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HCANYS Seeking Rx Accommodation for Hospice & Palliative Care Patients Under New DOH Controlled Substances Regulation

The Situation Report | June 9, 2025

The NYS Department of Health (DOH) has adopted regulatory amendments, effective May 21, that revise the requirements for prescription of controlled substances as they relate to in-person medical evaluation prior to issuance of a prescription, and permissibility of prescribing via telehealth.

The amendments, developed and issued by DOH’s Bureau of Narcotic Enforcement (BNE), prompted immediate concerns within HCANYS, our hospice members and hospice and palliative care physicians, which were immediately relayed to BNE and to the Office of Aging and Long Term Care (OALTC). HCANYS' concerns center on the potential unintended hardship created by the amendments for timely prescription and urgent access to pain control prescriptions for hospice and palliative care patients.  HCANYS has appealed to the BNE on behalf of the unique needs and prescribing circumstances for individuals who are dying and/or are in palliative care facing extreme pain.

In our outreach to both BNE and OALTC, HCANYS offered recommendations for clarifying language and/or clarifying interpretation of the adopted rule by BNE to ensure that hospice and palliative care patients and prescribers have the accommodations necessary within the parameters of the amendments for pain control medication prescription and access. As HCANYS awaits BNE reaction to the concerns and recommendations we have provided, we have requested a meeting for HCANYS hospice members, physicians and BNE to further walk through the regulatory amendments and offer one another our mutual insights.

HCANYS thanks BNE and OALTC for the opportunity to engage with and work out these accommodations for hospice and palliative care patients in the state. HCANYS also thanks our hospice members and physician affiliates, particularly our hospice Board members and our colleagues at the National Alliance for Care at Home, who offered their extremely timely and constructive recommendations for DOH.

HCANYS will alert hospice and palliative care member providers of BNE’s response and potential meeting opportunity.

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The state register publication of the amendments can be accessed here, with the basic purposes as summarized by BNE being intended to:

  • Clarify requirements for an in-person medical evaluation prior to issuance of a controlled substance prescription;
  • Clarify instances when a controlled substance prescription may be issued in the absence of a contemporaneous in-person medical evaluation;
  • Permit prescribing of a controlled substance prescription by telemedicine or telehealth when consistent with state and federal laws and regulations; and
  • Remove language referencing provisions of the federal Drug Addiction Treatment Act of 2000 (DATA 2000), which were repealed in 2023.