[Congressional Record Volume 151, Number 17 (Wednesday, February 16, 2005)]
[Senate]
[Pages S1531-S1535]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. COLEMAN:
  S. 400. A bill to prevent the illegal importation of controlled 
substances; to the Committee on the Judiciary.
  Mr. COLEMAN. Mr. President, I rise to introduce two bills that expand 
Federal authority to prevent controlled substances from flooding into 
the U.S., authorizing States to shut down illegitimate virtual 
pharmacies, and bar Internet drug stores from dispensing drugs to 
customers referred to on-line doctors for a prescription.
  Americans are increasingly turning to the Internet for access to 
affordable drugs. In 2003, consumer spending on drugs procured over the 
Internet exceeded $3.2 billion. Unfortunately, rogue Internet sites 
have proliferated and rake in millions of dollars by selling unproven, 
counterfeit, defective or otherwise inappropriate medications to 
unsuspecting consumers. Even more dangerously, these sites are 
profiting by selling addictive and potentially deadly controlled 
substances to consumers without a prescription or any physician 
oversight. This must stop before more individuals die or become 
addicted to easily obtainable narcotic drugs.
  The first bill I am introducing was developed in close consultation 
with Senator Feinstein, who is an original cosponsor. In appreciation 
for her role in helping write this legislation it is named after a 
young man from her state who died from an overdose of drugs purchased 
over the Internet. I am also pleased to announce that Congressmen Tom 
Davis and Henry Waxman are introducing this exact measure in the House 
today. The issue of rogue Internet sites and the availability of 
controlled substances on-line is indeed a bi-partisan and bi-cameral 
issue.
  17-year-old Ryan Haight of La Mesa, CA was an honor roll student, and 
avid baseball card collector about to enter college. As his mom says, 
``he was a good kid.'' But in May of 2000 Ryan started hanging out with 
a different crowd of friends. He joined an online chat forum, which 
advocates the safe use of drugs, and he began buying prescription drugs 
from the Internet.
  He used the family computer late at night and a debit card his 
parents gave him to buy baseball cards on Ebay. You might wonder how 
did a healthy 17-year-old obtain prescriptions for painkillers without 
a medical exam. He got them from Dr. Robert Ogle an ``online'' 
physician based out of Texas. With the prescriptions from Dr. Ogle, 
Ryan was able to order hydrocodone, morphine, Valium and Oxazepam and 
have them shipped via US mail right to his front door.
  In February 2001, Ryan overdosed on a combination of these 
prescription drugs. His mother found him dead on his bedroom floor.
  The Ryan Haight Internet Pharmacy Consumer Protection Act counters 
the growing sale of prescription drugs over the Internet without a 
valid prescription by one, providing new disclosure standards for 
Internet pharmacies; two, barring Internet sites from selling or 
dispensing prescription drugs to consumers who are provided a 
prescription solely on the basis of an online questionnaire; and three, 
allowing State Attorneys General to go to Federal court to shut down 
rogue sites.
  The bill is geared to counter domestic Internet pharmacies that sell 
drugs without a valid prescription, not international pharmacies that 
sell drugs at a low cost to individuals who have a valid prescription 
from their U.S. doctors.
  Under current law, purchasing drugs online without a valid 
prescription can be simple: a consumer just types the name of the drug 
into a search engine, quickly identifies a site selling the medication, 
fills in a brief questionnaire, and then clicks to purchase. The risks 
of self-medicating, however, can include potential adverse reactions 
from inappropriately prescribed medications, dangerous drug 
interactions, use of counterfeit or tainted products, and addiction to 
habit-forming substances. Several of these illegitimate sites fail to 
provide information about contraindications, potential adverse effects, 
and efficacy.
  Regulating these Internet pharmacies is difficult for Federal and

[[Page S1532]]

