TREATS Act Swaps Initial In-Person Visit for Telehealth for Addiction Meds

The aptly named Telehealth Response for E-prescribing Addiction Therapy Services Act, or TREATS Act, is making a significant change to how certain controlled substances for addiction treatment are prescribed. Currently, federal law requires at least one in-person medical evaluation before a doctor can prescribe these specific medications. This bill amends Section 309(e)(2) of the Controlled Substances Act to allow a single telehealth evaluation to replace that mandatory initial in-person visit.

The New Prescription for Access

This change isn't a free-for-all; it’s highly targeted. The telehealth exception only applies to controlled substances classified under Schedule III, IV, or V that the Food and Drug Administration (FDA) has specifically approved for treating a substance use disorder (SUD). Think medications like buprenorphine, which is essential for Medication-Assisted Treatment (MAT). For people living in rural areas, or those juggling two jobs and childcare who can't easily take time off and travel long distances to a clinic, this is a massive win for access.

What Counts as a Telehealth Visit?

The bill defines this alternative evaluation strictly, relying on existing language from the Social Security Act. The evaluation must be conducted using a telecommunications system that allows for “two-way, real-time interactive communication.” This means the doctor and the patient must be able to communicate instantly. Critically, this system can be either audio-only or include both audio and video. This flexibility is key for reaching patients who might lack reliable broadband access for video calls, but it also raises a flag: while an audio-only call is better than nothing, it limits the practitioner’s ability to assess the patient comprehensively, potentially missing vital non-verbal cues that are crucial in addiction treatment.

The Trade-Off: Convenience vs. Clinical Oversight

The TREATS Act is a classic trade-off between increasing access and maintaining strict oversight. By removing the initial in-person barrier, the bill makes it easier for people to start life-saving treatment immediately. For a patient trying to get their life back on track, cutting down the wait time and travel hassle can make all the difference. However, replacing the mandatory in-person visit with a remote one—even for controlled substances—reduces the level of direct clinical supervision at the very beginning of treatment, which is often the most vulnerable time for the patient. The bill attempts to balance this by requiring the evaluation to meet “current Federal and State laws,” but this reliance on varying state regulations could create ambiguity for practitioners operating across state lines or in areas where state laws haven’t caught up to this level of telehealth flexibility. Ultimately, this bill significantly lowers the barrier to entry for MAT, but it places a higher reliance on the quality and comprehensiveness of that initial remote assessment.