Medical board reverses again: Virtual prescribing in Georgia to continue

The Georgia Composite Medical Board had planned to require some in-person visits for prescribing controlled medications such as Ritalin starting in May. Once again, that’s on hold.
(PHOTO via Mariakonosky/Dreamstime/TNS)

Credit: TNS

Credit: TNS

(PHOTO via Mariakonosky/Dreamstime/TNS)

After a sustained outcry from doctors who use telemedicine visits to prescribe controlled drugs such as Ritalin, the Georgia Composite Medical Board on Thursday reversed its plans to restrict the practice, at least for now.

Instead, Georgia’s rules will remain the same as they have been throughout the pandemic until at least the end of the year. The board plans to write new rules from scratch.

The issue of virtual prescribing is a huge one in the South. Specialists are rare in rural Georgia and telemedicine has allowed some to see patients regularly from distant counties and even different states. For instance, the most recent state data showed more than half of Georgia’s 159 counties — 90 — had no psychiatrist.

When the Georgia medical board in December suddenly reimposed its old rules effective Jan. 1, prescribers erupted in confusion over what exactly the old rules allowed when it comes to distant patients who take prescriptions that might renew every month. Some doctors said they would have to stop seeing virtual patients for controlled drugs altogether until the board clarified what was legal.

Now, psychiatrists and other doctors who prescribe drugs via virtual patient visits, can continue to do so, even if they’ve never met the patient in person.

Board Chairman Dr. William Bostock said the board wants to protect patient health while making sure that health care practices have clear, legal rules to follow. A long, careful review of Georgia law concerning teleprescribing found language that was vague or inadvertently contradictory, Bostock said.

“Out of fairness to all parties involved, we’re going to go ahead and rescind our board order that was supposed to take effect May 1,” he said. “The telehealth industry is continuing to evolve. Obviously, it has a part in the delivery of health care for not only citizens of Georgia, but really for the entire nation. And I think our responsibility is to safeguard the public and make sure that we follow what is necessary to that end.”

The board still intends to make changes to telehealth prescribing guidelines, and those may come in January. The board has said it plans to give several months for the public and interest groups to review the proposed rules and chime in with any concerns before changes are made.

The issue arose because the federal government is having its own struggles figuring out how to regulate the booming field of virtual prescribing. Virtual prescribing was always regulated in theory, but only during the pandemic did the practice really take off with appointments on platforms that are the medically secure equivalent of Zoom. During the pandemic, the federal government lifted restrictions on prescriptions issued during those visits, but now the federal public health emergencies are ending.

The Drug Enforcement Administration held a listening session on virtual prescribing and decided to postpone restrictions a year, until December 2024, to give Congress the chance to come up with new national laws tailored for the modern virtual medical world.

But back in December 2023, the state medical board worried about continuing drug addiction, especially spurred by drugs that are supposed to be legally prescribed but can wind up in the wrong hands. It decided that regardless of the federal delay, it would act.

There may be new rules come January 2025, but regardless of the timeline, the state board now says it will give months of lead time for doctors and patients to comment and adjust.

A lobbyist for the American Telemedicine Association, who worked to push back the restrictions, complimented the board members’ decision.

“Bravo to the board,” said Kyle Zebley, senior vice president of public policy for the American Telemedicine Association. “It shows that they were listening and being very thoughtful in their approach.”

“If they had proceeded with the plans that they laid out prior board meetings, Georgia would be an outlier,” Zebley said. “It would close the door for a whole range of areas of care for really unique and underserved populations moving forward.”