TREATS Act
- Sponsor
- Rep. Norcross, Donald [D-NJ-1]
- Committees
- Judiciary Committee (primary)
- Last action
- Feb 26, 2025
Bottom line
The TREATS Act expands access to medication-assisted treatment for substance use disorders by allowing initial prescriptions of certain controlled substances via telehealth, aiming to reduce barriers to care.
What it actually does
This bill amends the Controlled Substances Act to permit a telehealth evaluation as an alternative to an in-person medical evaluation for the initial prescription of certain controlled substances. Specifically, it allows practitioners to prescribe Schedule III, IV, or V controlled substances approved by the Food and Drug Administration for substance use disorder treatment after a telehealth evaluation, rather than requiring an initial in-person visit. It also defines what constitutes a 'telehealth evaluation' for these purposes.
Proponents argue
Supporters argue that this bill will significantly improve access to critical substance use disorder treatment, especially for individuals in rural or underserved areas where in-person evaluations may be difficult to obtain. They contend that leveraging telehealth for initial evaluations will reduce barriers to care, facilitate earlier intervention, and align federal law with modern healthcare delivery methods, ultimately saving lives and improving public health outcomes.
Opponents contend
Critics may express concerns that allowing initial prescriptions of controlled substances via telehealth, without an in-person evaluation, could increase the risk of diversion, misuse, or inadequate patient assessment. They might argue that a physical examination is crucial for establishing a comprehensive understanding of a patient's condition and ensuring the appropriate and safe use of controlled medications, particularly in the context of substance use disorders.
The bill is short and clearly written, making it accessible for a quick read and understanding of its core changes.
Section 2(1)(A) and (B) of the bill, amending 21 U.S.C. 829(e)(2)(A)(i)
Telehealth Evaluation for SUD Treatment Prescriptions
This provision modifies existing law to allow a telehealth evaluation to satisfy the requirement for an initial medical evaluation before prescribing certain controlled substances. Specifically, for controlled substances in Schedule III, IV, or V that are approved by the FDA for treating substance use disorder, a practitioner can conduct a telehealth evaluation instead of an in-person one to initiate treatment. This creates an alternative pathway for patients to access medication-assisted treatment.
Supporters argue
Proponents argue that this change is crucial for addressing the ongoing opioid crisis and other substance use disorders by removing a significant barrier to treatment initiation. They highlight that many individuals struggle to access in-person care due to distance, transportation issues, or stigma, and telehealth offers a practical, effective solution to bridge this gap, allowing for timely intervention and improved patient outcomes.
Critics contend
Opponents might argue that while increasing access is important, the initial in-person evaluation provides a critical opportunity for a thorough physical and mental health assessment, which might be missed or compromised through telehealth. They may raise concerns about the potential for misdiagnosis, inappropriate prescribing, or increased risk of diversion of controlled substances if the initial patient-provider relationship is not established in person.
Tradeoffs
This provision navigates the tension between expanding access to critical medical care for a public health crisis and ensuring patient safety and preventing the misuse or diversion of controlled substances. It seeks to balance the benefits of telehealth convenience against the perceived risks of remote initial assessments for these specific medications.
Section 2(2) of the bill, adding 21 U.S.C. 829(e)(2)(D)
Definition of Telehealth Evaluation
This section defines 'telehealth evaluation' for the purposes of the Controlled Substances Act. It specifies that such an evaluation must comply with all applicable Federal and State laws, be conducted by a practitioner (excluding pharmacists) who is remote from the patient, and use a telecommunications system that allows for two-way, real-time interactive communication. Importantly, it explicitly permits the use of 'audio-only or audio and video equipment' and allows for communication with the patient directly or with 'a practitioner who is treating the patient,' implying flexibility for collaborative care models.
The definition of 'telehealth evaluation' references 'section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m))' for the type of telecommunications system to be used.
Section 2(2), adding 21 U.S.C. 829(e)(2)(D)
Why it matters:This is standard legislative drafting practice to avoid redundant text and ensure consistency with existing definitions used in federal healthcare programs, particularly Medicare.
Case for: Supporters would argue that referencing existing law ensures consistency across federal programs and avoids creating conflicting definitions for telehealth technology. It streamlines the legislative process by not reinventing established legal language.
Case against: Critics might contend that such cross-references make the bill less accessible to the average reader or even practitioners, requiring them to consult multiple legal texts to understand the full scope of the requirements. This can create unnecessary complexity.
Estimated impact: Ensures that the technical standards for telehealth systems used under this Act align with those already established for Medicare reimbursement, promoting interoperability and familiar technology.