State authorities. State medical and pharmacy boards have expressed the 
concern that they do not have adequate enforcement tools to regulate 
practice over the Internet. It can be virtually impossible for states 
to identify, investigate, and prosecute these illegal pharmacies 
because the consumer, prescriber, and seller of a drug may be located 
in different States.
  The Internet Pharmacy Consumer Protection Act amends the Federal 
Food, Drug, and Cosmetic Act to address this problem in three steps. 
First, it requires Internet pharmacy web sites to display information 
identifying the business, pharmacist, and physician associated with the 
website.
  Second, the bill bars the selling or dispensing of a prescription 
drug via the Internet when the website has referred the customer to a 
doctor who then writes a prescription without ever seeing the patient.
  Third, the bill provides States with new enforcement authority 
modeled on the Federal Telemarketing Sales Act that will allow a State 
attorney general to shut down a rogue site across the country, rather 
than only bar sales to consumers of his or her State.
  I am proud to say that the Ryan Haight Internet Pharmacy Consumer 
Protection Act is supported by the Federation of State Medical Boards, 
the National Community Pharmacists Association, and the American 
Pharmacists Association.
  The second bill I am introducing enables Customs and Border 
Protection to immediately seize and destroy any package containing a 
controlled substance that is illegally imported into the U.S. without 
having to fill out duplicative forms and other unnecessary 
administrative paperwork. The Act will allow Customs to focus on 
interdicting and destroying potentially addictive and deadly controlled 
substances. The Act is dedicated to Todd Rode, a young man who died 
after overdosing on imported drugs.
  Todd Rode had the heart and soul of a musician. He graduated from 
college magna cum laude with a major in psychology and a minor in 
music. The faculty named him the outstanding senior in the Psychology 
Department. He worked in this field for a number of years, but he 
constantly fought bouts of depression and anxiety.
  Unfortunately Todd ordered controlled drugs from a pharmacy and 
doctor in another country. These drugs included Venlafaxine, 
Propoxyphene, and Codeine. All were controlled substances and all were 
obtained from overseas pharmacies without any safeguards. To obtain 
these controlled substances all Todd had to do was to fill out an 
online questionnaire and with the click of a mouse they were shipped 
directly to his front door.
  In October of 1999, Todd's family found him dead in his apartment.
  A six-month investigation by the Permanent Subcommittee on 
Investigations has revealed that tens of thousands of dangerous and 
addictive controlled substances are streaming into the U.S. on a daily 
basis from overseas Internet pharmacies. For example, on March 15 and 
17, 2004, at JFK airport, home to the largest International Mail Branch 
in the U.S., at least 3000 boxes from a single vendor in the 
Netherlands containing hydrocodone and Diazepam (Valium) were seized by 
Customs and Border Protection (Customs).
  In fact, senior Customs inspectors at JFK estimate that 40,000 
parcels containing drugs are imported on a daily basis. During last 
summer's FDN Customs blitz, 28 percent of the drugs tested were 
controlled substances. Extrapolating these figures, 11,200 drug parcels 
containing controlled substances are imported through JFK daily, 78,400 
weekly, 313,600 monthly and 3,763,200 annually. Top countries of origin 
include Brazil, India, Pakistan, Netherlands, Spain, Portugal, Canada, 
Mexico, and Romania.
  Likewise, as of March 2003, senior Customs officials at the Miami 
International Airport indicated that as much as 30,000 packages 
containing drugs were being imported on a daily basis. A large 
percentage of these are controlled substances as well. Customs is 
simply overwhelmed. At Mail facilities across the U.S., Customs 
regularly seizes shipments of oxycodone, hydroquinone, tranquilizers, 
steroids, codeine laced product, GHB, date rape drug, and morphine.
  In order to comply with paperwork requirements, Customs is forced to 
devote investigators solely to opening, counting, and analyzing drug 
packages, filling out duplicative forms, and logging into a computer 
all of the seized controlled substances. It takes Customs at least one 
hour to process a single shipment of a controlled substance. This 
minimizes the availability of inspectors to screen incoming drug 
packages. In fact, last year at JFK, there were as many as 20,000 
packages of seized controlled substances waiting processing. Customs 
acknowledges that, because of the sheer volume of product, bureaucratic 
regulations, and lack of manpower, the vast majority of controlled 
substances that are illegally imported are simply missed and allowed 
into the U.S. stream of commerce.
  The Act to Prevent the Illegal Importation of Controlled Substances 
is a simple bill to address this burgeoning and potentially lethal 
problem.
  I am confident that, if enacted as stand-alone measures, each of 
these bills will make on-line drug purchasing safer. However, I have 
worked with Senator Gregg to ensure these safety features are included 
in his comprehensive reimportation bill and urge my colleagues to help 
make sure that this important piece of legislation becomes law this 
year.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bills was ordered to be 
printed in the Record, as follows:

                                 S. 399

       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 ``Internet Pharmacy Consumer 
     Protection Act'' or the ``Ryan Haight Act''.

