DEA and Telemedicine Prescribing Policy

1. Introduction and Purpose

SDKare LLC (“SDKare,” “Company,” “we,” “us,” or “our”) is committed to providing safe, responsible, and legally compliant healthcare services through telemedicine.

This DEA and Telemedicine Prescribing Policy (“Policy”) explains the requirements governing prescription medications, including controlled substances, prescribed or considered during healthcare consultations through SDKare.

This Policy addresses:

• Healthcare provider licensing and prescribing authority.
• Drug Enforcement Administration (DEA) registration requirements.
• Federal telemedicine prescribing rules.
• Applicable state prescribing laws.
• Controlled-substance prescribing restrictions.
• SDKare’s internal 28-day controlled-substance policy.
• Medication renewals, changes, and replacement requests.
• Prescription Drug Monitoring Program requirements.
• Patient evaluations and clinical documentation.
• Pharmacy dispensing and medication availability.
• Patient responsibilities and medication safety.
• Emergency care and continuity of treatment.
• Changes to federal prescribing requirements.

Prescription decisions are made by appropriately authorized healthcare providers using independent clinical judgment.

Nothing in this Policy permits a prescription that is prohibited by applicable law or requires a provider to prescribe medication when doing so would be clinically inappropriate.

2. Scope and Applicability

This Policy applies to prescription-related activities associated with healthcare services provided through SDKare, including, where applicable:

• Mental and behavioral healthcare.
• Psychiatric medication management.
• Attention-deficit/hyperactivity disorder (ADHD) treatment.
• Primary care.
• Pain management consultations.
• Addiction-related healthcare.
• Women’s healthcare.
• Men’s healthcare.
• Weight management.
• Follow-up care involving prescription medications.
• Other clinical services for which prescribing is appropriate.

Not every SDKare service includes medication prescribing.

Not every provider is authorized to prescribe every medication or controlled-substance category.

The availability of prescriptions depends on the patient’s clinical condition, physical location, provider qualifications, applicable law, and SDKare’s prescribing policies.

SDKare services are intended for adults aged 18 years or older.

3. Prescription Decisions and Independent Clinical Judgment

Prescription medications are issued only when the treating healthcare provider determines, after an appropriate clinical evaluation, that the medication is medically appropriate and legally permitted.

Scheduling or paying for an appointment does not guarantee:

• A prescription.
• A controlled-substance prescription.
• A specific medication or brand.
• A particular dosage.
• A medication refill or subsequent prescription.
• Continuation of medication prescribed by another healthcare professional.
• A change to another medication.
• Replacement of lost, stolen, or damaged medication.
• Approval of an early medication request.

Healthcare providers may recommend additional testing, request medical records, require follow-up consultations, suggest alternative treatment, or determine that an in-person examination is necessary.

A provider may decline to prescribe when a medication is clinically inappropriate, unsafe, or prohibited by applicable law or policy.

Payment for a consultation covers the applicable professional healthcare evaluation and does not constitute payment for a guaranteed prescription.

4. Controlled Substances and DEA Registration

Certain medications are regulated as controlled substances under the federal Controlled Substances Act.

Controlled medications are classified into schedules according to their legal classification, accepted medical uses, and potential risks.

Commonly prescribed controlled substances fall within Schedules II through V.

4.1 Provider Authorization

A provider may prescribe a controlled substance only when legally authorized to do so.

Applicable requirements may include:

• Valid professional licensure.
• Appropriate prescribing authority.
• Required DEA registration.
• Applicable state controlled-substance registration.
• Compliance with prescribing regulations.
• Compliance with professional standards of care.

4.2 Legitimate Medical Purpose

Controlled-substance prescriptions must be issued for a legitimate medical purpose by an authorized practitioner acting in the usual course of professional practice.

4.3 Clinical Appropriateness

The treating provider must determine whether the medication is appropriate based on the patient’s relevant clinical circumstances.

4.4 Organizational Restrictions

In addition to legal requirements, SDKare applies internal controlled-substance prescribing restrictions described in this Policy.

DEA registration does not guarantee that a provider may prescribe every controlled medication for every patient or in every jurisdiction.

5. Federal Telemedicine Prescribing Requirements

Federal law establishes requirements for prescribing controlled substances through telemedicine.

