The TREATS Act would amend the Controlled Substances Act to permit telehealth evaluations when prescribing certain FDA-approved medications for substance use disorders (SUD), alongside an in-person evaluation. It specifies that for FDA-approved SUD medications, a telehealth evaluation may be used in addition to, or in place of, traditional in-person assessments under defined conditions.
The bill also defines what “telehealth evaluation” means and ties the approach to existing telehealth frameworks by referencing the SSA’s telehealth provisions. The intent is to expand access to evidence-based SUD treatment while maintaining compliance with federal and state laws.
At a Glance
What It Does
The bill amends Section 309(e)(2) to require an in-person medical evaluation and adds a telehealth evaluation for prescribing certain FDA-approved SUD medications (Schedule III-V). It also defines telehealth evaluation and clarifies its use under federal law.
Who It Affects
Clinicians treating SUD patients, telehealth providers, and patients who rely on FDA-approved medications for SUD, particularly in settings that rely on remote care.
Why It Matters
Expands access to treatment for substance use disorders by enabling telehealth-based evaluations and e-prescribing, potentially reaching patients in underserved areas while aligning with Medicare’s telehealth framework.
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What This Bill Actually Does
The TREATS Act makes a targeted change to how substance use disorder (SUD) treatment can be delivered when it comes to prescribing medications that the FDA has approved for SUD. Specifically, it modifies the in-person evaluation rule in the Controlled Substances Act, establishing a hybrid approach: a patient must have at least one in-person medical evaluation, and for certain FDA-approved SUD medications, there must also be a telehealth evaluation.
This telehealth evaluation is defined as a medical evaluation conducted by a practitioner at a remote location using a telecommunications system that allows real-time two-way communication, including audio-only options, and it refers to the Medicare telehealth framework in section 1834(m).
In practical terms, the bill aims to expand access to treatment by allowing clinicians to use telehealth to assess patients and prescribe FDA-approved SUD medications (Schedules III-V) when appropriate, provided all applicable federal and state laws are followed. The telehealth pathway is designed to broaden reach, especially for patients who cannot easily attend in-person visits, while maintaining safeguards consistent with existing telehealth and controlled-substance regulatory structures.
The TREATS Act does not create a blanket authorization for telehealth prescribing; it ties the new evaluation mechanism to specific medications and to compliance with the broader regulatory environment.
The Five Things You Need to Know
The bill amends the Controlled Substances Act to permit a telehealth evaluation for prescribing FDA-approved SUD medications (Schedules III-V) alongside an in-person evaluation.
A new definition of 'telehealth evaluation' allows remote medical assessments using a telecommunications system with real-time two-way communication, including audio-only.
The telehealth framework references the SSA 1834(m) telehealth provisions, integrating the SUD telehealth approach with Medicare-style telehealth standards.
The modification applies specifically to FDA-approved SUD medications in Schedule III-V, not to all controlled substances.
It requires compliance with applicable federal and state laws when conducting telehealth evaluations for SUD treatment.].
Section-by-Section Breakdown
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Short title and citation
Section 1 establishes the Act’s short title as the Telehealth Response for E-prescribing Addiction Therapy Services Act, or the TREATS Act. This is the formal naming and citation convention that will appear in legal references and in court filings.
Telehealth for Substance Use Disorder Treatment
Section 2 amends Section 309(e)(2) of the Controlled Substances Act. It strikes the existing language requiring at least one in-person medical evaluation and inserts subdivisions that require an in-person evaluation plus a telehealth evaluation when prescribing FDA-approved SUD medications in Schedule III-V. It also adds a new defined term, telehealth evaluation, specifying that the evaluation may be conducted remotely by a practitioner using a telecommunications system that supports two-way real-time communication, including audio-only or audio-video, in accordance with applicable federal and state laws, and referencing the SSA’s section on telehealth (1834(m)) as the framework for such evaluations.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Patients with substance use disorders in underserved or rural areas who will gain access to telehealth-based assessments and e-prescribing.
- Clinicians and health systems that deliver SUD treatment via telehealth, expanding reach and flexibility in prescribing FDA-approved medications.
- Telehealth platforms and covered entities specializing in remote health services, enabling compliant telemedicine workflows for SUD care.
- Payers and insurers that support broader access to FDA-approved SUD medications through covered telehealth services.
Who Bears the Cost
- Healthcare providers may incur upfront costs for telehealth technology, training, and compliance systems to support telehealth evaluations.
- Payers and insurers could face higher administrative costs associated with telehealth claims processing and monitoring for SUD treatments.
- State licensing and regulatory agencies may need to adjust oversight and enforcement to accommodate cross-state telehealth evaluations, creating potential administrative costs.
- Pharmacies and dispensing entities might experience workflow changes related to telehealth-based prescriptions for Schedule III-V medications and associated recordkeeping.
Key Issues
The Core Tension
Balancing expanded access to FDA-approved SUD treatments via telehealth with the risk of misuse or diversion of controlled substances, all while ensuring multi-state compliance and payer support.
The TREATS Act introduces a policy shift by expanding telehealth access for SUD treatment, but several tensions and implementation questions remain. The cross-state practice implications require careful navigation of licensing and prescribing rules in each state, and the interaction with existing DEA and prescriber requirements will need clarifications.
Privacy and data security concerns arise whenever telehealth is used to evaluate and prescribe controlled substances, especially with audio-only modalities. Finally, while the bill anchors telehealth to the SSA 1834(m) framework, ensuring consistent reimbursement, quality standards, and patient safety across varied payer landscapes will be essential as the policy moves forward.
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