     SEC. 2. INTERNET SALES OF PRESCRIPTION DRUGS.

       (a) In General.--Chapter 5 of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 351 et seq.) is amended by inserting 
     after section 503A the following section:

     ``SEC. 503B. INTERNET SALES OF PRESCRIPTION DRUGS.

       ``(a) Requirements Regarding Information on Internet 
     Site.--
       ``(1) In general.--A person may not dispense a prescription 
     drug pursuant to a sale of the drug by such person if--
       ``(A) the purchaser of the drug submitted the purchase 
     order for the drug, or conducted any other part of the sales 
     transaction for the drug, through an Internet site;
       ``(B) the person dispenses the drug to the purchaser by 
     mailing or shipping the drug to the purchaser; and
       ``(C) such site, or any other Internet site used by such 
     person for purposes of sales of a prescription drug, fails to 
     meet each of the requirements specified in paragraph (2), 
     other than a site or pages on a site that--
       ``(i) are not intended to be accessed by purchasers or 
     prospective purchasers; or
       ``(ii) provide an Internet information location tool within 
     the meaning of section 231(e)(5) of the Communications Act of 
     1934 (47 U.S.C. 231(e)(5)).
       ``(2) Requirements.--With respect to an Internet site, the 
     requirements referred to in subparagraph (C) of paragraph (1) 
     for a person to whom such paragraph applies are as follows:
       ``(A) Each page of the site shall include either the 
     following information or a link to a page that provides the 
     following information:
       ``(i) The name of such person.
       ``(ii) Each State in which the person is authorized by law 
     to dispense prescription drugs.
       ``(iii) The address and telephone number of each place of 
     business of the person with respect to sales of prescription 
     drugs through the Internet, other than a place of business 
     that does not mail or ship prescription drugs to purchasers.
       ``(iv) The name of each individual who serves as a 
     pharmacist for prescription drugs that are mailed or shipped 
     pursuant to the site, and each State in which the individual 
     is authorized by law to dispense prescription drugs.
       ``(v) If the person provides for medical consultations 
     through the site for purposes of providing prescriptions, the 
     name of each individual who provides such consultations; each 
     State in which the individual is licensed or otherwise 
     authorized by law to provide such consultations or practice 
     medicine; and the type or types of health professions for 
     which the individual holds such licenses or other 
     authorizations.
       ``(B) A link to which paragraph (1) applies shall be 
     displayed in a clear and prominent place and manner, and 
     shall include in the caption for the link the words 
     `licensing and contact information'.
       ``(b) Internet Sales Without Appropriate Medical 
     Relationships.--
       ``(1) In general.--Except as provided in paragraph (2), a 
     person may not dispense a prescription drug, or sell such a 
     drug, if--

[[Page S1533]]

