[Congressional Record Volume 150, Number 124 (Tuesday, October 5, 2004)]
[House]
[Pages H8069-H8073]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  NATIONAL ALL SCHEDULES PRESCRIPTION ELECTRONIC REPORTING ACT OF 2004

  Mr. BARTON of Texas. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 3015) to amend the Public Health Service Act to 
establish an electronic system for practitioner monitoring of the 
dispensing of any schedule II, III, or IV controlled substance, and for 
other purposes, as amended.
  The Clerk read as follows:

                               H.R. 3015

       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 ``National All Schedules 
     Prescription Electronic Reporting Act of 2004''.

     SEC. 2. CONTROLLED SUBSTANCE MONITORING PROGRAM.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.) is amended by adding after section 399N 
     the following:

     ``SEC. 399O. CONTROLLED SUBSTANCE MONITORING PROGRAM.

       ``(a) Formula Grants.--
       ``(1) In general.--Each fiscal year, the Secretary shall 
     make a payment to each State with an application approved 
     under this section for the purpose of establishing and 
     implementing a controlled substance monitoring program under 
     this section.
       ``(2) Determination of amount.--In making payments under 
     paragraph (1) for a fiscal year, the Secretary shall allocate 
     to each State with an application approved under this section 
     an amount which bears the same ratio to the amount 
     appropriated to carry out this section for that fiscal year 
     as the number of pharmacies of the State bears to the number 
     of pharmacies of all States with applications approved under 
     this section (as determined by the Secretary), except that 
     the Secretary may adjust the amount allocated to a State 
     under this paragraph after taking into consideration the 
     budget cost estimate for the State's controlled substance 
     monitoring program.
       ``(b) Application Approval Process.--
       ``(1) In general.--To seek a grant under this section, a 
     State shall submit an application at such time, in such 
     manner, and containing such assurances and information as the 
     Secretary may reasonably require. Each such application shall 
     include--
       ``(A) a budget cost estimate for the State's controlled 
     substance monitoring program;
       ``(B) proposed standards for security for information 
     handling and for the database maintained by the State under 
     subsection (d) generally including efforts to use appropriate 
     encryption technology or other such technology;
       ``(C) proposed standards for meeting the uniform electronic 
     format requirement of subsection (g);
       ``(D) proposed standards for availability of information 
     and limitation on access to program personnel;
       ``(E) proposed standards for access to the database, and 
     procedures to ensure database accuracy;
       ``(F) proposed standards for redisclosure of information;
       ``(G) proposed penalties for illegal redisclosure of 
     information; and
       ``(H) assurances of compliance with all other requirements 
     of this section.
       ``(2) Approval or disapproval.--Not later than 90 days 
     after the submission by a State of an application under 
     paragraph (1), the Secretary shall approve or disapprove the 
     application. The Secretary shall approve the application if 
     the State demonstrates to the Secretary that the State will 
     establish and implement or operate a controlled substance 
     monitoring program in accordance with this section.
       ``(3) Withdrawal of authorization.--If a State fails to 
     implement a controlled substance monitoring program in 
     accordance with this section--
       ``(A) the Secretary shall give notice of the failure to the 
     State; and
       ``(B) if the State fails to take corrective action within a 
     reasonable period of time, the Secretary shall withdraw any 
     approval of the State's application under this section.
       ``(4) Voluntary discontinuance.--A funding agreement for 
     the receipt of a payment under this section is that the State 
     involved will give a reasonable period of notice to the 
     Secretary before ceasing to implement or operate a controlled 
     substance monitoring program under this section. The 
     Secretary shall determine the period of notice that is 
     reasonable for purposes of this paragraph.
       ``(5) Return of funds.--If the Secretary withdraws approval 
     of a State's application under this section, or the State 
     chooses to cease to implement a controlled substance 
     monitoring program under this section, a funding agreement 
     for the receipt of a payment under this section is that the 
     State will return to the Secretary an amount which bears the 
     same ratio to the overall payment as the remaining time 
     period for expending the payment bears to the overall time 
