New Jersey Extends Telemedicine Flexibilities but Only Until 4/2/2026
In response to the COVID-19-era need for remote medical consultations and treatments, the United States Drug Enforcement Administration (“DEA”) granted temporary exceptions under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (“the Ryan Haight Act”). We have previously reported on those COVID-19 telemedicine flexibilities that can be found here. This allowed healthcare providers to prescribe controlled medications via telemedicine without requiring in-person medical examination. Since then, the DEA, in concert with the Department of Health and Human Services (“HHS”), has issued three temporary rules extending COVID-19 flexibilities for telemedicine prescriptions of controlled medications. The Third Temporary Rule, effective Jan. 1, 2025, extended the Covid-era prescribing flexibilities through Dec. 31. 2025, allowing prescribers to continue, under certain conditions, to prescribe Schedule II-V controlled substances without having conducted an in-person evaluation of the patient.
The DEA and HHS have now jointly issued a Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications. Effective Jan. 1, 2026, it extends the existing COVID-era prescribing flexibilities for an additional year, through Dec. 31, 2026, enabling the continued prescribing of Schedule II-V controlled substances via telemedicine without having conducted an in-person evaluation of the patient if the following conditions are met:
- The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice;
- The prescription is issued pursuant to a communication between practitioner and patient using an interactive telecommunications system as defined in 42 CFR 410.78(a)(3);
- The practitioner is:
- 1301. Authorized under their registration under 21 CFR 1301.13(e)(1)(iv) to prescribe the basic class of controlled substance specified on the prescription; or
- 1302. Exempt from obtaining a registration to dispense controlled substances under 21 U.S.C. 822(d); and
- The prescription is consistent with all other requirements of 21 CFR part 1306.
The Fourth Temporary Rule was issued to prevent what is commonly referred to as the “telemedicine cliff”: the reinstatement of pre-pandemic restrictions requiring in-person consultation, which could potentially and abruptly limit patients’ access to care.
While the rule allows the continuation of certain prescribing flexibilities via telemedicine at the federal level, New Jersey, like some other states have begun to roll back certain COVID-era flexibilities, including telemedicine prescribing flexibilities.
In January 2026, New Jersey Gov. Phil Murphy signed Executive Order 415, terminating several active public health emergency declarations in New Jersey (including the COVID-19 State of Emergency previously instituted by Executive Order 103) and ending temporary COVID-era practice flexibilities. Originally intended take effect Feb. 16, 2026, the effective date of the new requirements under Executive Order 415 has been extended by Gov. Mikie Sherrill. On Feb. 13, 2026, Gov. Sherrill signed New Jersey Executive Order No. 13, a state directive temporarily extending portions of the New Jersey State of Emergency originally declared during the pandemic. Executive Order 13 extends the State of Emergency for 45 more days (until 5 p.m. on Apr. 2, 2026) for specific health-care regulatory purposes. This provides additional time for certain health care professionals to transition to post-emergency regulatory requirements without disrupting patient care. While brief, this extension gives APNs and physician assistants (PAs) more time to comply with requirements such as entering into joint protocol or delegation agreements with supervising physicians. Still, New Jersey APNs and PAs must act immediately to bring their practices and policies into compliance prior to the Apr. 2 deadline.
Gov. Murphy’s Executive Order 415 effectively reinstates the joint protocol requirement for New Jersey APNs and no longer allows independent prescribing without a joint protocol in place with a collaborating physician. New Jersey APNs are governed by NJAC 13:37-8.1 and NJSA 45:11-49. This will surely be a major shift for many New Jersey APNs who have been working under COVID-era flexibilities for nearly 6 years. Senate Bill 2996, which has been introduced to the New Jersey Legislature, could potentially allow certain APNs with over 2,400 hours of licensed, active, advanced nursing practice experience to practice independently. It is unclear whether the bill will be successful, however, as similar attempts in the past have failed.
Once Executive Order 415takes effect, prescribing of Schedule II CDS in New Jersey will again be governed by N.J.S.A 45:1-62(e), which requires:
- initial in-person examination prior to the telemedicine prescription of Schedule II CDS; and
- quarterly in-person visits following the initial in-person examination. The quarterly examination is required for the entire time the patient is prescribed the Schedule II CDS.
The in-person initial examination and quarterly visit requirements do not apply when a healthcare provider is prescribing a Schedule II CDS stimulant via telemedicine for a minor patient (under age 18), provided that:
- the healthcare provider uses interactive, real-time, two-way audio and video technology; and
- the healthcare provider has written consent from the minor patient’s parent(s) or guardian.
New Jersey state requirements, currently N.J.S.A. 45:1-62(e), override the federal flexibilities extended under the Fourth Temporary Rule. The New Jersey Division of Consumer Affairs website posted a notice explicitly stating the requirements of N.J.S.A. 45:1-62(e) apply regardless of any continued flexibilities at the federal level.
Going forward, changes are likely at both state and federal levels, and we will continue to report on new developments. It is vital that practitioners keep up to date with current applicable state laws to ensure their practice and policies comply.
If you have questions concerning current telemedicine requirements and how they may impact your practice, please email Sophia B. Villani, Esq., at sbvillani@norris-law.com or call her at (917) 369-8883. The Health Care and Life Sciences attorneys at Norris McLaughlin, P.A., provide a variety of services to clients throughout the health care field, including highly specialized work in the regulatory areas governing the delivery of health care services under state and federal law.
About the Author- The Legal Diagnosis
Sophia B. Villani is an Associate in the Firm’s New York office, where she works on health care and life sciences matters.
Sophia was previously a Non-Equity Partner at a public entity firm, where she specialized in coverage and monitoring counsel to insurance and reinsurance underwriters with a focus on healthcare business, including hospital, physician, allied health, and long-term care programs. In addition, she drafted and negotiated insurance policy provisions, service level agreements, settlement agreements, and fee-sharing agreements.
As a healthcare coverage and risk assessor, Sophia supports clients throughout the U.S. during the pre-underwriting phase. Her experience includes managing large and diverse healthcare programs with high exposure liabilities and complex coverage issues.