       ``(A) for purposes of such dispensing or sale, the 
     purchaser communicated with the person through the Internet;
       ``(B) the patient for whom the drug was dispensed or 
     purchased did not, when such communications began, have a 
     prescription for the drug that is valid in the United States;
       ``(C) pursuant to such communications, the person provided 
     for the involvement of a practitioner, or an individual 
     represented by the person as a practitioner, and the 
     practitioner or such individual issued a prescription for the 
     drug that was purchased;
       ``(D) the person knew, or had reason to know, that the 
     practitioner or the individual referred to in subparagraph 
     (C) did not, when issuing the prescription, have a qualifying 
     medical relationship with the patient; and
       ``(E) the person received payment for the dispensing or 
     sale of the drug.
     For purposes of subparagraph (E), payment is received if 
     money or other valuable consideration is received.
       ``(2) Exceptions.--Paragraph (1) does not apply to--
       ``(A) the dispensing or selling of a prescription drug 
     pursuant to telemedicine practices sponsored by--
       ``(i) a hospital that has in effect a provider agreement 
     under title XVIII of the Social Security Act (relating to the 
     Medicare program); or
       ``(ii) a group practice that has not fewer than 100 
     physicians who have in effect provider agreements under such 
     title; or
       ``(B) the dispensing or selling of a prescription drug 
     pursuant to practices that promote the public health, as 
     determined by the Secretary by regulation.
       ``(3) Qualifying medical relationship.--
       ``(A) In general.--With respect to issuing a prescription 
     for a drug for a patient, a practitioner has a qualifying 
     medical relationship with the patient for purposes of this 
     section if--
       ``(i) at least one in-person medical evaluation of the 
     patient has been conducted by the practitioner; or
       ``(ii) the practitioner conducts a medical evaluation of 
     the patient as a covering practitioner.
       ``(B) In-person medical evaluation.--A medical evaluation 
     by a practitioner is an in-person medical evaluation for 
     purposes of this section if the practitioner is in the 
     physical presence of the patient as part of conducting the 
     evaluation, without regard to whether portions of the 
     evaluation are conducted by other health professionals.
       ``(C) Covering practitioner.--With respect to a patient, a 
     practitioner is a covering practitioner for purposes of this 
     section if the practitioner conducts a medical evaluation of 
     the patient at the request of a practitioner who has 
     conducted at least one in-person medical evaluation of the 
     patient and is temporarily unavailable to conduct the 
     evaluation of the patient. A practitioner is a covering 
     practitioner without regard to whether the practitioner has 
     conducted any in-person medical evaluation of the patient 
     involved.
       ``(4) Rules of construction.--
       ``(A) Individuals represented as practitioners.--A person 
     who is not a practitioner (as defined in subsection (d)(1)) 
     lacks legal capacity under this section to have a qualifying 
     medical relationship with any patient.
       ``(B) Standard practice of pharmacy.--Paragraph (1) may not 
     be construed as prohibiting any conduct that is a standard 
     practice in the practice of pharmacy.
       ``(C) Applicability of requirements.--Paragraph (3) may not 
     be construed as having any applicability beyond this section, 
     and does not affect any State law, or interpretation of State 
     law, concerning the practice of medicine.
       ``(c) Actions by States.--
       ``(1) In general.--Whenever an attorney general of any 
     State has reason to believe that the interests of the 
     residents of that State have been or are being threatened or 
     adversely affected because any person has engaged or is 
     engaging in a pattern or practice that violates section 
     301(l), the State may bring a civil action on behalf of its 
     residents in an appropriate district court of the United 
     States to enjoin such practice, to enforce compliance with 
     such section (including a nationwide injunction), to obtain 
     damages, restitution, or other compensation on behalf of 
     residents of such State, to obtain reasonable attorneys fees 
     and costs if the State prevails in the civil action, or to 
     obtain such further and other relief as the court may deem 
     appropriate.
       ``(2) Notice.--The State shall serve prior written notice 
     of any civil action under paragraph (1) or (5)(B) upon the 
     Secretary and provide the Secretary with a copy of its 
     complaint, except that if it is not feasible for the State to 
     provide such prior notice, the State shall serve such notice 
     immediately upon instituting such action. Upon receiving a 
     notice respecting a civil action, the Secretary shall have 
     the right--
       ``(A) to intervene in such action;
       ``(B) upon so intervening, to be heard on all matters 
     arising therein; and
       ``(C) to file petitions for appeal.
       ``(3) Construction.--For purposes of bringing any civil 
     action under paragraph (1), nothing in this chapter shall 
     prevent an attorney general of a State from exercising the 
     powers conferred on the attorney general by the laws of such 
     State to conduct investigations or to administer oaths or 
     affirmations or to compel the attendance of witnesses or the 
     production of documentary and other evidence.
