DEA Updates on Telehealth Prescriptions: A Detailed Guide

Starting from November 11, 2023, the process of prescribing controlled substances via telehealth will be updated according to the new DEA regulations. Learn more about what this means for you and how you can continue getting uninterrupted treatment online at Mango Clinic. 

End of the Public Health Emergency Declared

The federal government declared a public health emergency (PHE) in 2020 in response to the COVID-19 pandemic. The emergency allowed for certain flexibilities, including telehealth prescriptions. For example, patients weren’t required to visit their physicians in person and could get controlled medications prescribed after an online evaluation.

With the expiry of the PHE, the above-mentioned rule changes. The updated regulation will come into force on November 11, 2023. It becomes compulsory that patients who require controlled substances must see a primary care physician (PCP) in-person to continue getting prescriptions online. After completing an in-person evaluation one can get a referral letter — a document that allows a patient to receive prescriptions for controlled substances via telehealth providers.

What the Update Means

Current patients

If you are already a Mango Clinic patient or have your initial appointment before November 11, 2023, you continue your treatment with controlled substances as usual until November 11, 2024.

To continue treatment after November 11, 2024, you should have an in-person evaluation and provide us with a referral letter from your primary care physician.

New patients

If you plan to book your first appointment at Mango Clinic on November 11, 2023, or later, and require controlled substances, you can only get them prescribed for 30 days.

During 30 days, you will have to provide us with a referral letter from your primary care physician. It will allow you to get controlled medications prescribed for a longer period or refill your initial telehealth prescription. Note that schedule II drugs require a referral even for a 30-day supply.

A referral letter is valid for a year. After that, you have to renew it.

What is a Qualifying Telemedicine Referral?

A qualifying telemedicine referral is a document containing your medical record and information about a physician who provided it. A referral serves as a permit to get prescriptions for controlled substances via telehealth providers, such as Mango Clinic. You must have an in-person appointment with a healthcare provider to get the referral.

Your referral will be valid for a year. This means that the document allows you to receive and refill prescriptions for controlled substances via a telehealth service for a year. You will need another in-person appointment with a PCP to renew the referral after a year elapses.

How to Get a Qualifying Referral

Follow these easy steps to get a qualifying telemedicine referral:

  1. Download a referral form here and send it to your PCP or local healthcare provider. You can also share a link or take a printout of the document to your appointment.
  2. See a healthcare provider and complete the in-person evaluation.
  3. Ask that the healthcare provider complete the form and request that you continue your care and prescription management with Mango Clinic.
  4. Ask your healthcare provider to send the completed form to Mango Clinic via eFax (+1 888 395 9144).
  5. Once your referral is reviewed and submitted, Mango Clinic can refill your prescription for controlled substances.

Some primary care physicians have their own referral forms, which we do accept. 

For any assistance with your referral, contact our Hotline at (786) 422-9327 and press 6.

Refer the healthcare provider to our guide for medical professionals for any questions they may have.

Frequently Asked Questions

  • When do these updates take effect?
  • What medications are called controlled substances?
  • Do I need a referral letter to get any controlled medication prescribed?
  • Can I get schedule II controlled substances if I don’t have a referral yet?
  • Do I need a referral for non-controlled substances or a schedule III-V controlled substance?
  • Who can provide a qualifying telemedicine referral letter?
  • Does Mango Clinic have a walk-in clinic? Can you recommend a PCP?
  • Does Mango Clinic have a walk-in clinic near me? Can you recommend a PCP?
  • Where can I get the referral form, and when should I send it?
  • How often will I need to see my PCP in person?
  • May I get an appointment without a referral?
When do these updates take effect?

The new DEA rules come into force on November 11, 2023. Starting from that date, our new patients will be required to provide a referral letter to get schedule II controlled substances prescribed or to get schedule III-V medications prescribed for longer than 30 days.

Our current patients (and those who start treatment at Mango Clinic before November 11, 2023) can continue treatment without a referral until November 11, 2024.

Non-controlled medications remain prescribed without a referral letter.

What medications are called controlled substances?

A controlled substance is a medication, drug, or another substance whose manufacture, possession, and use are regulated by the government due to the risk of misuse, abuse, and addiction. 

Many medications used in treating conditions such as attention deficit hyperactivity disorder (ADHD), anxiety disorders, and depression fall in the category of controlled substances.

Do I need a referral letter to get any controlled medication prescribed?

The requirements for a qualifying telemedicine referral vary depending on the type of controlled substances:

  • You can get schedule III-V controlled substances prescribed online for 30 days without a referral. You will, however, need a referral to refill the prescription through telehealth services after this 30-day period.
  • You must provide a referral letter to get schedule II controlled substances (Adderall, Concerta, Ritalin, etc.) even for a 30-day period.
Can I get schedule II controlled substances if I don’t have a referral yet?
  • If you are a current patient at Mango Clinic and already have a prescription for schedule II drugs, you can continue treatment as it is. However, you need to provide a referral before November 11, 2024.
  • If you are our current patient but have yet to be prescribed schedule II drugs and require them past November 10, 2023, then you must provide a referral to get a prescription.

If you are a new patient (having an initial appointment after November 10, 2023) and need a schedule II drug, you will need to provide a referral. While you can have the initial appointment without the referral, your prescription will only be processed after you provide the referral.

Do I need a referral for non-controlled substances or a schedule III-V controlled substance?
  • The above-mentioned changes only apply to controlled substances. For this reason, you can continue to be prescribed non-controlled substances as usual.If you require a schedule III-V drug, you can get it prescribed online for 30 days without a referral. However, you will need a referral to refill the prescription online after 30 days.
Who can provide a qualifying telemedicine referral letter?

Your primary care physician, family medicine provider, urgent care provider, or internal medicine provider can conduct an evaluation and provide you with a referral letter.

Does Mango Clinic have a walk-in clinic? Can you recommend a PCP?

We presently don’t have walk-in clinics and work on collaborating with certified PCPs who can conduct in-person evaluations and provide qualifying referrals. 

Need help to find a certified PCP? Contact our Hotline at (786) 422-9327 and press 6 for PCP recommendations and further assistance.

Does Mango Clinic have a walk-in clinic near me? Can you recommend a PCP?

As of now, Mango Clinic doesn’t have walk-in clinics. We work on collaborating with certified primary care physicians (PCP) who can conduct an in-person evaluation and provide you with a referral. For further assistance, please contact our Hotline at (786) 422-9327 and press 6.

Where can I get the referral form, and when should I send it?

You can download the referral form from our website. If you are a current Mango Clinic patient, your PCP should provide the referral via eFax (+1 888 395 9144) before November 11, 2024. If you are a new patient needing a controlled substance prescription, after November 11, 2023, you must provide a referral within 30 days after a telehealth appointment to refill your prescription online.

How often will I need to see my PCP in person?

It depends on the duration of your treatment course. The referral is valid for 12 months, so if you need controlled substances after that period, you have to see a PCP in person again and get a new referral letter.

Also, suppose your telehealth provider changes your diagnosis or defines another mental health condition. In that case, you will have to see your PCP and get a new referral to receive a prescription for controlled substances to treat the new condition.

May I get an appointment without a referral?

Even without a referral letter, you can still attend an online appointment at Mango Clinic.

  • You will not be asked to provide a referral if you don’t require controlled medication.
  • You can get schedule III-V medication prescribed for 30 days without a referral. You will, however, need a referral letter to refill the prescription online.
  • You can still attend the appointment without the referral if you require a schedule II medication prescription. You will, however, need the referral to have your prescription processed.

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