New Hampshire telehealth commission proposes changes for controlled medication prescriptions

In a pivotal meeting of the New Hampshire Senate Health and Human Services Committee, discussions centered around the future of telehealth services in the state, particularly regarding the prescribing of controlled medications. The meeting, held on March 12, 2025, featured key insights from Dr. Jonathan Ballard, Chief Medical Officer of the New Hampshire Department of Health and Human Services, who presented findings from a legislative commission dedicated to studying telehealth.

As the meeting commenced, Dr. Ballard highlighted the significant changes in telehealth practices that emerged during the COVID-19 pandemic. He noted that federal regulations had relaxed, allowing for the prescription of controlled substances via telehealth, while New Hampshire's laws remained more stringent. This discrepancy has raised concerns among healthcare providers, particularly those in psychiatry and substance use treatment, who argue that the state's regulations create unnecessary barriers to patient care.

One of the main recommendations from the commission was to amend New Hampshire statutes to align them with federal laws, thereby allowing for the prescription of controlled medications without requiring an in-person visit. This change aims to enhance access to care, especially for patients in rural areas or those who are homebound. Dr. Ballard emphasized that the commission's findings were unanimous, reflecting a collective desire to improve telehealth services while maintaining patient safety.

The conversation also touched on the role of nurse practitioners and physician assistants in primary care, with calls for their inclusion in telehealth discussions. Dr. Ballard acknowledged the importance of these healthcare providers and indicated plans to engage them further in the legislative process.

Concerns were raised by committee members regarding the potential risks of prescribing opioids through telehealth without prior in-person consultations. Dr. Ballard reassured them that current standards of care would still apply, ensuring that any prescription, particularly for opioids, would be closely monitored and reported if deemed outside of acceptable practice.

The meeting concluded with a broader discussion on the implications of telehealth for vulnerable populations, including those in hospice care and incarcerated individuals. The proposed changes could facilitate better access to necessary medications and support services, ultimately aiming to reduce recidivism and improve health outcomes.

As New Hampshire navigates the evolving landscape of telehealth, the committee's discussions underscore a critical moment for healthcare policy, balancing accessibility with safety in a post-pandemic world. The recommendations from this meeting could pave the way for significant reforms, enhancing the state's healthcare delivery system for years to come.