       ``(4) Venue; service of process.--Any civil action brought 
     under paragraph (1) in a district court of the United States 
     may be brought in the district in which the defendant is 
     found, is an inhabitant, or transacts business or wherever 
     venue is proper under section 1391 of title 28, United States 
     Code. Process in such an action may be served in any district 
     in which the defendant is an inhabitant or in which the 
     defendant may be found.
       ``(5) Actions by other state officials.--
       ``(A) Nothing contained in this section shall prohibit an 
     authorized State official from proceeding in State court on 
     the basis of an alleged violation of any civil or criminal 
     statute of such State.
       ``(B) In addition to actions brought by an attorney general 
     of a State under paragraph (1), such an action may be brought 
     by officers of such State who are authorized by the State to 
     bring actions in such State on behalf of its residents.
       ``(d) General Definitions.--For purposes of this section:
       ``(1) The term `practitioner' means a practitioner referred 
     to in section 503(b)(1) with respect to issuing a written or 
     oral prescription.
       ``(2) The term `prescription drug' means a drug that is 
     subject to section 503(b)(1).
       ``(3) The term `qualifying medical relationship', with 
     respect to a practitioner and a patient, has the meaning 
     indicated for such term in subsection (b).
       ``(e) Internet-related Definitions.--
       ``(1) In general.--For purposes of this section:
       ``(A) The term `Internet' means collectively the myriad of 
     computer and telecommunications facilities, including 
     equipment and operating software, which comprise the 
     interconnected world-wide network of networks that employ the 
     transmission control protocol/internet protocol, or any 
     predecessor or successor protocols to such protocol, to 
     communicate information of all kinds by wire or radio.
       ``(B) The term `link', with respect to the Internet, means 
     one or more letters, words, numbers, symbols, or graphic 
     items that appear on a page of an Internet site for the 
     purpose of serving, when activated, as a method for executing 
     an electronic command--
       ``(i) to move from viewing one portion of a page on such 
     site to another portion of the page;
       ``(ii) to move from viewing one page on such site to 
     another page on such site; or
       ``(iii) to move from viewing a page on one Internet site to 
     a page on another Internet site.
       ``(C) The term `page', with respect to the Internet, means 
     a document or other file accessed at an Internet site.
       ``(D)(i) The terms `site' and `address', with respect to 
     the Internet, mean a specific location on the Internet that 
     is determined by Internet Protocol numbers. Such term 
     includes the domain name, if any.
       ``(ii) The term `domain name' means a method of 
     representing an Internet address without direct reference to 
     the Internet Protocol numbers for the address, including 
     methods that use designations such as `.com', `.edu', `.gov', 
     `.net', or `.org'.
       ``(iii) The term `Internet Protocol numbers' includes any 
     successor protocol for determining a specific location on the 
     Internet.
       ``(2) Authority of secretary.--The Secretary may by 
     regulation modify any definition under paragraph (1) to take 
     into account changes in technology.
       ``(f) Interactive Computer Service; Advertising.--No 
     provider of an interactive computer service, as defined in 
     section 230(f)(2) of the Communications Act of 1934 (47 
     U.S.C. 230(f)(2)), or of advertising services shall be liable 
     under this section for dispensing or selling prescription 
     drugs in violation of this section on account of another 
     person's selling or dispensing such drugs, provided that the 
     provider of the interactive computer service or of 
     advertising services does not own or exercise corporate 
     control over such person.''.
       (b) Inclusion as Prohibited Act.--Section 301 of the 
     Federal Food, Drug, and Cosmetic Act (21 U.S.C. 331) is 
     amended by inserting after paragraph (k) the following:
       ``(l) The dispensing or selling of a prescription drug in 
     violation of section 503B.''.
       (c) Internet Sales of Prescription Drugs; Consideration by 
     Secretary of Practices and Procedures for Certification of 
     Legitimate Businesses.--In carrying out section 503B of the 
     Federal Food, Drug, and Cosmetic Act (as added by subsection 
     (a) of this section), the Secretary of Health and Human 
     Services shall take into consideration the practices and 
     procedures of public or private entities that certify that 
     businesses selling prescription drugs through Internet sites 
     are legitimate businesses, including practices and procedures 
     regarding disclosure formats and verification programs.
       (d) Reports Regarding Internet-related Violations of State 
     and Federal Laws on Dispensing of Drugs.--
       (1) In general.--The Secretary of Health and Human Services 
     (referred to in this subsection as the ``Secretary'') shall, 
     pursuant to the submission of an application meeting the 
     criteria of the Secretary, make an award of a grant or 
     contract to the National Clearinghouse on Internet 
     Prescribing (operated by the Federation of State Medical 
     Boards) for the purpose of--
       (A) identifying Internet sites that appear to be in 
     violation of State or Federal laws concerning the dispensing 
     of drugs;

