H.R. 6994 — Mental Health TALK SAFE Act of 2026

This section revises requirements for valid telehealth prescriptions of controlled substances under the Controlled Substances Act by (1) expanding the definition in 21 U.S.C. 829(e)(2)(A) to deem prescriptions valid if issued by a telehealth practitioner who has conducted at least one telehealth evaluation of the patient for an approved mental health controlled substance or for a schedule II, III, IV, or V controlled substance to treat opioid use disorder; (2) modifying the covering practitioner definition in 21 U.S.C. 829(e)(2)(C)(i) to include those who have conducted at least one in-person medical evaluation, telemedicine evaluation, or telehealth evaluation of the patient within the previous 90 days (previously limited to in-person evaluations); and (3) adding definitions for 12 new terms, including “approved mental health controlled substance” (i.e., a schedule II non-narcotic, III, IV, or V controlled substance prescribed for a mental health disorder consistent with FDA-approved conditions, administration, and oversight), “exempt entity” (e.g., federally qualified health center, hospital, nonprofit organization, or government agency), “exempt health care organization,” “telehealth entity,” and “telehealth affiliate.” (As background, these changes broaden post-pandemic telehealth flexibilities for prescribing controlled substances, which generally require an in-person exam, to facilitate mental health and opioid use disorder treatment.)

This section amends controlled substance registration requirements (21 U.S.C. 822(e)) to exempt registrants from obtaining additional Drug Enforcement Administration (DEA) registrations in states where dispensing (including prescribing and administering) occurs via telemedicine or following a telehealth evaluation. It further authorizes a registrant employed or contracted with a telehealth entity—who qualifies as a telehealth practitioner and dispenses controlled substances solely via telemedicine or telehealth evaluation—to use the entity's address as the principal place of business or professional practice.

This section establishes interstate recognition of psychiatrist licensure and medical professional liability insurance portability for covered psychiatrists providing covered psychiatry services via telehealth to patients located in a secondary state, provided the services are within the psychiatrist's scope of practice in the primary state and the secondary state's licensure requirements are substantially similar. (A covered psychiatrist is a physician who has completed an Accreditation Council for Graduate Medical Education-accredited psychiatry residency, whose practice focuses predominantly on mental health disorders, and who is licensed in the primary state—defined as the state where the psychiatrist is licensed and the majority of their practice is insured; covered psychiatry services are telehealth-based diagnosis, treatment, or prevention of mental health or behavioral health disorders; and a secondary state is any other state, territory, or possession.) The provision takes effect on the date of enactment.

This section provides that the Act and its amendments supersede and preempt any state statute, regulation, order, or interpretation to the extent it directly or indirectly prohibits or restricts activities permitted by the Act.