The Ryan Haight Online Pharmacy Consumer Protection Act generally requires an in-person medical evaluation before certain controlled-substance prescribing unless an applicable statutory or regulatory exception authorizes prescribing through telemedicine.

5.1 Temporary Federal Telemedicine Flexibilities

The DEA and the U.S. Department of Health and Human Services have extended certain telemedicine prescribing flexibilities through December 31, 2026.

Under these temporary federal rules, qualifying DEA-registered practitioners may prescribe Schedule II through Schedule V controlled medications through telemedicine without first conducting an in-person medical evaluation when all applicable conditions are satisfied.

5.2 Audio-Video Requirements

For controlled-substance prescribing under the general temporary telemedicine flexibilities, qualifying consultations ordinarily require real-time, two-way audio-video interaction.

Audio-only telemedicine prescribing is permitted only in circumstances authorized by applicable law.

5.3 Limited Audio-Only Exceptions

Specific federal provisions permit qualifying audio-only telemedicine prescribing for certain FDA-approved controlled medications used in the treatment of opioid use disorder, subject to applicable conditions.

These exceptions do not authorize audio-only prescribing for every controlled medication or clinical condition.

5.4 Continuing Legal Obligations

Temporary federal flexibilities do not eliminate:

• Provider licensing requirements.
• DEA registration requirements.
• Applicable state laws.
• Legitimate medical purpose requirements.
• Professional standards of care.
• Patient safety obligations.
• Prescription monitoring requirements.
• Applicable recordkeeping requirements.
• SDKare’s internal prescribing policies.

5.5 No Guarantee of Remote Prescribing

A provider may require an in-person medical examination or additional evaluation even when federal law permits telemedicine prescribing.

Patients do not have an automatic right to receive a controlled-substance prescription remotely.

6. Patient Location and Provider Licensure

Telehealth prescribing requirements depend in part on the patient’s physical location at the time of the consultation.

6.1 Accurate Location Information

Patients must disclose their actual physical location during each telehealth appointment.

6.2 Provider Authorization

Healthcare providers must be appropriately licensed, registered, or otherwise legally authorized to provide care and prescribe medication in the relevant jurisdiction.

6.3 Changes in Patient Location

Patients should inform SDKare before an appointment if they will be in a different state or jurisdiction.

6.4 Restrictions on Services

If an assigned provider is not authorized to prescribe in the patient’s location, SDKare may be unable to provide the requested prescription or consultation.

The appointment may be rescheduled with an eligible provider or handled in another appropriate manner.

SDKare does not guarantee prescribing availability in every state.

7. State Controlled-Substance Prescribing Requirements

Federal telemedicine prescribing flexibilities do not override applicable state laws.

States may impose additional requirements relating to:

• Telemedicine evaluations.
• Controlled-substance prescribing.
• Provider registration.
• Prescription Drug Monitoring Programs.
• Patient identity verification.
• In-person examinations.
• Medication quantities.
• Prescription duration.
• Electronic prescribing.
• Documentation.
• Medication-specific restrictions.
• Follow-up and monitoring requirements.

Providers must comply with the relevant federal and state laws.

When a state requirement is more restrictive than an applicable federal telemedicine permission, the provider must follow the controlling legal requirement.

8. Prescription Drug Monitoring Programs

A Prescription Drug Monitoring Program (“PDMP”) is a state-administered system containing information concerning certain dispensed controlled-substance prescriptions.

8.1 Required Reviews

Providers must review applicable PDMP information when required by law.

8.2 Clinical Reviews

Providers may also conduct PDMP reviews when clinically appropriate and legally permitted.

8.3 Information Considered

PDMP reviews may assist a provider in evaluating:

• Recent controlled-substance prescriptions.
• Potentially overlapping medications.
• Prescription history.
• Relevant medication safety concerns.
• Potential misuse or diversion risks.

8.4 Prescribing Decisions

A provider may decline, delay, or modify prescribing based on information identified during an appropriate review.

Patients are responsible for accurately reporting controlled medications obtained from other prescribers.

9. Additional Evaluations and Clinical Documentation

SDKare providers may require additional information before issuing, continuing, or modifying a prescription.