     period for expending the payment (as specified by the 
     Secretary at the time of the payment).
       ``(c) Reporting Requirements.--In implementing a controlled 
     substance monitoring program under this section, a State 
     shall comply with the following:
       ``(1) The State shall require dispensers to report to such 
     State each dispensing in the State of a controlled substance 
     to an ultimate user or research subject not later than 1 week 
     after the date of such dispensing.
       ``(2) The State may exclude from the reporting requirement 
     of this subsection--
       ``(A) the direct administration of a controlled substance 
     to the body of an ultimate user or research subject;
       ``(B) the dispensing of a controlled substance in a 
     quantity limited to an amount adequate to treat the ultimate 
     user or research subject involved for 48 hours or less; or
       ``(C) the administration or dispensing of a controlled 
     substance in accordance with any other exclusion identified 
     by the Secretary for purposes of this paragraph.
       ``(3) The information to be reported under this subsection 
     with respect to the dispensing of a controlled substance 
     shall include the following:
       ``(A) Drug Enforcement Administration Registration Number 
     of the dispenser.
       ``(B) Drug Enforcement Administration Registration Number 
     and name of the practitioner who prescribed the drug.
       ``(C) Name, address, and telephone number of the ultimate 
     user or research subject.
       ``(D) Identification of the drug by a national drug code 
     number.
       ``(E) Quantity dispensed.
       ``(F) Estimated number of days for which such quantity 
     should last.
       ``(G) Number of refills ordered.
       ``(H) Whether the drug was dispensed as a refill of a 
     prescription or as a first-time request.
       ``(I) Date of the dispensing.
       ``(J) Date of origin of the prescription.
       ``(4) The State shall require dispensers to report 
     information under this section in accordance with the 
     electronic format specified by the Secretary under subsection 
     (g), except that the State may waive the requirement of such 
     format with respect to an individual dispenser.
       ``(5) The State shall automatically share information 
     reported under this subsection with another State with an 
     application approved under this section if the information 
     concerns--
       ``(A) the dispensing of a controlled substance to an 
     ultimate user or research subject who resides in such other 
     State; or
       ``(B) the dispensing of a controlled substance prescribed 
     by a practitioner whose principal place of business is 
     located in such other State.
       ``(6) The State may notify the appropriate authorities 
     responsible for drug diversion investigation if information 
     in the database maintained by the State under subsection (d) 
     indicates an unlawful diversion or misuse of a controlled 
     substance.
       ``(d) Database.--In implementing a controlled substance 
     monitoring program under this section, a State shall comply 
     with the following:
       ``(1) The State shall establish and maintain an electronic 
     database containing the information reported to the State 
     under subsection (c).
       ``(2) The database must be searchable by any field or 
     combination of fields.
       ``(3) The State shall include reported information in the 
     database at such time and in such manner as the Secretary 
     determines appropriate, with appropriate safeguards for 
     ensuring the accuracy and completeness of the database.
       ``(4) The State shall take appropriate security measures to 
     protect the integrity of, and access to, the database.
       ``(e) Provision of Information.--Subject to subsection (f), 
     in implementing a controlled substance monitoring program 
     under this section, a State may provide information from the 
     database established under subsection (d) and, in the case of 
     a request under paragraph (3), summary statistics of such 
     information, in response to a request by--
       ``(1) a practitioner (or the agent thereof) who certifies, 
     under the procedures determined by the State, that the 
     requested information is for the purpose of providing medical 
     or pharmaceutical treatment or evaluating the need for such 
     treatment to a bona fide current patient;
       ``(2) any local, State, or Federal law enforcement, 
     narcotics control, licensure, disciplinary, or program 
     authority, who certifies, under the procedures determined by 
     the State, that the requested information is related to an 
     individual investigation or proceeding involving the unlawful 
     diversion or misuse of a schedule II, III, or IV substance, 
     and such information will further the purpose of the 
     investigation or assist in the proceeding;

[[Page H8070]]

