication proved to reduce overdose deaths and support recovery. And for the first time, patients were able to access buprenorphine through a telephone rather than video connection, which was critical for individuals with limited access to internet service or those who struggle with technology.

Since the early months of the pandemic in 2020, health care providers have prescribed buprenorphine in thousands of audio and video calls, which no doubt has helped to save lives. For example, remote prescribing has helped to close gaps in care for communities with low treatment rates. It has expanded access for people living in remote rural areas and those lacking adequate transportation or child care. And it has increased treatment retention for veterans and reduced overdose risk and improved treatment adherence among Medicare recipients.

Health care providers have also noted that prescribing buprenorphine via telehealth has led to better patient engagement and treatment adherence and has afforded unique insights into patients’ home lives. But unless lawmakers act, this lifeline will expire at the end of this year, when the Drug Enforcement Administration and Substance Abuse and Mental Health Services Administration’s temporary rule ends.

Remote buprenorphine treatment has always been temporary, which creates uncertainty for both patients and health care providers. Patients are continually in danger of losing access to lifesaving medication, while many providers remain hesitant to invest in telehealth services. In one study, addiction providers noted that they were reluctant to conduct remote evaluations of patients because of a lack of clarity surrounding the telehealth guidelines and fears about transitioning patients back to in-person care.

The TREATS legislation would solve these problems immediately. It would guarantee remote access to buprenorphine for all patients by removing the requirement that patients see their providers in person before starting treatment.

Patients with OUD and their providers can’t afford to live with this uncertainty around remote treatment anymore. It’s time for Congress to make telehealth access to OUD treatment permanent—and help save lives.

Marcelo H. Fernández-Viña works on Pew’s substance use prevention and treatment initiative.