VA to Congress: Keep Pandemic Rule Allowing Prescriptions Across State Lines

Pharmacist at Naval Branch Health Clinic Kings Bay reviews a prescription.
Marcell Mack-Hamilton, a pharmacist at Naval Branch Health Clinic Kings Bay, reviews a prescription’s package information. (U.S. Navy photo by Jacob Sippel, Naval Hospital Jacksonville)

As Congress and the Biden administration eye the end of national and public health emergency measures taken to combat the COVID-19 pandemic, the Department of Veterans Affairs is asking to keep the authority to conduct telehealth appointments and prescribe medications across state lines.

The emergencies allowed physicians to hold appointments with patients on computers or smartphones and approve medications, including controlled substances, regardless of location, bolstering the VA's ability to provide care to veterans in rural or remote areas, according to VA Secretary Denis McDonough.

Should these permissions end without congressional intervention, 2.7 million veterans in rural locales who use VA health care and another 1.3 million veterans who are not enrolled in VA health services but use private care could lose easy access to their prescription drugs.

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During a press conference Tuesday in Washington, D.C., McDonough cited an example of a veteran living in rural Colorado who receives prescription renewals through the VA's Clinical Resource Hub in Boise, Idaho.

"We need action from Congress before these emergencies end to ensure that veterans maintain the same level of access and high-quality care they deserve," McDonough said.

President Joe Biden announced Monday that national emergency pandemic measures will end May 11 -- a move that will end federal allowances for hospitals treating COVID-19 patients, shift development of COVID-19 treatments and vaccines back to the private sector, and end the availability of free at-home COVID-19 tests and vaccines for consumers.

Congress has extended permissions for providers to conduct appointments online for two years, but the prescription allowances, particularly the waiver of a Drug Enforcement Agency requirement that controlled substances such as opioids, attention-deficit/hyperactivity disorder (ADHD) medications and benzodiazepines must have an in-person medical evaluation, will expire.

The Biden administration declaration came as House Republicans offered a resolution and a bill, the Pandemic is Over Act, to end the national emergency immediately.

Bill sponsor Rep. Brett Guthrie, R-Ky., said his legislation was necessary to force the Biden administration to act.

"It is long overdue for President Biden to end the COVID-19 public health emergency and relinquish the emergency powers that he just renewed again," Guthrie said while introducing his bill Jan. 17.

But the Office of Management and Budget said such an end "would create wide-ranging chaos and uncertainty through the health care system," citing drastic changes to provisions put in place to protect patients who use Medicaid, have personal insurance or must adjust to changes in billing practices.

"Millions of patients, including many of our nation's veterans, who rely on telehealth would suddenly be unable to access critical clinical services and medications. The most acutely impacted would be individuals with behavioral health needs and rural patients," OMB wrote in a Statement of Administrative Policy issued with Biden's declaration to end the emergency measures.

About 1.1 million Americans have died from COVID-19 since February 2020, including at least 24,000 veterans. Cases and hospitalizations are on the decline, but deaths have experienced an uptick in the last month, with 3,756 last week, according to the VA and the Centers for Disease Control and Prevention.

McDonough said VA officials are working diligently to ensure that the cross-state prescription benefit is preserved.

"I want to make sure that Congress helps us close that," McDonough said.

-- Patricia Kime can be reached at Follow her on Twitter @patriciakime.

Related: Here's the VA's 3-Part Plan to Resume Full Services for Veterans

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