       ``(3) any agent of the Department of Health and Human 
     Services, a State medicaid program, a State health 
     department, or the Drug Enforcement Administration who 
     certifies that the requested information is necessary for 
     research to be conducted by such department, program, or 
     administration, respectively, and the intended purpose of the 
     research is related to a function committed to such 
     department, program, or administration by law that is not 
     investigative in nature; or
       ``(4) any agent of another State, who certifies that the 
     State has an application approved under this section and the 
     requested information is for the purpose of implementing the 
     State's controlled substance monitoring program under this 
     section.
       ``(f) Limitations.--In implementing a controlled substance 
     monitoring program under this section, a State--
       ``(1) shall make reasonable efforts to limit the 
     information provided pursuant to a valid request under 
     subsection (e) to the minimum necessary to accomplish the 
     intended purpose of the request; and
       ``(2) shall not provide any individually identifiable 
     information in response to a request under subsection (e)(3).
       ``(g) Electronic Format.--The Secretary shall specify a 
     uniform electronic format for the reporting, sharing, and 
     provision of information under this section.
       ``(h) Rules of Construction.--
       ``(1) Functions otherwise authorized by law.--Nothing in 
     this section shall be construed to restrict the ability of 
     any authority, including any local, State, or Federal law 
     enforcement, narcotics control, licensure, disciplinary, or 
     program authority, to perform functions otherwise authorized 
     by law.
       ``(2) No preemption.--Nothing in this section shall be 
     construed as preempting any State law, except that no such 
     law may relieve any person of a requirement otherwise 
     applicable under this Act.
       ``(3) Additional privacy protections.--Nothing in this 
     section shall be construed as preempting any State from 
     imposing any additional privacy protections.
       ``(4) Certain confidentiality requirements.--Nothing in 
     this section shall be construed as superceding the 
     confidentiality requirements of programs defined by and 
     subject to part 2 of title 42, Code of Federal Regulations.
       ``(5) No federal private cause of action.--Nothing in this 
     section shall be construed to create a Federal private cause 
     of action.
       ``(i) Relation to HIPAA.--Except to the extent inconsistent 
     with this section, the provision of information pursuant to 
     subsection (c)(5), (c)(6), or (e) and the subsequent transfer 
     of such information are subject to any requirement that would 
     otherwise apply under the regulations promulgated pursuant to 
     section 264(c) of the Health Insurance Portability and 
     Accountability Act of 1996.
       ``(j) Preference.--Beginning January 1, 2007, the 
     Secretary, in awarding any competitive grant that is related 
     to drug abuse (as determined by the Secretary) to a State, 
     shall give preference to any State with an application 
     approved under this section.
       ``(k) Study.--Not later than 2 years after the date of the 
     enactment of this section, the Secretary shall--
       ``(1) complete a study that--
       ``(A) determines the progress of States in establishing and 
     implementing controlled substance monitoring programs under 
     this section;
       ``(B) determines the feasibility of implementing a real-
     time electronic controlled substance monitoring program, 
     including the costs associated with establishing such a 
     program; and
       ``(C) provides an analysis of the privacy protections in 
     place for the information reported to the controlled 
     substance monitoring program in each State receiving a grant 
     for the establishment or operation of such program, and a 
     comparison to the privacy requirements that apply to covered 
     entities under regulations promulgated pursuant to section 
     264(c) of the Health Insurance Portability and Accountability 
     Act of 1996, along with any recommendations for additional 
     requirements for protection of this information; and
       ``(2) submit a report to the Congress on the results of the 
     study.
       ``(l) Advisory Council.--
       ``(1) Establishment.--A State may establish an advisory 
     council to assist in the establishment and implementation of 
     a controlled substance monitoring program under this section.
       ``(2) Sense of congress.--It is the sense of the Congress 
     that, in establishing an advisory council under this 
     subsection, a State should consult with appropriate 
     professional boards and other interested parties.
       ``(m) Definitions.--For purposes of this section:
       ``(1) The term `bona fide patient' means an individual who 
     is a patient of the dispenser or practitioner involved.
       ``(2) The term `controlled substance' means a drug that is 
     included in schedule II, III, or IV of section 202(c) of the 
     Controlled Substance Act.
       ``(3) The term `dispense' means to deliver a controlled 
     substance to an ultimate user or research subject by, or 
     pursuant to the lawful order of, a practitioner, irrespective 
     of whether the dispenser uses the Internet or other means to 
     effect such delivery.
       ``(4) The term `dispenser' means a physician, pharmacist, 
     or other individual who dispenses a controlled substance to 
     an ultimate user or research subject.
       ``(5) The term `practitioner' means a physician, dentist, 
     veterinarian, scientific investigator, pharmacy, hospital, or 
     other person licensed, registered, or otherwise permitted, by 
     the United States or the jurisdiction in which he or she 
     practices or does research, to distribute, dispense, conduct 
     research with respect to, administer, or use in teaching or 
     chemical analysis, a controlled substance in the course of 
     professional practice or research.
       ``(6) The term `State' means each of the 50 States and the 
     District of Columbia.
       ``(7) The term `ultimate user' means a person who has 
     lawfully obtained, and who possesses, a controlled substance 
     for his or her own use, for the use of a member of his or her 
     household, or for the use of an animal owned by him or her or 
     by a member of his or her household.
       ``(n) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated--
       ``(1) $25,000,000 for each of fiscal years 2006 and 2007; 
     and
       ``(2) $15,000,000 for each of fiscal years 2008, 2009, and 
     2010.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Barton) and the gentleman from Ohio (Mr. Brown) each will 
control 20 minutes.
  The Chair recognizes the gentleman from Texas (Mr. Barton).


