PPAEMA amended the Controlled Substances Act (CSA) to allow EMS agencies to obtain independent registrations to administer controlled substances, a change intended to codify existing law and ensure EMS responders operated seamlessly under the supervision of a licensed physician. Unfortunately, the DEA’s subsequent final rule has created disruption and confusion for Maine’s healthcare system, according to Sen. Collins and her colleagues, who included U.S. Sen. Angus King (I-ME). The CSA, along with related DEA regulations, requires registration for any practice that dispenses controlled substances. However, the senators pointed out that subsequent rulemaking and implementation of PPAEMA has created uncertainty and significant costs to EMS agencies as they look to comply with the law and new regulations. “We ask DEA to issue clarifying guidance as soon as possible to prevent further confusion and to ensure more unnecessary costs are not borne by our EMS agencies,” wrote Sen. Collins and her colleagues.