AAHD and the Lakeshore Foundation have joined the Alliance for Connected Care letter on proposed DEA rules asking that telemedicine prescribing flexibilities be extended through at least December 2027. The November 2 letter to DEA and OMB is here: PDF.
Accessibility Note: The PDF document linked in the paragraph above has not been fully remediated and is not recommended for screen reader users. The full November 2nd Alliance for Connected Care letter is available in an accessible format below:
November 2, 2026
The Honorable Terrance C. Cole
Administrator
Drug Enforcement Administration
U.S. Department of Justice
8701 Morrissette Drive
Springfield, VA 22152
Russell Vought
Director
Office of Management and Budget
Executive Office of the President
725 17th Street NW
Washington, DC 20503
Dear Administrator Cole and Director Vought,
We write to express our deep concern about the impending lapse of the Drug Enforcement Administration (DEA) telemedicine flexibilities that have allowed patients to safely access needed medications. The fourth temporary extension, published on December 30, 2025, expires on December 31, 2026, and the Special Registrations for Telemedicine and Limited State Telemedicine Registrations final rule (RIN 1117-AB40) has not been finalized. Given this delay in final rulemaking, we respectfully request that you issue a fifth temporary extension of these flexibilities, through at least December 31, 2027, as soon as possible to prevent avoidable lapses in treatment and protect continuity of care for millions who rely on these services.
Since expanded by the Trump Administration, telemedicine has proven to be a lifeline by allowing providers to reach patients where they are, reducing delays in treatment, and improving outcomes. We have seen firsthand how technology-enabled care strengthens the provider-patient relationship, increases adherence to treatment plans, and helps patients lead healthier lives. This progress must not be undone.
Congress has long required DEA to establish a Special Registration process that balances patient access with appropriate safeguards against misuse. Authorized in the 2008 Ryan Haight Act and reinforced by the 2018 SUPPORT Act, this process remains unfulfilled after 18 years. A thoughtful Special Registration framework would give providers the ability to care for patients responsibly while ensuring DEA has the tools it needs to prevent inappropriate prescribing. We urge you to continue to work with Congress on a path forward for permanent access to controlled medications via telehealth.
With only 59 days remaining before these critical telemedicine authorities expire, patients and providers are facing unacceptable uncertainty and the real risk of care disruptions. Even if the final rule is published in November as forecast, providers and platforms will need time to understand the new requirements and apply for registration, and DEA will need time to process those applications. Providers are scheduling appointments with patients at least 30 days in advance. Without an extension, any gap between the expiration of the current flexibilities and an operational Special Registration process will create confusion among patients, cancellations, and abrupt treatment gaps. These flexibilities have been essential for maintaining continuity of care, particularly for those with mental and behavioral health needs, over the past six years.
The proposed rule, as written, would be very difficult for providers and platforms to implement, and we urge DEA to ensure the final rule reflects stakeholder feedback. Even a revised rule will take considerable time to implement, since providers and platforms must learn the requirements and apply for registration, and DEA must process those applications. An extension is necessary to bridge that period, but it should not be read as support for the proposal as written, or as a sign that the proposal would work with more time. We urge you to issue the extension as soon as possible. Last year’s extension was published on December 30, one day before the flexibilities were set to expire. Acting well before the deadline would give patients and practitioners the stability they need to plan care weeks in advance.
In the long-term, we encourage DEA to fully engage with stakeholders in a discussion of the policy barriers to patient care and to collect medical provider feedback on safeguards that mitigate real-world risks of diversion.
Thank you for your attention to this critical issue and for working with the provider and patient community to protect access to care. We urge you to issue a fifth temporary extension through December 31, 2027 as soon as possible, so that patients can continue to receive care without interruption while the final rule is completed and implemented.