                             General Leave

  Mr. BARTON of Texas. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks on this legislation and to insert extraneous material on 
the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise in very strong support of H.R. 3015. All of us 
have deep concerns about the abuse of prescription drugs. Whether after 
surgery or in the treatment of chronic pain, ensuring that patients 
receive proper pain management is a critical component in the provision 
of health care. However, these medications can and sometimes are 
abused. The Committee on Energy and Commerce has heard about the 
problems prescription drug abuse has created in our communities 
throughout America. In some areas, the nonmedical use of prescription 
drugs presents a bigger problem than even cocaine and heroin. This is a 
serious issue that cannot be addressed through traditional drug control 
programs. We need to find a balanced approach that does not interfere 
with the doctor-patient relationship but also ensures that these 
potentially addictive drugs are not abused. Prescription drug 
monitoring programs can be a part of the solution to this public health 
challenge.
  These programs help physicians better serve their patients because 
they can review the patient's prescription drug history. Drug 
interactions can often lead to adverse events for patients so that 
these monitoring programs serve as an additional safety check.
  Only 21 States have implemented drug monitoring programs. While this 
is a good start, problems arise because illicit drug use shifts to 
contiguous States without monitoring programs. H.R. 3015 will 
strengthen prescription drug monitoring programs to eliminate gaps in 
systems between States and ensure that programs are interoperable so 
information is readily available across State lines.
  I would like to thank the distinguished gentleman from Kentucky (Mr. 
Whitfield), the distinguished gentleman from New Jersey (Mr. Pallone), 
the distinguished gentleman from Georgia (Mr. Norwood) and the 
distinguished gentleman from Ohio (Mr. Strickland), all members of the 
Committee on Energy and Commerce, for their hard work on this 
legislation.

                              {time}  1415

  At the appropriate time after the debate, I would urge that all of my 
colleagues support it.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself 2\1/2\ minutes.
  Prescription drug pain relievers, stimulants, and other controlled 
substances play a crucial role in health care. But when misused, those 
same medicines can be enormously destructive, as we know. Some are 
addictive, life threatening; many are both.

[[Page H8071]]

