[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
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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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