I 
119TH CONGRESS 
2D SESSION 
H. R. 6994 
To amend the Controlled Substances Act to modify requirements relating 
to the prescription of controlled substances by means of the internet, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 9, 2026 
Mr. DUNN of Florida introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on the Judiciary, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To amend the Controlled Substances Act to modify require-
ments relating to the prescription of controlled sub-
stances by means of the internet, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Mental Health TALK 
SAFE Act of 2026’’. 
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SEC. 2. TELEHEALTH PRESCRIBING OF CONTROLLED SUB-
STANCES. 
(a) DEFINITION OF VALID PRESCRIPTION.—Section 
309(e)(2)(A) of the Controlled Substances Act (21 U.S.C. 
829(e)(2)(A)) is amended— 
(1) in clause (i), by striking ‘‘or’’ at the end; 
(2) in clause (ii), by striking the period at the 
end and inserting a semicolon; and 
(3) by adding at the end the following: 
‘‘(iii) a telehealth practitioner who, for 
purposes of prescribing an approved men-
tal health controlled substance, has con-
ducted at least 1 telehealth evaluation of 
the patient; or 
‘‘(iv) a practitioner who, for purposes 
of prescribing a controlled substance in 
schedule II, III, IV, or V for the treatment 
of an opioid use disorder, has conducted at 
least 1 telehealth evaluation of the pa-
tient.’’. 
(b) DEFINITION OF COVERING PRACTITIONER.—Sec-
tion 309(e)(2)(C)(i) of such Act (21 U.S.C. 829(e)(2)(C) 
(i)) is amended to read as follows: 
‘‘(i) has conducted at least 1 in-per-
son medical evaluation of the patient, an 
evaluation of the patient through the prac-
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tice of telemedicine, or a telehealth evalua-
tion of the patient, within the previous 90 
days; and’’. 
(c) ADDITIONAL DEFINITIONS.—Section 309(e)(2) of 
such Act (21 U.S.C. 829(e)(2)) is amended by adding at 
the end the following: 
‘‘(D) The term ‘approved mental health 
controlled substance’ means a controlled sub-
stance in schedule II non-narcotics, III, IV, or 
V that is being prescribed— 
‘‘(i) for the treatment of a mental 
health disorder; and 
‘‘(ii) only for the conditions, and only 
in the manner of administration and over-
sight, approved by the Food and Drug Ad-
ministration. 
‘‘(E) The term ‘exempt entity’ means— 
‘‘(i) a federally qualified health center; 
‘‘(ii) a hospital; 
‘‘(iii) a non-profit organization; 
‘‘(iv) a Federal, State, or local govern-
ment agency; or 
‘‘(v) an exempt health care organiza-
tion. 
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‘‘(F) The term ‘exempt health care organi-
zation’ means a legal entity that, directly or in-
directly, acquires all, or substantially all, of the 
stock, equity interests, or assets of, or merges 
with or into, a telehealth entity where such tele-
health entity, as of the effective date of such ac-
quisition or merger— 
‘‘(i) has met the criteria to be a tele-
health entity for each of the previous 24 
months; 
‘‘(ii) employs at least 250 psychia-
trists who each work at least 30 hours per 
week for the telehealth entity; and 
‘‘(iii) has at least 75 percent of the 
telehealth entity’s total patient volume at-
tributed to individuals who are direct pa-
tients of the telehealth entity. 
‘‘(G) The term ‘federally qualified health 
center’ means an organization described in sec-
tion 1861(aa)(4) of the Social Security Act (42 
U.S.C. 1395x(aa)(4)). 
‘‘(H) The term ‘health care provider’ 
means any individual who— 
‘‘(i) is engaged in the delivery of 
health care services in a State; and 
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‘‘(ii) is required by State law (includ-
ing regulations) to be licensed or certified 
by the State to engage in the delivery of 
such services in the State. 
‘‘(I) The term ‘hospital’ means an institu-
tion in any State in which State or applicable 
local law provides for the licensing of hospitals, 
that is— 
‘‘(i) licensed as a hospital pursuant to 
such law; or 
‘‘(ii) approved, by the agency of such 
State or locality responsible for licensing 
hospitals, as meeting the standards estab-
lished for such licensing. 
‘‘(J) The term ‘interactive telecommuni-
cations system’ means the multimedia commu-
nications equipment that includes, at a min-
imum, audio-only or audio-video equipment per-
mitting two-way, real-time interactive commu-
nication between the patient and the health 
care provider. 
‘‘(K) The term ‘nonprofit organization’ 
means an organization described in section 
501(c)(3) of the Internal Revenue Code of 1986 
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that is exempt from taxation under section 
501(a) of such Act. 
‘‘(L) The term ‘physician’ means a doctor 
of medicine or osteopathy legally authorized to 
practice medicine by the State in which such in-
dividual performs such function or action. 
‘‘(M)(i) 
The 
term 
‘psychiatric-mental 
health advanced practice nurse’ means a reg-
istered professional nurse who meets the re-
quirements specified in clause (ii) or (iii). 