[[Page S1534]]

       (B) reporting such sites to State medical licensing boards 
     and State pharmacy licensing boards, and to the Attorney 
     General and the Secretary, for further investigation; and
       (C) submitting, for each fiscal year for which the award 
     under this subsection is made, a report to the Secretary 
     describing investigations undertaken with respect to 
     violations described in subparagraph (A).
       (2) Authorization of appropriations.--For the purpose of 
     carrying out paragraph (1), there is authorized to be 
     appropriated $100,000 for each of the fiscal years 2005 
     through 2007.
       (e) Effective Date.--The amendments made by subsections (a) 
     and (b) take effect upon the expiration of the 60-day period 
     beginning on the date of the enactment of this Act, without 
     regard to whether a final rule to implement such amendments 
     has been promulgated by the Secretary of Health and Human 
     Services under section 701(a) of the Federal Food, Drug, and 
     Cosmetic Act. The preceding sentence may not be construed as 
     affecting the authority of such Secretary to promulgate such 
     a final rule.

                                 S. 400

       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 ``Prevention of Illegally 
     Imported Controlled Substances Act of 2005'' or ``Todd Rode 
     Act''.

     SEC. 2. DESTRUCTION OF CERTAIN IMPORTED SHIPMENTS.

       Part D of the Controlled Substances Act (21 U.S.C. 841 et 
     seq.) is amended by adding at the end the following:


              ``DESTRUCTION OF CERTAIN IMPORTED SHIPMENTS

       ``Sec. 424. (a) In General.--A shipment of controlled 
     substances that is imported or offered for import into the 
     United States in violation of section 401 and whose value is 
     less than $10,000 shall be seized and summarily forfeited to 
     the United States.
       ``(b) Destruction.--Controlled substances seized under 
     subsection (a) shall be destroyed, subject to subsection (d). 
     Section 801(b) of the Federal Food, Drug, and Cosmetic Act 
     (21 U.S.C. 381(b)) does not authorize the delivery of the 
     substances pursuant to the execution of a bond, and the 
     substances may not be exported.
       ``(c) Notice.--
       ``(1) Procedures.--The seizure and destruction of 
     controlled substances under subsections (a) and (b) may be 
     carried out without notice to the importer, owner, or 
     consignee of the controlled substances involved. Appraisement 
     of such substances is required only to the extent sufficient 
     to document that the substances are subject to subsection 
     (a).
       ``(2) Goals.--Procedures promulgated under paragraph (1) 
     shall be designed toward the goal of ensuring that, with 
     respect to efficiently utilizing Federal resources available 
     for carrying out this subsection, a substantial majority of 
     shipments of controlled substances subject to subsection (a) 
     are identified and seized under such paragraph and destroyed 
     under subsection (b).
       ``(d) Presentation of Evidence.--Controlled substances may 
     not be destroyed under subsection (b) to the extent that the 
     Attorney General of the United States determines that the 
     controlled substances should be preserved as evidence or 
     potential evidence with respect to an offense against the 
     United States.''.