Sincerely,
AAMC (Association of American Medical Colleges)
Access TeleCare
AdventHealth
Adventist Health
AGMP Telehealth
Alliance for Connected Care
Alliance Mental Health
ALS Association
Alternating Hemiplegia of Childhood Foundation
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Pediatrics
American Academy of Physician Associates
American Association of Nurse Practitioners
American Association of Psychiatric Pharmacists
American Association on Health and Disability
American College of Emergency Physicians
American Epilepsy Society
American Geriatrics Society
American Health Care Association
American Medical Informatics Association (AMIA)
American Nurses Association
American Osteopathic Association
American Psychiatric Association
American Psychological Association Services, Inc.
American Society of Consultant Pharmacists
Anderson Medical Services LLC
Anderson Mental Health Services
Ascension
ASCP – Age Friendly Pharmacists and Pharmacies
Association for Behavioral Health and Wellness
Association of Children’s Residential & Community Services
At Your Service Psychiatry, PLLC
ATA Action
Avel eCARE
Avery’s Hope
BBennettMD 1 on 1 Virtual Healthcare
Beazell Psychological Services
Better Life Mental Wellness
Big Cities Health Coalition
Blue Ridge Telehealth
Boston Medical Center
CACNA1A Foundation
Center to Advance Palliative Care
Chesapeake Psychological Associates
Child Neurology Foundation
Children and Adults with Attention-Deficit/Hyperactivity Disorder
Children’s Hospital Association
Coalition to Cure CHD2
Columbia University Irving Medical Center
Compassion & Choices
Complete Behavioral Health, PLLC
Conference of Boston Teaching Hospitals
Creating Compassion LLC
CSNK2A1 Foundation
CURE Epilepsy
Current Mind Care, LLC
Cyclic Vomiting Syndrome Association
Diabetes Leadership Council
Diabetes Patient Advocacy Coalition
Different MHP, PC
Digital Medicine Society (DiMe)
Dogtown Media LLC
doxy.me
DreamCloud Psychiatry
Dup15q Alliance
Dysautonomia International
East Coast Telepsychiatry Inc
Eleanor Health
Emory
Emplify Health
Empowering Epilepsy
Encounter Telehealth
Epilepsy Alliance America
Epilepsy Foundation of America
Epilepsy Foundation Alabama
Epilepsy Foundation Alaska
Epilepsy Foundation Arizona
Epilepsy Foundation Arkansas
Epilepsy Foundation Central & South Texas
Epilepsy Foundation Eastern Pennsylvania
Epilepsy Foundation Florida
Epilepsy Foundation Greater Orange County
Epilepsy Foundation Indiana
Epilepsy Foundation Iowa
Epilepsy Foundation Long Island
Epilepsy Foundation Los Angeles
Epilepsy Foundation Lousiana
Epilepsy Foundation Maryland
Epilepsy Foundation Metro D.C.
Epilepsy Foundation Mississippi
Epilepsy Foundation Montana
Epilepsy Foundation Nebraska
Epilepsy Foundation Nevada
Epilepsy Foundation New England
Epilepsy Foundation New Jersey
Epilepsy Foundation New Mexico
Epilepsy Foundation North Carolina
Epilepsy Foundation North Dakota
Epilepsy Foundation of Colorado & Wyoming
Epilepsy Foundation of Connecticut
Epilepsy Foundation of Delaware
Epilepsy Foundation of East Tennessee
Epilepsy Foundation of Georgia
Epilepsy Foundation of Greater Chicago
Epilepsy Foundation of Greater Southern Illinois
Epilepsy Foundation of Hawaii
Epilepsy Foundation of Idaho
Epilepsy Foundation of Kentuckiana
Epilepsy Foundation of Metropolitan New York
Epilepsy Foundation of Michigan
Epilepsy Foundation of Minnesota
Epilepsy Foundation of Missouri and Kansas
Epilepsy Foundation of Northeastern New York, Inc.