‘‘(ii) If the State specifies qualifications for 
psychiatric-mental health advanced practices 
nurses, the individual must— 
‘‘(I) be currently licensed to practice 
in the State as a registered professional 
nurse; and 
‘‘(II) meet the State requirements for 
qualification as a psychiatric-mental health 
advanced practice nurse in the State in 
which the individual furnishes the services. 
‘‘(iii) If the State does not specify quali-
fications for psychiatric-mental health advance 
practice nurses, the individual must— 
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‘‘(I) meet the qualifications for nurses 
in advanced practice or general nurse prac-
titioners as defined by the State; and 
‘‘(II) maintain an active psychiatric- 
mental health nursing certification from 
the American Nurses Credentialing Center 
or the American Academy of Nurse Practi-
tioners Certification Board. 
‘‘(N) The term ‘psychiatrist’ means a phy-
sician who has completed a psychiatry residency 
program accredited by the Accreditation Coun-
cil for Graduate Medical Education and whose 
practice focuses predominantly on the diagnosis, 
treatment, prevention, or study of mental 
health disorders. 
‘‘(O)(i) The term ‘telehealth affiliate’ 
means as to any telehealth entity, any other 
legal entity that— 
‘‘(I) directly or indirectly, is in 
control of, is controlled by, or is under 
common control with, such telehealth 
entity; or 
‘‘(II) provides the majority of the 
administrative or business services 
that do not constitute the practice of 
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medicine or any other licensed profes-
sion, to, or on behalf of, such tele-
health entity. 
‘‘(ii) For purposes of this definition, 
control of an entity means the power, di-
rectly or indirectly, to direct or cause the 
direction of the management and policies 
of such entity whether by contract or oth-
erwise. 
‘‘(P) The term ‘telehealth entity’ means an 
entity organized and operating within the 
United States that employs or engages with 
practitioners who prescribe controlled sub-
stances via a telehealth evaluation and, except 
in the case of an exempt entity, meets each of 
the following requirements: 
‘‘(i) The telehealth entity does not, di-
rectly or indirectly, through a telehealth af-
filiate or otherwise, maintain an ownership 
interest, investment interest, or manage-
ment relationship with any pharmacy 
that— 
‘‘(I) does not dispense medica-
tions from physical locations that are 
accessible to the public; and 
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‘‘(II) fills and delivers the major-
ity of its pharmaceutical products via 
the mail service. 
‘‘(ii) The telehealth entity does not, 
directly or indirectly, through a telehealth 
entity or otherwise, charge patients pursu-
ant to a financial arrangement where pa-
tients agree to make recurring payments at 
regular intervals in exchange for medica-
tions or patient care services provided by a 
health care provider employed or engaged 
with the telehealth entity (or a telehealth 
affiliate). 
‘‘(iii) For the duration of any 12- 
month period, no more than 50 percent of 
all charges for patient care services pro-
vided by a health care provider employed 
or engaged with the telehealth entity (or a 
telehealth affiliate) are paid by patients di-
rectly on an out-of-pocket basis. 
‘‘(iv) At least 25 percent of the total 
actual time spent performing patient care 
services by all health care providers en-
gaged or employed by the telehealth entity 
(or a telehealth affiliate) relates to the di-
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agnosis, treatment, prevention, or study of 
mental health disorders. 
‘‘(v) At least 10 percent of all health 
care providers employed or engaged by the 
telehealth entity (or a telehealth affiliate), 
excluding any covering practitioners, are 
practitioners who are bona fide employees 
who work at least 30 hours per week for 
the telehealth entity. 
‘‘(vi) At least 25 percent of all health 
care providers employed or engaged by the 
telehealth entity (or a telehealth affiliate), 
excluding any covering practitioners, are 
bona fide employees of the telehealth entity 
who work at least 30 hours per week for 
the entity. 
‘‘(vii) The total number of advanced 
practice nurses employed or engaged with 
the telehealth entity (or a telehealth affil-
iate), excluding any covering practitioners, 
does not exceed two-thirds of the total 
number of practitioners employed or en-
gaged with the telehealth entity (or a tele-
health affiliate). 
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ployed or engaged by the telehealth entity 
are prescribed only for the conditions, and 
only in the manner of administration and 
oversight, approved by the Food and Drug 
Administration. 
‘‘(xiii) The telehealth entity at all 
times maintains active accreditation from 
the Accreditation Counsel for Continuing 
Medical Education. 
‘‘(Q) The term ‘telehealth evaluation’ 
means a medical evaluation that is conducted in 
accordance with applicable Federal and State 
laws by a health care provider who is— 
‘‘(i) at a location remote from the pa-
tient; and 
‘‘(ii) communicating with the patient 
using an interactive telecommunications 
system. 
‘‘(R) The term ‘telehealth practitioner’ 
means a psychiatrist or a psychiatric-mental 
health advanced practice nurse who meets the 
following requirements: 
‘‘(i) The individual is an employee or 
independent contractor of a telehealth enti-
ty. 
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‘‘(ii) Except in the case of an exempt 
entity, the individual works at least 10 
hours per week for the telehealth entity. 