Depending on the clinical circumstances, this may include:

• Medical history.
• Previous clinical records.
• Medication and prescription history.
• Pharmacy fill records.
• Identity verification.
• Laboratory results.
• Vital signs.
• Diagnostic testing.
• PDMP information.
• Relevant specialist evaluations.
• Follow-up consultations.
• In-person medical examinations.

The specific evaluation required depends on the medication, patient’s condition, applicable law, and professional clinical judgment.

Submission of requested information does not guarantee that a prescription will be issued.

10. SDKare’s 28-Day Controlled-Substance Prescribing Policy

SDKare maintains a strict internal 28-day prescribing restriction for controlled-substance medications.

This restriction applies to all controlled-substance categories covered by SDKare’s prescribing services.

The 28-day restriction is an organizational prescribing policy and should not be interpreted as a universal DEA requirement.

10.1 General 28-Day Restriction

SDKare does not permit routine early prescription renewals, replacement prescriptions, or changes to another controlled medication within the same therapeutic category before 28 days have elapsed from the previous pharmacy fill date.

The restriction applies regardless of whether the patient requests:

• The same controlled medication.
• A different dosage of a controlled medication.
• An alternative controlled medication within the same therapeutic category.
• A replacement for unavailable medication.
• Early continuation of existing controlled medication treatment.

10.2 Beginning of the 28-Day Period

The 28-day period begins on the date the patient’s previous controlled-substance prescription was filled by the pharmacy.

It does not begin on:

• The date the prescription was written.
• The date the prescription was transmitted.
• The date of the patient’s previous appointment.
• The date the patient requested another prescription.

For example, if the relevant medication was filled on October 1, the 28-day interval elapses on October 29.

The expiration of the interval does not automatically authorize another prescription.

10.3 Early Prescription Requests

Patients may not obtain routine early controlled-substance renewals or replacements during the restricted period.

A new appointment, patient request, or additional payment does not create an exception to the prescribing restriction.

10.4 Medication Changes Within the Same Therapeutic Category

The restriction also applies when a patient requests a change from one controlled medication to another controlled medication within the same therapeutic category.

A request to switch because of personal preference, perceived effectiveness, medication availability, or another reason does not automatically permit an early prescription.

10.5 Lost, Stolen, Damaged, or Misplaced Medication

Lost, stolen, damaged, or misplaced controlled medication does not create an automatic exception to SDKare’s 28-day restriction.

SDKare does not routinely authorize early replacement controlled-substance prescriptions under these circumstances.

Patients should promptly communicate medication-related concerns to their treating healthcare professional.

Patients should not obtain medication from unauthorized sources or use medication prescribed to another individual.

10.6 Medication Safety Concerns

Patients experiencing side effects, serious adverse reactions, possible withdrawal symptoms, or other medication safety concerns should seek timely medical evaluation.

A patient’s need for clinical evaluation does not guarantee early controlled-substance prescribing or a medication change within the restricted period.

The treating provider remains responsible for assessing clinical circumstances and recommending medically appropriate care consistent with applicable law.

10.7 Emergency Situations

SDKare does not provide emergency controlled-substance replacement services.

Patients experiencing a medical emergency should call 911 or visit the nearest emergency department.

This Policy does not prevent patients from receiving emergency evaluation or other medical care permitted by law.

10.8 Clinical and Legal Requirements

SDKare’s internal prescribing restrictions do not override applicable federal or state law or a licensed provider’s professional responsibilities concerning patient safety.

If a prescribing restriction conflicts with a mandatory legal requirement or professional duty, the matter must be addressed in accordance with applicable law and appropriate clinical oversight.

10.9 No Automatic Prescribing After 28 Days

Completion of the required interval does not guarantee:

• A prescription.
• A medication renewal.
• A change in dosage.
• A different controlled medication.
• Continuation of treatment.
• A prescription without further evaluation.

All prescribing decisions remain subject to clinical assessment and applicable legal requirements.

11. Controlled-Substance Schedules and Refill Restrictions

Controlled medications are subject to federal and state requirements that vary by schedule.

11.1 Schedule II Controlled Substances

Federal law prohibits refills of Schedule II controlled-substance prescriptions.

When continued treatment is clinically appropriate, a new prescription must be issued in accordance with applicable federal and state law.

A new Schedule II prescription is not the same as a refill.