  As these medicines proliferate, so, unfortunately, does the risk of 
misuse. Over the last decade, use of prescription pain relievers has 
increased by nearly 200 percent, while the use of stimulants has 
increased by more than 150 percent. Some 6.2 million Americans misuse 
prescription medicines for nonmedical purposes. In 1999 a quarter of 
those who took prescription drugs for nonmedical purposes were new 
users. In other words, this problem is not just growing; simply, it is 
exploding.
  To combat this problem, physicians and pharmacists need information. 
This legislation, which is the culmination of hard work and compromise 
by the gentleman from New Jersey (Mr. Pallone), the gentleman from 
Kentucky (Mr. Whitfield), and the gentleman from Ohio (Mr. Strickland) 
will provide the information and coordination necessary to stem the 
misuse of prescription medicines. The legislation creates grants to 
establish State-run programs for prescription monitoring that will be 
administered and will be coordinated at the Federal level.
  Fighting prescription drug abuse, preventing nonmedical use together 
are a difficult problem that requires doctors and law enforcement 
authorities to acquire and to share information. I think this bill is 
an important step forward in this fight. I am pleased to support it.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  I am going to yield to the gentleman from Kentucky (Mr. Whitfield), 
but before I do that I would like to announce to the House that one of 
the other cosponsors of this important legislation, the gentleman from 
Georgia (Mr. Norwood), as we speak, is awaiting a lung transplant, 
which may very well occur this afternoon and this legislation would 
have not gotten to the floor of the House without his strong commitment 
to it. So I would encourage all my colleagues to pray for the gentleman 
from Georgia (Mr. Norwood) that his surgery goes well and that he is 
back amongst us as soon as possible.
  Mr. Speaker, I yield 4 minutes to the distinguished gentleman from 
Kentucky (Mr. Whitfield).
  Mr. WHITFIELD. Mr. Speaker, I thank the chairman for yielding me this 
time.
  We are excited today to have on the floor this legislation relating 
to prescription drug abuse in the United States, which has reached 
epidemic proportions. Recent statistics show that 6.2 million Americans 
abuse prescription drugs. To help combat this problem, many States, 
such as my own State of Kentucky and about 20 others, have adopted 
prescription drug monitoring programs to assist physicians and law 
enforcement officials stop the abuse and prosecute those individuals 
who are breaking the law.
  The cornerstone of most existing drug-monitoring programs is that 
they allow physicians access to the information before writing a 
prescription for a controlled substance. Physicians tell us that it is 
an invaluable tool in treating their patients. However, there is one 
glaring problem, and that is that these programs operate only intra-
state. And as the gentleman from Texas (Chairman Barton) mentioned, it 
is essential that we have an inter-state program.
  To that end, I have been pleased to work with the gentleman from New 
Jersey (Mr. Pallone), the gentleman from Georgia (Mr. Norwood), the 
gentleman from Ohio (Mr. Strickland), my colleagues on both sides of 
the aisle, on legislation to address this issue. This legislation, H.R. 
3015, the National All Schedules Prescription Electronic Reporting Act, 
creates a grant program housed at the Department of Health and Human 
Services which will fund the establishment and operation of State-run 
prescription drug monitoring programs. It establishes standards for 
reporting data and governs who has access to such information and under 
what circumstances because of the privacy issues. From the beginning 
our goal has been to give physicians the tool they need to treat 
patients, which also provides a better mechanism to prosecute 
individuals who are allegedly using illegal controlled substances.
  I believe this is a good bill, a balanced bill, and one that will 
provide States with an important tool to curb prescription drug abuse.
  I would like at this time to thank all of the cosponsors and give 
particular thanks to the gentleman from Texas (Chairman Barton) and the 
gentleman from Florida (Chairman Bilirakis); the gentleman from 
Michigan (Mr. Dingell), ranking member; and the gentleman from Ohio 
(Mr. Brown), without all of whom we would not have been successful 
without their efforts to get this legislation through the Committee on 
Energy and Commerce.
  I would also like to recognize the hard work of our committee staff, 
particularly Chuck Clapton and Ryan Long and John Halliwell on my 
staff; and, of course, we could not have done it without the Democratic 
committee staff, and I would also like to thank them.
  I would urge all Members to vote for this important legislation.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman 
from New Jersey (Mr. Pallone), who has been a leader on health care in 
this Congress.
  Mr. PALLONE. Mr. Speaker, I thank the gentleman from Ohio (Mr. Brown) 
for yielding me this time.
  Mr. Speaker, as a sponsor of H.R. 3015, I rise today in strong 
support of this important piece of legislation and urge its passage in 
the House of Representatives. H.R. 3015, the National All Schedules 
Prescription Electronic Reporting Act, provides an avenue for 
addressing the illegal diversion and misuse of prescription drugs, 
which constitutes one of the fastest growing areas of drug abuse in our 
Nation today, affecting people of all areas of our Nation, all ages and 
all income levels.
  Health care practitioners and pharmacists desperately need electronic 
prescription drug monitoring systems to ensure that they are 
prescribing and dispensing schedule II, III, and IV controlled 
substances that are medically necessary. This bill provides the 
resources to States to create and operate State-based prescription drug 
monitoring programs, allows physicians to access this information, and 
allows for States to communicate with one another. If enacted into law, 
this bill would help physicians prevent their patients from becoming 
addicted to prescription medications and would help law enforcement 
with criminal investigations in the illicit prescription drug market.
  Mr. Speaker, H.R. 3015 represents a work of great bipartisan effort; 
and I thank the gentleman from Kentucky (Mr. Whitfield), of course the 
gentleman from Georgia (Mr. Norwood), and the gentleman from Ohio (Mr. 
Strickland) for their willingness to move forward with this effort. But 
I also want to thank our chairmen and our ranking members of the full 
committee as well as the subcommittee.
  This is an effort to alleviate the prescription drug abuse problem 
plaguing our Nation. In addition, I want to applaud the leadership of 
the American Society for Interventional Pain Physicians for working 
with Congress in this significant public health initiative. I have to 
say I have never seen a more effective lobbying effort than what they 
put forth to try to move this bill.
  Mr. WAXMAN. Mr. Speaker, I believe that H.R. 3015, legislation to 
support State controlled substance monitoring programs, is well 
intentioned. Non-medical use of controlled substances is a serious 
problem. Establishing State databases that contain information on 
prescriptions for such substances may help stem the practice of 
individuals seeking prescriptions from multiple providers for the 
purpose of non-medical use.
  However, as we forge policies to facilitate controlled substance 
prescription information sharing among providers, States, and others, 
we must carefully consider the privacy implications of such steps. The 
databases H.R. 3015 supports potentially will contain a vast amount of 
personal medical information--including individually identifiable data 
regarding many individuals who are given prescriptions for legitimate 
medical reasons such as recovery from surgery. The last thing we want 
to do is deter individuals from seeking medical care out of fear that 
the privacy of their health information will not be protected.
  I am pleased that, following up on concerns I expressed when the bill 
was under consideration in committee, sponsors of the measure agreed to 
add language that is a step forward