Epilepsy Foundation of Northern California
Epilepsy Foundation of San Diego County
Epilepsy Foundation of Southeast Tennessee
Epilepsy Foundation of Texas
Epilepsy Foundation of Virginia
Epilepsy Foundation of Wisconsin
Epilepsy Foundation Ohio
Epilepsy Foundation Oklahoma
Epilepsy Foundation Oregon
Epilepsy Foundation South Carolina
Epilepsy Foundation South Dakota
Epilepsy Foundation Utah
Epilepsy Foundation Washington
Epilepsy Foundation West Virginia
Essentia Health
Facial Pain Association
Fairview Health Services
Federation of American Hospitals
Florida Alliance for Healthcare Value
Florida Health Information Management Association
Forbes Wellness, LLC
FORCE: Facing Our Risk of Cancer Empowered
Gaucher Community Alliance
Gilda’s Club South Florida
Health Innovation Alliance
Healthcare Information and Management Systems Society (HIMSS)
Holland and Associates Counseling, PLLC.
Hone Health
Hope for HIE
Hopeful Mind Mental Health PLLC
Hospice and Palliative Nurses Association
Human Vitality, Inc.
In-Tuitt Behavioral Health Services
Indiana University Health, Inc.
Integrated Telehealth Partners
Integrative Counsel
International Foundation for CDKL5 Research
KMA SERVICES LLC
Kohnlinq, Inc.
Lakeshore Foundation
Lavender
Lavender Psychiatry
Layh & Associates, Inc.
LeadingAge
Lennox-Gastaut Syndrome (LGS) Foundation
Lifebridge Health
LMA MENTAL HEALTH SERVICES
Mass General Brigham
Massachusetts Health & Hospital Association
Massachusetts Health Data Consortium, Inc.
Medical Group Management Association
Meds.com
MedStar Health
Medwand Solutions, Inc
MEF2C Family Foundation
Midi Health
mindful intentions, llc
Mississippi Telehealth Association
MitoAction
Moving Mountains – Mental Health & Recovery, PLLC
National Association for Behavioral Healthcare
National Association of Epilepsy Centers
National Association of Pediatric Nurse Practitioners
National Center for Assisted Living
National Center on Domestic Violence, Trauma, and Mental Health
National Council for Mental Wellbeing
National Headache Foundation
National Partnership for Healthcare and Hospice Innovation
National Patient Advocate Foundation
National Rural Health Association
Network of Jewish Human Service Agencies
Neura Health
New Jersey Association of Mental Health and Addiction Agencies, Inc.
NIM LONGEVITY
NORSE Institute
Northside Medical Professionals
Northwell Health
NP Housecalls, PLLC
OCHIN
Oncology Nursing Society
Paragon Behavioral Health
Pediatric Epilepsy Surgery Alliance
Pelago
Pennsylvania Rural Health Association
Planned Parenthood of Greater Washington and North Idaho (PPGWNI)
Pulmonary and Sleep Medicine Group LLC
QMed, PC
QuickVisit urgent care
Rare and Undiagnosed Network (RUN)
Rare Epilepsy Network
Recovery & Wellness Mental Health Counseling Svcs PLLC
REDC Consortium
Research for Healthy Communities
Ring 20 USA
Ro
Rooted Balance Therapy
RxHomeTest
Sacred Space Psychiatry
Sarvis Mental Health
Shock Therapy Group, LLC
Small Business & Entrepreneurship Council
Sovato
Spectrum Psychological Services
Spring Health
SSADH Association
SSM Health
Stanford Health Care
Still Waters Psychiatry PLLC
Sunrise Mental Health
Synchronous Mental Health
Taconic Psychiatry
Telehealth.org
Telehealthdocs Medical Group
TeleMed2U
Texas Health Resources
The Coalition of Headache and Migraine Patients (CHAMP)
The Cute Syndrome Foundation
The Global Foundation for Peroxisomal Disorders
The Sturge-Weber Foundation
The Trevor Project
tMED – The Massachusetts Telemedicine Coalition
Transcendental Wellness, PLLC
Transformative Healthcare
TSC Alliance
U.S. Pain Foundation
UCHealth
University of Pittsburgh Medical Center Health System
URAC
UW Medicine
Virginia Telehealth Network
WeKonnect, LLC.
Welliti
Williamsburg Endocrinology, Inc
Wise Patient Internal Medicine, PLLC
Workit Health, Inc.
Yale New Haven Health System
Yale School of Medicine