11.2 Multiple Schedule II Prescriptions

Federal law permits practitioners to issue certain multiple Schedule II prescriptions under specified conditions.

However, federal permission does not require SDKare or its providers to issue multiple prescriptions.

Any such arrangement is subject to the provider’s professional judgment, applicable state law, and SDKare’s internal prescribing restrictions.

11.3 Schedule III Through V Medications

Schedule III through V medications are subject to applicable federal and state rules concerning refills, prescription validity, and related requirements.

The legal refill requirements differ by schedule.

11.4 Additional SDKare Restrictions

SDKare’s 28-day restriction applies in addition to applicable scheduling, prescribing, and dispensing laws.

It does not replace any stricter legal requirement.

12. Controlled-Substance Follow-Up and Medication Monitoring

Controlled-substance prescribing may require ongoing clinical monitoring.

A provider may require a follow-up appointment before issuing an additional prescription.

Monitoring may include consideration of:

• Treatment response.
• Current symptoms.
• Medication effectiveness.
• Side effects.
• Medication adherence.
• Changes in health status.
• Potential drug interactions.
• Prescription history.
• Medication misuse risks.
• Other relevant clinical concerns.

Patients must follow the treating provider’s instructions regarding appointments, examinations, and monitoring.

Attending a follow-up appointment does not guarantee that another prescription will be issued.

13. Previous Prescriptions and Transfer of Care

Patients who previously received medication treatment from another healthcare professional may request an evaluation through SDKare.

13.1 Prior Medical Records

Patients may be asked to provide:

• Previous diagnoses.
• Prescription history.
• Pharmacy fill history.
• Relevant medical records.
• Prior treatment details.
• Medication monitoring information.

13.2 Independent Clinical Review

A previous prescription or established diagnosis does not require an SDKare provider to continue the same medication, dosage, or treatment plan.

13.3 Controlled Medications

Continuation or modification of controlled-substance treatment remains subject to SDKare’s 28-day restriction and applicable laws.

13.4 Transfer of Care

Patients should plan appropriately when transferring ongoing medical care.

SDKare does not guarantee uninterrupted continuation of medications previously prescribed by another healthcare professional.

Where clinically appropriate, providers may discuss legally available alternatives or recommend another level of care.

14. Medication Changes and Alternative Treatments

The treating healthcare provider may recommend a different treatment when clinically appropriate.

Depending on the circumstances, alternatives may include:

• Non-controlled medications.
• Behavioral or therapeutic interventions.
• Additional clinical evaluation.
• Laboratory testing.
• Specialist referral.
• In-person care.
• Other appropriate treatment options.

Changes involving controlled medications within the same therapeutic category remain subject to SDKare’s 28-day restriction.

Clinical recommendations will be based on professional judgment and applicable law.

Patients should not independently change or discontinue prescribed medications without appropriate medical guidance.

15. Non-Controlled Prescription Medications

Non-controlled prescription medications are not subject to federal DEA controlled-substance scheduling requirements.

They remain subject to:

• Provider licensing requirements.
• State prescribing laws.
• Telehealth standards.
• Professional clinical judgment.
• Medication safety requirements.
• Appropriate clinical evaluation.

SDKare’s 28-day controlled-substance restriction does not automatically apply to medications that are not legally classified as controlled substances.

A non-controlled medication is not guaranteed simply because it is not subject to controlled-substance restrictions.

16. Pharmacy Dispensing and Medication Availability

A prescription issued by an SDKare provider does not guarantee that the medication will be dispensed by a pharmacy.

Pharmacies and dispensing professionals have independent responsibilities under applicable law.

16.1 Dispensing Decisions

A pharmacy may review prescriptions for legal validity, safety, authenticity, or other relevant considerations.

16.2 Medication Availability

Medication availability may depend on:

• Pharmacy inventory.
• Manufacturer supply.
• Distribution restrictions.
• Pharmacy policies.
• Controlled-substance regulations.
• Pharmacist professional judgment.

16.3 Pharmacy Refusal or Delay

A pharmacy may decline or delay dispensing where legally permissible or required.

SDKare cannot guarantee that every pharmacy will dispense a particular medication.

16.4 Pharmacy Availability and the 28-Day Rule

Medication unavailability at a pharmacy does not automatically create an exception to SDKare’s controlled-substance prescribing restriction.