[[Page H8072]]

from earlier versions of the bill with respect to privacy protection. 
This language includes (1) a requirement that the Secretary of Health 
and Human Services study and report to Congress on the privacy 
protections regarding each State database that receives funding under 
the bill; and (2) requirements that the State grant applications 
submitted to the Secretary of HHS propose standards regarding 
redisclosure of information, penalties for illegal redisclosure of 
information, and other privacy related standards. These provisions 
increase focus by States and HHS on the privacy issues raised by the 
State controlled substance monitoring programs.
  However, H.R. 3015's State-to-State disclosure and uniform electronic 
format provisions promote the development of, in essence, a national 
prescription database network. As such, it is particularly important 
that Congress work to ensure that appropriate privacy standards apply 
to databases in the network. The bill does not accomplish this task. It 
contains no minimum Federal standards or even a requirement that the 
HHS Secretary develop publicly reviewable criteria for assessing the 
sufficiency of the privacy standards that States must propose for their 
programs when applying for grants under the bill.
  I do want to recognize and acknowledge the efforts of the sponsors to 
respond to the privacy concerns that I raised, particularly the efforts 
of Mr. Pallone, Dr. Norwood, and Mr. Whitfield. And while I cannot 
support this bill at this point, I hope that with further consideration 
by the Senate and ultimately in conference, Members will carefully 
consider the privacy ramifications of controlled substance monitoring 
systems and make improvements in this area before the bill is enacted.
  Mr. CHANDLER. Mr. Speaker, I am pleased to stand in support of H.R. 
3015, the National All Schedules Prescription Electronic Reporting Act 
(NASPER).
  As my Kentucky colleagues know, prescription drug abuse is one of the 
paramount challenges in our effort to curb substance abuse in our 
State. In 1997, as Attorney General of Kentucky, I established the 
Prescription Drug Abuse Task Force in order to examine the problem. 
Among the Task Force's accomplishments was the establishment of KASPER, 
the Kentucky All Schedule Prescription Electronic Reporting System.
  KASPER was designed to stop the practice of ``doctor shopping,'' 
where abusers and dealers of illegally obtained prescription drugs 
visit multiple physicians in order to obtain multiple prescriptions. 
The success of KASPER has been impressive. In fact the program has been 
so successful that the Government Accounting Office described it as one 
of the Nation's best prescription drug abuse monitoring systems.
  The result has been that it is now more difficult for people to fill 
multiple or fraudulent prescriptions in the Bluegrass State. However, 
``Doctor Shoppers'' have circumvented KASPER by traveling to one of the 
seven States surrounding Kentucky. That is why without a national 
approach to this problem, Kentucky will not be able to truly succeed in 
its fight against prescription drug abuse.
  For this reason, I salute Representative Whitfield for recognizing 
the strengths of KASPER and using it as a framework for a national 
system. That's why I have joined him as a cosponsor of this important 
legislation. I urge my colleagues to vote in favor of H.R. 3015 and 
help communities across America to combat the abuse of prescription 
drugs.
  Mr. STUPAK. Mr. Speaker, as an original co-sponsor of the National 
All Schedules Prescription Electronic Reporting, or NASPER, Act of 
2003, I rise today in strong support of its passage. The prescription 
drug abuse problem in our country has been well documented, and by 
passing the NASPER Act (H.R. 3015), Congress will take one step towards 
addressing the problem.
  The NASPER Act will help ensure that Schedule II, and III, and IV 
controlled substances are used and prescribed safely and responsibly. 
The legislation will help States create electronic monitoring systems 
that will allow physicians and pharmacists to ensure that their 
patients are not being over-prescribed these powerful, yet potentially 
dangerous drugs. The legislation builds upon proven programs already 
started in 15 States, including Michigan. The Government Accounting 
Office (GAO) found in 2002 that these State programs are useful tools 
to help prevent the illegal distribution of these drugs.
  However, the GAO also found a loophole that is often exploited. The 
States with electronic monitoring systems are often undermined by 
neighbor States who lack monitoring systems. The NASPER Act addresses 
this problem by allowing States to contact each other so that 
practitioners in one State can ensure that their patients are not 
receiving medications in another State.
  I am proud to join with Congressmen Pallone, Whitfield, Strickland, 
and Norwood in providing leadership on this issue. I also applaud the 
tireless work of the American Society of Interventional Pain Physicians 
