Letter to the Editor: Most EPs Won't Qualify for DEA Exemption : Emergency Medicine News

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Letter to the Editor

Letter to the Editor

Most EPs Won't Qualify for DEA Exemption

doi: 10.1097/01.EEM.0000898280.14232.ac


    I called the DEA and spoke with their representative Kenneth Crouch, and it turns out that very few emergency physicians will qualify for the $888 exemption that Michael Newdow, MD, JD, wrote about. (“DEA Rule Lets EPs Skip Costly Fee,” EMN. 2022;44[9]:3; https://bityl.co/ESZD.)

    To qualify, you must be using your hospital pharmacy's DEA number. That means no moonlighting and no prescribing controlled substances outside of the hospital, even Lomotil. Very few of us use our DEA license only within the confines of the hospital. This exemption sounds wonderful, but it doesn't help the vast majority of EPs. Too bad.

    John C. Gill, MD

    San Diego

    Dr. Newdow responds: I tried to contact Mr. Crouch, but he is on an extended leave. I am highly doubtful that he contended (or that anyone else in the DEA would contend) that “very few emergency physicians will qualify for this $888 exemption.” The code is clear: Any physician who prescribes controlled substances in a hospital setting (which I think describes the overwhelming majority of EPs) may do so using that hospital's DEA registration.

    As for only prescribing within the confines of the hospital, I can only say that you and I must come from different worlds. I can't recall the last time (if ever) that I prescribed a controlled substance outside of my role as a hospital-based physician. Assuming that you are, like I am, using an n of 1, I guess we will need to see some decent data to determine if that has any basis in fact. If you have those data, I would love to see them. Similarly, I would expect that the vast majority of EPs who moonlight do so in other EDs, where the $888 registration fee can still be avoided by simply having a numerical suffix assigned under the other hospitals' registrations.

    Despite my skepticism regarding the accuracy of your first sentence, the question still remains about whether hospital administrators and the other powers-that-be will agree to allow their EPs to take advantage of this law. As my article concluded, “But this exemption is virtually never used, probably because few physicians know about it and bureaucracies often resist change. But it has essentially no downsides and an $888 upside, and it should be the new standard of DEA registration for emergency physicians and other hospital-based professionals.”

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