A patient should contact the relevant pharmacy and healthcare provider regarding dispensing concerns.

17. Medication Safety and Patient Responsibilities

Patients must provide truthful, accurate, and reasonably complete information relevant to prescribing.

This includes information about:

• Current medications.
• Prior prescriptions.
• Recent pharmacy fill dates.
• Medication allergies.
• Existing medical conditions.
• Relevant substance use.
• Previous adverse reactions.
• Other healthcare providers involved in treatment.

Patients must not:

• Falsify medical or prescription information.
• Attempt to obtain duplicate controlled-substance prescriptions improperly.
• Misrepresent lost or stolen medications.
• Alter or falsify prescriptions.
• Share prescription medications.
• Use another person’s prescription medication.
• Use medication contrary to provider instructions.
• Attempt to circumvent applicable controlled-substance restrictions.

Suspected medication misuse, fraud, diversion, or unsafe medication practices may affect clinical decisions and will be addressed according to applicable law.

Patients should promptly report concerning symptoms or adverse medication effects to an appropriate healthcare professional.

18. Substance Use Disorder and Addiction-Related Prescribing

Certain addiction-related healthcare services may involve additional clinical and legal requirements.

18.1 Clinical Eligibility

Prescribing decisions for substance use disorder treatment require an appropriate assessment of the patient’s clinical circumstances.

18.2 Controlled Medication Treatment

Certain medications used to treat opioid use disorder are controlled substances and are governed by applicable prescribing requirements.

18.3 Telemedicine Exceptions

Federal law provides certain telemedicine prescribing permissions for qualifying medications used in opioid use disorder treatment, including specified audio-only circumstances.

These permissions require compliance with the conditions applicable to the particular prescribing pathway.

18.4 Monitoring and Follow-Up

A provider may require additional evaluation, prescription monitoring, or follow-up care according to applicable law and clinical standards.

18.5 SDKare’s Internal Restrictions

Where controlled-substance medications are prescribed through SDKare, the organization’s applicable 28-day policy and other prescribing requirements govern, subject to controlling law and professional obligations.

18.6 Privacy and Confidentiality

Certain substance use disorder records may be subject to additional confidentiality protections under 42 CFR Part 2.

Such records will be handled in accordance with applicable law.

19. Prescription Records and Documentation

Appropriate clinical and prescribing documentation must be maintained according to applicable requirements.

Documentation may include:

• The patient’s medical history.
• Relevant clinical findings.
• Medication decisions.
• Prescription information.
• Applicable monitoring results.
• Follow-up recommendations.
• Pharmacy-related information.
• Relevant clinical communications.
• Patient consent when required.
• Other legally required records.

Records concerning controlled-substance prescribing may be subject to additional documentation and retention requirements.

Patient information must be handled according to applicable privacy and security laws.

20. Privacy and Confidentiality of Prescription Information

Prescription and medication information may constitute protected health information under HIPAA.

SDKare handles such information according to applicable privacy and security requirements.

Authorized uses and disclosures may include:

• Treatment and care coordination.
• Permitted payment activities.
• Healthcare operations.
• Prescription transmission to appropriate pharmacies.
• Legally required monitoring or reporting.
• Other uses or disclosures permitted by law.

Where patient authorization is required, the applicable authorization must be obtained.

Patients may review SDKare’s HIPAA Notice of Privacy Practices and HIPAA Privacy and Security Policy for further information.

21. Payments, Consultations, and Prescription Outcomes

SDKare operates on a self-pay basis.

A consultation fee covers the applicable professional healthcare evaluation and does not guarantee a prescription, particular medication, or desired clinical outcome.

21.1 Consultation Fees

Patients are responsible for the disclosed charge associated with the selected healthcare appointment.

21.2 Prescription Decisions

If a provider declines to prescribe because of clinical concerns, legal restrictions, or SDKare’s prescribing policies, this decision does not automatically entitle the patient to a refund for a completed consultation.

21.3 Additional Appointments

Follow-up appointments may be separately charged according to the disclosed service price.

21.4 Refund and Payment Policies

Refunds, appointment cancellations, missed consultations, and rescheduling fees are governed by SDKare’s:

• Refund Policy.
• Payment Policy for Clients.
• Patient No-Show and Late Cancellation Policy.

