[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4836 Introduced in House (IH)]







107th CONGRESS
  2d Session
                                H. R. 4836

 To amend title 38, United States Code, to establish policies for any 
  requirement by the Department of Veterans Affairs that veterans be 
     required to split their medications as a cost-saving measure.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 23, 2002

  Mr. Cardin introduced the following bill; which was referred to the 
                     Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
 To amend title 38, United States Code, to establish policies for any 
  requirement by the Department of Veterans Affairs that veterans be 
     required to split their medications as a cost-saving measure.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Safe Medications Act.''.

SEC. 2. DEPARTMENT OF VETERANS AFFAIRS POLICY ON TABLET SPLITTING OF 
              MEDICATIONS.

    (a) Required Policy.--Section 1712 of title 38, United States Code, 
is amended by adding at the end the following new subsection:
    ``(f)(1) The Secretary shall prescribe a policy for use by health 
care providers and pharmacies of the Department of the practice of 
prescribing or dispensing tablet medication in a form that requires 
tablet splitting by the patient. Such policy shall require that a 
Department pharmacy may provide a medication to a veteran in tablet 
form in a dosage so as to require tablet splitting only if each of the 
conditions specified in paragraph (2) is met. Nothing in this 
subsection shall be construed so as to encourage or require prescribing 
or dispensing medicine in a form that requires tablet splitting.
    ``(2) The conditions referred to in paragraph (1) are the 
following:
            ``(A) A health care professional has determined that the 
        patient has the mental and physical ability to properly use a 
        table splitter.
            ``(B) The tablets dispensed are in a form referred to as 
        `scored'.
            ``(C) The tablets are not sustained-release tablets.
            ``(D) The tablets are intended to be taken every 48 hours 
        or more frequently.
            ``(E) A tablet splitter that the Secretary has determined 
        to be effective has been provided to the patient.
    ``(3) If the prescriber of a medication determines that a 
particular patient should not be required to use tablet splitting, the 
prescriber may specify that medication for that patient prescribed by 
that prescriber be dispensed in a form that does not require tablet 
splitting. Any such specification shall be honored by Department 
pharmacies.
    ``(4) For patients who demonstrate the ability to perform tablet 
splitting, the Secretary shall provide appropriate instruction in 
written form (as determined by the Secretary). Such instruction shall 
include informing the patient to split a tablet immediately before use 
so that the remaining portion is not exposed for a period greater than 
48 hours.
    ``(5) The Secretary shall require that any adverse events that are 
directly attributable to the practice of splitting tablets be reported 
to the Under Secretary for Health on a monthly basis.
    ``(6) The Under Secretary for Health shall establish a national 
formulary of medications that have been approved for tablet splitting. 
The list of medications in the formulary shall be made available, upon 
request, to patients and their families. The Under Secretary shall 
review the formulary annually to determine if patient or financial 
outcomes through the use of tablet splitting validate continuation of 
specific medications on the formulary.
    ``(7) In this subsection, the term `tablet splitting' means, in the 
case of a medication that is dispensed in a tablet form in a dosage 
that is twice the prescribed dosage, action by the patient to split the 
tablet in half for consumption.''.
    (b) Effective Date.--The policy required by the amendment made by 
subsection (a) shall be prescribed not later than 60 days after the 
date of the enactment of this Act.
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