to combat the illegal use and inadvertent over-precribing of controlled 
substances and promote this legislation.
  Mr. STRICKLAND. Mr. Speaker, I rise today to speak in support of H.R. 
3015. I would first like to thank the Energy and Commerce Committee 
staff for their great work on this bill. I would also like to thank my 
colleagues Mr. Pallone, Mr. Norwood, and Mr. Whitfield and their staff 
for their hard work. H.R. 3015 includes prescription monitoring 
provisions similar to those included in H.R. 3870, a bill Congressman 
Norwood and I introduced earlier this year. While, H.R. 3870 is a more 
comprehensive effort to close loopholes in current law that lead to 
prescription drug abuse, I am very pleased with the progress that has 
been made in H.R. 3015 on prescription drug monitoring.
  I am particularly interested in deterring prescription drug diversion 
because of the immense problem of OxyContin abuse in many of the rural 
Appalachian Ohio counties I represent. I have received letters from 
constituents whose sons and daughters have died after taking a crushed 
OxyContin tablet. These tragedies cannot go unchecked. I am sure that 
OxyContin is not the only prescription drug that is abused in 
Appalachia, but its abuse is the most obvious example of the 
devastating consequences of prescription drug diversion.
  H.R. 3015 would build on existing State prescription monitoring 
programs by providing grants through the Department of Health and Human 
Services for States to establish, operate, and update prescription 
monitoring programs. These grants are meant to ensure State monitoring 
systems can share information with other States, and our intention is 
to expand and improve current State monitoring programs without 
eliminating the work that, for example, Kentucky or Nevada has already 
done.
  I believe that drugs like OxyContin are important advances in pain 
management, but we must work to stop the dangerous abuse of such drugs. 
H.R. 3015 is a positive step in that direction.
  Again, I thank my colleagues and congratulate them on this compromise 
legislation.
  Mr. PAUL. Mr. Speaker, I rise in opposition to H.R. 3015, the 
National All Schedules Prescription Electronic Reporting Act. This bill 
is yet another unjustifiable attempt by the Federal government to use 
the war on drugs as an excuse for invading the privacy and liberties of 
the American people and for expanding the Federal government's 
disastrous micromanagement of medical care. As a physician with over 30 
years experience in private practice, I must oppose this bill due to 
the danger it poses to our health as well as our liberty.
  By creating a national database of prescriptions for controlled 
substances, the Federal government would take another step forward in 
the war on pain patients and their doctors. This war has already 
resulted in the harassment and prosecution of many doctors, and their 
staff members, whose only ``crime'' is prescribing legal medication, 
including opioids, to relieve their patients' pain. These prosecutions, 
in turn, have scared other doctors so that they are unwilling to 
prescribe an adequate amount of pain medication, or even any pain 
medication, for their suffering patients.
  Doctors and their staffs may even be prosecuted because of a 
patient's actions that no doctor approved or even knew about. A doctor 
has no way of controlling if a patient gives some of the prescribed 
medication away or consumes a prescribed drug in a dangerous 
combination with illegal drugs or other prescription drugs obtained 
from another source. Nonetheless, doctors can be subjected to 
prosecution when a patient takes such actions.
  Applying to doctors laws intended to deal with drug kingpins, the 
government has created the illusion of some success in the war on 
drugs. Investigating drug dealers can be hard and dangerous work. In 
comparison, it is much easier to shut down medical practices and 
prosecute doctors who prescribe pain medication.
  A doctor who is willing to treat chronic pain patients with medically 
justified amounts of controlled substances may appear at first look to 
be excessively prescribing. Because so few doctors are willing to take 
the drug war prosecution risks associated with treating chronic pain 
patients, and because chronic pain patients must often consume 
significant doses of pain medication to obtain relief, the prosecution 
of one pain doctor can be heralded as a large success. All the 
government needs to do is point to the large amount of patients and 
drugs associated with a medical practice.
  Once doctors know that there is a national database of controlled 
substances prescriptions that overzealous law enforcement will be 
scrutinizing to harass doctors, there may be no doctors left who are 
willing to treat chronic pain. Instead of creating a national database, 
we should be returning medical regulation to local control, where it 
historically and constitutionally belongs. Instead of drug warriors 
regulating medicine with an eye to maximizing

