Opioid use disorder (OUD) is a leading cause of death in the US, yet many patients face barriers to accessing buprenorphine, an evidence-based treatment. Since March 2020, the temporary suspension of the Ryan Haight Act’s in-person evaluation requirement has enabled patients with OUD to receive buprenorphine via telemedicine (tele-buprenorphine) without an initial in-person visit. Studies show tele-buprenorphine improves treatment retention.
Proposed rulemaking by the US Drug Enforcement Administration (DEA) would create a special registration pathway under the Ryan Haight Act to permanently allow fully virtual OUD care by authorized physicians, nurse practitioners (NPs), and physician assistants (PAs), where permitted under state law and with safeguards for identity verification and diversion monitoring.
Given this federal policy context, we assessed variation in state policy support for fully virtual tele-buprenorphine care for Medicaid enrollees through a systematic legal mapping analysis of statutes, regulations, and Medicaid policies across all 50 US states and the District of Columbia.