  Mrs. FEINSTEIN. Mr. President, I am pleased to join Senator Coleman 
again this year to re-introduce the Ryan Haight Internet Pharmacy 
Consumer Protection Act. Our legislation will protect the safety of 
Americans who choose to purchase their prescription drugs legally over 
the Internet.
  This legislation is necessary because of a growing problem of illegal 
prescription drug diversion and abuse of prescription drugs. Coupled 
with the ease of access to the Internet, it has led to an environment 
where illegitimate pharmacy websites can bypass traditional regulations 
and established safeguards for the sale of prescription drugs. Internet 
websites that allow consumers to obtain prescriptions drugs without the 
existence of a bona fide physician-patient relationship pose an 
immediate threat to public health and safety.
  To address this problem, the Internet Pharmacy Consumer Protection 
Act makes several critical steps, to ensure safety and to assist 
regulatory authorities in shutting down ``rogue'' Internet pharmacies.
  First, this bill establishes disclosure standards for Internet 
pharmacies.
  Second, this bill prohibits the dispensing or sale of a prescription 
drug based solely on communications via the Internet such as the 
completion of an online medical questionnaire.
  Third, it allows a State Attorney General to bring a civil action in 
a Federal district court to enjoin a pharmacy operation and to enforce 
compliance with the provisions of this law.
  Under this bill, for a domestic Web site to sell prescription drugs 
legally, the web site would have to display identifying information 
such as the names, addresses, and medical licensing information for 
pharmacists and physicians associated with the Web site.
  In addition, if a person wants to use the Internet to purchase their 
prescription drugs he or she will not be prohibited from doing so under 
this bill but, in order to do so, must already have a prescription for 
the drug that is valid in the United States prior to making the 
Internet purchase.
  Reliance on the Internet for public health purposes and the expansion 
of telemedicine, particularly in rural areas, make it essential that 
there be at the very least a minimum standard for what qualifies as an 
acceptable medical relationship between patients and their physicians.
  According to the American Medical Association, a health care 
practitioner who offers a prescription for a patient he or she has 
never seen before, based solely on an online questionnaire, generally 
does not meet the appropriate medical standard of care.
  Let me illustrate the situation facing our country today. If a 
physician's office prescribed and dispensed prescription drugs the same 
way Internet pharmacies currently can do, it would look something like 
this: a physician opens a physical office, asks a patient to fill out a 
medical history questionnaire in the lobby and give his or her credit 
card information to the office manager. There is no nurse, and 
therefore no one to take the patients' height, weight, blood pressure, 
verify his or her medical history, and so forth and no one to answer 
the patient's questions regarding their health.
  The questionnaire is then slipped through a hole in the window; the 
office manager takes it to the physician, or person acting as the 
physician, who then writes the prescription and hands it to the 
pharmacist, or person acting as the pharmacist, in the next room. Once 
the patient signs his credit card, he is on his way out the door, drugs 
in hand.
  No examination is performed, no questions asked, and no verification 
or clarification of the answers provided on the medical history 
questionnaire.
  This illustration is not an exaggeration. It occurs everyday all 
across the United States. The National Association of Boards of 
Pharmacy estimates that there are around 500 identifiable rogue 
pharmacy Web sites operating on the Internet.
  According to the Federation of State Medical Boards, 31 States and 
the District of Columbia either have laws or medical board initiatives 
addressing Internet medical practice.
  Many States have already enacted laws defining acceptable practices 
for qualifying medical relationships between doctors and patients and 
this bill would not affect any existing State laws.
  For example, California law was changed in 2000 to say: ``no person 
or entity may prescribe, dispense, or furnish, or cause to be 
prescribed, dispensed, or furnished dangerous drugs or dangerous 
devices [defined as any drug or device unsafe for self-use] on the 
Internet for delivery to any person in this state, without a good faith 
prior examination and medical indication . . .''
  I believe California's law is a perfect example of why this 
legislation is needed. The law only applies to persons living in 
California. As we all know, however, the Internet is not bound by State 
or even country borders.
  This legislation makes a critical step forward by providing 
additional authority for State Attorneys General to file an injunction 
in Federal court to shut down an Internet site operating in another 
State that violates the provisions in the bill.
  Under current law, in order to close down an Internet website selling 
prescription drugs prosecutors must take enforcement actions in every 
State where the Internet pharmacy operates, requiring a tremendous 
amount of resources in an environment where the location of the website 
is difficult, if not impossible, to determine or keep track of.
  This bill will allow a State Attorney General to bring a civil action 
in a Federal district court to enjoin a pharmacy operation and to 
enforce compliance with the provisions of the law in every jurisdiction 
where the pharmacy is operating.

[[Page S1535]]

  While this legislation pertains to domestic Internet pharmacies, the 
practice of international pharmacies selling low-cost drugs to U.S. 
consumers who have valid prescriptions from their doctors deserves to 
be discussed and debated on the Senate floor. It is my hope that the 
Senate will act this year on prescription drug importation legislation.
  In closing, I want to share with you the story of Ryan T. Haight of 
La Mesa, California in whose memory this bill is named.
  Ryan was an 18-year old honor student from La Mesa, CA, when he died 
in his home on February 12, 2001.
  His parents found a bottle of Vicodin in his room with a label from 
an out-of-State pharmacy.
  It turns out that Ryan had been ordering addictive drugs online and 
paying with a debit card his parents gave him to buy baseball cards on 
eBay.
  Without a physical exam or his parents' consent, Ryan had been 
obtaining controlled substances, some from an Internet site in 
Oklahoma. It only took a few months before Ryan's life was ended by an 
overdose on a cocktail of painkillers.
  Ryan's story and others like it force us to ask why anyone in the 
U.S. would be able to access such highly addictive and dangerous drugs 
over the Internet with such ease?
  Why was there no physician or pharmacist on the other end of this 
teenager's computer verifying his age, his medical history and that 
there was a valid prescription?
  That is why I support this legislation. It makes sensible 
requirements of Internet pharmacy websites that will not impact access 
to convenient, oftentimes cost-saving drugs.
  With simple disclosure requirements for Internet sites such as names, 
addresses and medical or pharmacy licensing information, patients will 
be better off and State medica1 and pharmacy boards can ensure that 
pharmacists and doctors are properly licensed.
  Lastly, this bill will give State attorneys general the authority 
they need to shut down rogue Internet pharmacies operating in other 
states.
  I urge my colleagues to support this bill.
                                 ______