[[Page H8073]]

prosecutions, we should return to State medical boards and State civil 
courts review that looks to science-based standards of medical care and 
patients' best interests.
  H.R. 3015 also threatens patients' privacy. A patient's medical 
records should be treated according to the mutual agreement of the 
patient and doctor. In contrast, H.R. 3015 will put a patient's 
prescriptions on a government-mandated database that can be accessed 
without the patient's permission.
  Instead of further eroding our medical privacy, Congress should take 
steps to protect it. Why should someone not be able to deny the 
government and third parties access to his medical records without his 
permission or a warrant?
  One way the House can act to protect patients' privacy is by enacting 
my Patient Privacy Act (H.R. 1699) that repeals the provision of 
Federal law establishing a medical ID for every American. Under the 
guise of ``protecting privacy,'' the Health and Human Services' so-
called ``medical privacy'' regulations allow medical researchers, 
insurance agents, and government officials access to your personal 
medical records--without your consent. Congress should act now to 
reverse this government-imposed invasion of our medical privacy.
  Please join me in opposing H.R. 3015--legislation that, if enacted, 
will make us less free and less healthy.
  Mr. BROWN of Ohio. Mr. Speaker, I have no further requests for time, 
and I yield back the balance of my time.
  Mr. BARTON of Texas. Mr. Speaker, I have no further requests for 
time, and I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Fossella). The question is on the motion 
offered by the gentleman from Texas (Mr. Barton) that the House suspend 
the rules and pass the bill, H.R. 3015, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill, as amended, was passed.
  The title of the bill was amended so as to read: ``A bill to provide 
for the establishment of a controlled substance monitoring program in 
each State.''.
  A motion to reconsider was laid on the table.

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