‘‘(iii) Except in the case of an exempt 
entity, no more than 75 percent of the 
total annual compensation received by the 
individual from the telehealth entity (or a 
telehealth affiliate) varies with the volume 
or value of the telehealth evaluations pro-
vided by such practitioner. 
‘‘(iv) The individual only prescribes 
controlled substances under subparagraph 
(A)(ii) for one telehealth entity in any 
given calendar month.’’. 
(d) MINIMUM STANDARDS BEFORE REFUSING TO 
FILL A PRESCRIPTION.—Section 309(e) of such Act (21 
U.S.C. 829(e)) is amended by adding at the end the fol-
lowing: 
‘‘(4) MINIMUM STANDARDS BEFORE REFUSING 
TO FILL A PRESCRIPTION.— 
‘‘(A) PROHIBITION.—A pharmacist shall 
not refuse to fill a prescription for a controlled 
substance issued in compliance with this sub-
section based solely upon a concern the pre-
scription was issued via a telehealth evaluation. 
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‘‘(B) VALIDATION OF PRESCRIPTION.—Be-
fore a pharmacist can refuse to fill a prescrip-
tion based solely upon a concern with the valid-
ity of the prescription, the pharmacist shall at-
tempt to resolve those concerns and shall at-
tempt to validate the prescription by performing 
the following: 
‘‘(i) Initiate communication with the 
patient (or the patient’s representative) to 
acquire information relevant to the concern 
with the validity of the prescription. 
‘‘(ii) Initiate communication with the 
prescriber or the prescriber’s agent to— 
‘‘(I) describe the pharmacist’s 
concern with the validity of the pre-
scription; and 
‘‘(II) acquire information rel-
evant to the pharmacist’s concern 
with the validity of the prescription. 
‘‘(C) CIVIL
PENALTY.—Any person who 
violates this paragraph shall, with respect to 
any such violation, be subject to a civil penalty 
of up to $25,000 per violation.’’. 
(e) REPEALS.— 
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(1) PRACTICE OF TELEMEDICINE DEFINED.— 
Section 102(54)(E) of such Act (21 U.S.C. 
802(54)(E)) is repealed. 
(2) SPECIAL
REGISTRATION
FOR
TELEMEDI-
CINE.—Section 311(h) of such Act (21 U.S.C. 
831(h)) is repealed. 
(f) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date of enactment of 
this Act. 
SEC. 3. CONTROLLED SUBSTANCES REGISTRATIONS. 
(a) IN GENERAL.—Section 302(e) of such Act (21 
U.S.C. 822(e)) is amended by adding at the end the fol-
lowing: 
‘‘(5)(A) Notwithstanding paragraph (1), a registrant 
shall not be required to obtain additional registrations 
with the Drug Enforcement Administration in any addi-
tional State where the dispensing (including prescribing 
and administering) occurs if the dispensing is conducted 
via the practice of telemedicine or following a telehealth 
evaluation. 
‘‘(B) A registrant who is employed or contracted with 
a telehealth entity may use the address of such telehealth 
entity as the principal place of business or professional 
practice of the registrant so long as the registrant— 
‘‘(i) is a telehealth practitioner; and 
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‘‘(ii) only dispenses (including prescribing and 
administering) controlled substances via the practice 
of telemedicine or a telehealth evaluation.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on the date of enactment 
of this Act. 
SEC. 4. PSYCHIATRIST LICENSURE. 
(a) IN GENERAL.—In the case of a covered psychia-
trist who has in effect medical professional liability insur-
ance coverage and provides in a secondary State covered 
psychiatry services that are within the scope of practice 
of such covered psychiatrist in the primary State to a pa-
tient— 
(1) such medical professional liability insurance 
coverage shall cover (subject to any related premium 
adjustments) such covered psychiatrist with respect 
to such covered psychiatry services provided by the 
psychiatrist in the secondary State to such patient 
as if such services were provided by such psychiatrist 
in the primary State to such patient; and 
(2) to the extent such covered psychiatrist is li-
censed under the requirements of the primary State 
to provide such services to such patient, the psychia-
trist shall be treated as satisfying any licensure re-
quirements of the secondary State to provide such 
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services to such patient to the extent the licensure 
requirements of the secondary State are substan-
tially similar to the licensure requirements of the 
primary State. 
(b) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed— 
(1) to allow a covered psychiatrist to provide 
psychiatry services in the secondary State that ex-
ceed the scope of that psychiatrist’s license in the 
primary State; or 
(2) to allow a covered psychiatrist to provide 
psychiatry services in the secondary State that ex-
ceed the scope of a substantially similar psychiatrist 
license in the secondary State. 
(c) DEFINITIONS.—In this Act: 
(1) COVERED PSYCHIATRIST.—The term ‘‘cov-
ered psychiatrist’’ means a physician— 
(A) who has completed a psychiatry resi-
dency program accredited by the Accreditation 
Council for Graduate Medical Education; 
(B) whose practice focuses predominantly 
on the diagnosis, treatment, prevention, or 
study of mental health disorders; and 
(C) who is licensed to practice in the pri-
mary State. 
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