Nothing in this section limits refunds or other remedies required by applicable law.

22. No Guarantee of a Specific Medication or Treatment

SDKare does not guarantee that patients will receive requested medication simply because they have previously used that medication or requested it during a consultation.

A provider may determine that:

• Medication is not clinically indicated.
• Additional information is required.
• A different treatment is more appropriate.
• The requested medication carries unacceptable risks.
• An in-person evaluation is necessary.
• A prescription would violate applicable law.
• A controlled-substance request is inconsistent with SDKare’s internal prescribing restrictions.

Such decisions are made in accordance with professional clinical judgment and applicable legal requirements.

23. Medical Emergencies and Urgent Medication Concerns

SDKare is not an emergency medical service.

Patients should not rely on scheduled appointments, routine messaging, website forms, or Patient Support communications for emergency medication replacement or urgent medical intervention.

23.1 Emergency Situations

For a medical or psychiatric emergency, call 911 or visit the nearest emergency department.

23.2 Serious Adverse Reactions

Patients experiencing severe medication reactions, breathing difficulties, seizures, loss of consciousness, or other potentially life-threatening symptoms should seek emergency care immediately.

23.3 Potential Withdrawal Symptoms

Patients concerned about withdrawal or interruption of a prescribed medication should seek timely medical evaluation.

Severe or potentially dangerous withdrawal symptoms may require emergency medical attention.

23.4 Mental Health Crisis

Individuals in the United States experiencing a mental health crisis or suicidal thoughts may call or text 988.

23.5 Controlled-Substance Restrictions

Seeking emergency evaluation does not automatically guarantee that SDKare will issue an early controlled-substance prescription.

Appropriate emergency treatment and evaluation remain separate from SDKare’s routine prescribing services.

24. Federal Rules After December 31, 2026

The current temporary federal telemedicine prescribing flexibilities are scheduled to remain in effect through December 31, 2026.

The DEA and HHS may issue additional or permanent regulations governing controlled-substance prescribing through telemedicine.

Changes may affect:

• In-person evaluation requirements.
• Telemedicine prescribing eligibility.
• Provider registration.
• Permitted methods of communication.
• Prescription monitoring.
• Clinical documentation.
• Other prescribing conditions.

SDKare LLC will adjust its prescribing practices as necessary to comply with legally effective changes.

Patients should not assume that the temporary federal rules will remain unchanged after December 31, 2026.

Applicable law controls if federal or state prescribing requirements change.

25. Changes to This Policy

SDKare LLC may revise this Policy to reflect changes in:

• DEA regulations.
• HHS requirements.
• Federal or state law.
• Telehealth prescribing requirements.
• Clinical standards.
• Patient safety procedures.
• Organizational prescribing practices.

The Last Updated date at the beginning of this Policy will identify the most recent approved revision.

Where applicable law requires notice, consent, or other action concerning a change, SDKare will comply with that requirement.

No revision authorizes prescribing contrary to applicable law.

26. Relationship to Other SDKare Policies

This DEA and Telemedicine Prescribing Policy should be read together with:

• Terms & Conditions.
• Privacy Policy.
• HIPAA Notice of Privacy Practices.
• HIPAA Privacy and Security Policy.
• Payment Policy for Clients.
• Refund Policy.
• Patient No-Show and Late Cancellation Policy.

SDKare’s other policies address patient privacy, general telehealth responsibilities, financial arrangements, and scheduling procedures.

This Policy specifically addresses medication prescribing and controlled-substance requirements.

Where applicable law conflicts with a policy provision, the governing legal requirement controls.

27. Contact SDKare

For questions about this Policy, prescription-related administrative procedures, or general telehealth services, contact:

SDKare LLC

Website: https://sdkare.com/

Email: contact.support@sdkare.com

Phone: (520) 800-6043

Mailing address: 2810 N Church St, Wilmington, DE 19802, United States

Patients with questions concerning the medical appropriateness of a medication, dosage, treatment change, or prescription request should consult their treating healthcare provider.

Patient Support personnel cannot independently authorize prescriptions or override clinical and legal prescribing requirements.

SDKare is not an emergency medical service. For emergencies, call 911 or visit the nearest emergency department.