• District of Columbia: HHS and the Drug Enforcement Administration (DEA) recently issued a final rule to extend pandemic-era telemedicine prescribing flexibilities through the end of 2025. The extension allows controlled substances like Adderall to be prescribed virtually instead of in-person. According to Axios, health providers like the American Psychiatric Association and the Association of American Cancer Institutes lobbied for a two-year extension of the flexibilities. However, the issue had been complicated by a dispute between HHS and DEA over a DEA proposal that would have excluded Schedule II controlled substances and required providers to write 50% of controlled substance prescriptions in person, among other things. Although DEA said it was concerned about the possible diversion and misuse of substances, patient and behavioral health experts said restrictive requirements could disrupt care and access to treatment. (Bettelheim/Goldman, Axios, 11/18)
• District of Columbia: According to a new U.S. Surgeon General's report, adult and youth smoking rates have dipped to their lowest levels on record, but disparities remain among the 36 million adults and 760,000 children who smoke. According to Surgeon General Vivek Murthy, cigarette smoking is more common among American Indian and Alaska Native people than other racial/ethnic groups. People living in poverty are also more than twice as likely to smoke, and Black people, lower-income populations, and people with less education are more likely to be exposed to secondhand smoke. "What's at stake are the lives of our kids and adults across America," Murthy said. "Tobacco is the leading cause of preventable death in the country − 490,000 lives we lose every year to tobacco-related disease. Despite all the progress we've made, that remains the truth today." The report calls for limiting nicotine in tobacco products, banning menthol cigarettes and flavored cigars, passing smoke-free air laws, and providing resources for people who want to quit smoking. (Alltucker, USA Today, 11/19)
• Michigan: Blue Cross Blue Shield of Michigan was ordered to pay $12.7 million for terminating an employee for not complying with its COVID-19 vaccine mandate during the pandemic. According to Crain's Detroit Business/Modern Healthcare, BCBS Michigan denied a religious accommodation request from former IT specialist Lisa Domski, who said the company's COVID-19 vaccine requirement violated her Catholic beliefs. In response to the jury decision, BCBS Michigan said it stands by its vaccine mandate and has not yet decide whether to appeal the decision and on what grounds. "Throughout the pandemic, Blue Cross Blue Shield of Michigan, together with its employees, worked to promote the health and safety of our colleagues, stakeholders, and communities," the company said. "As part of that shared work, in October 2021, Blue Cross, and its subsidiaries, enacted a vaccine policy requiring all of its employees to be fully vaccinated for Covid-19 or obtain a religious or medical accommodation. In implementing the vaccine policy, Blue Cross designed an accommodation process that complied with state and federal law and respected the sincerely held religious beliefs of its employees. While Blue Cross respects the jury process and thanks the individual jurors for their service, we are disappointed in the verdict. Blue Cross is reviewing its legal options and will determine its path forward in the coming days." (Walsh, Crain's Detroit Business/Modern Healthcare, 11/11)

Telehealth has experienced significant growth due to pandemic-related flexibilities around care delivery and payment — but those flexibilities are set to expire at the end of 2024. Delve into the challenges facing providers as they consider how (and if) they'll continue their telehealth programs.