[Congressional Record Volume 156, Number 103 (Tuesday, July 13, 2010)]
[Senate]
[Pages S5791-S5792]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN (for himself, Mr. Sessions, Mr. Dodd, Mr. Brown of 
        Ohio, Mr. Vitter, and Mr. Alexander):
  S. 3575. A bill to amend and reauthorize the controlled substance 
monitoring program under section 3990 of the Public Health Service Act 
and to authorize the Secretary of Veterans Affairs to share information 
about the use of controlled substances by veterans with State 
prescription monitoring programs to prevent misuse and diversion of 
prescription medicines; to the Committee on Health, Education, Labor, 
and Pensions.
  Mr. DURBIN. Mr. President, the nonmedical use and abuse of 
prescription drugs is a serious and growing public health problem in 
this country. The 2008 National Survey on Drug Use and Health showed 
that more than 15 million Americans had used prescription 
psychotherapeutic drugs non-medically in the past year. That is more 
than 6 percent of the U.S. population. More than 20 percent of 
Americans had abused these drugs during their lifetime. The Substance 
Abuse and Mental Health Services Agency, SAMHSA, estimates that half a 
million residents in my home State of Illinois are using prescription 
drugs illegally and in ways that can lead to dependence and even death.
  Since 1999, abuse, misuse, and overdose of prescription drugs has 
increased, and the health consequences are significant. Each year, more 
than 20,000 people in the United States die from drug overdose. 
Illinois hospitals report an increase in patients visiting Emergency 
Departments because of prescription drug misuse. From 2003 to 2007, 
Chicago area hospitals saw the number of visits for pain medication 
misuse more than double and visits for sedative misuse quadruple.
  The trends among teens are especially worrisome. Prescription pain 
relievers are the second most common drugs used as gateway drugs among 
teens. Over the past decade, there has been a 300 percent increase in 
the number of teens seeking treatment for addiction to prescription 
painkillers.
  To address this threat to public health, my colleague Senator 
Sessions and I worked together to enact Public Law 109-60, the National 
All Schedules Prescription Electronic Reporting Act of 2005, NASPER. 
This program provides grants through the Department of Health and Human 
Services to establish or improve State-based prescription drug 
monitoring programs, PDMPs. The first grants were awarded through 
NASPER beginning in fiscal year 09, and currently over 40 States are 
operating PDMPs or have enacted legislation to establish them.
  While each State's program is unique, in general they require that 
pharmacies, physicians or both submit information to a central office 
within the State on prescriptions dispensed for certain controlled 
substances--narcotics, stimulants, sedatives, depressants, etc. By 
creating these systems, States can ensure that health care providers, 
law enforcement officials and other regulatory and licensing bodies 
have access to accurate, timely prescription history information as 
permitted by law.
  The data in these systems can be used for many purposes: to assist in 
the early identification of patients at risk for addiction, prevent 
patients from doctor shopping, and help with investigations of drug 
diversion and errant prescribing or dispensing practices by pharmacists 
or medical providers.
  In my home State of Illinois, the State PDMP is called Prescription 
Information Library, PIL. The State was awarded a NASPER grant in 
fiscal year 09, which allowed it to expand and improve its program. In 
the month of June 2010 alone, the PIL website was used by over 3,600 
doctors, pharmacists and other registered users who made over 24,000 
visits to the site. In addition, the number of law enforcement requests 
for information from PIL increased from 16 in 2007 to 321 in 2009. Use 
of the program continues to grow--in the first 6 months of 2010, law 
enforcement officials have already made 271 requests for information 
from the database. The growth of the Illinois program demonstrates that 
it is valuable tool for protecting public health and safety by 
identifying people at risk for prescription drug abuse and doctors who 
betray the high ethical standards of their profession by over or 
incorrectly prescribing prescription drugs.
  Today, along with Senator Sessions and several other colleagues, I am 
introducing the National All Schedules Prescription Electronic Reposing 
Reauthorization Act of 2010. This bill reauthorizes and extends this 
vital program for 5 more years at $15 million for fiscal year 2011 and 
$10 million each year thereafter. It also makes small changes to 
improve and strengthen the program, including allowing grants to be 
made available to States to plan or maintain a PDMP in addition to 
establishing or improving a program; requiring States to help educate 
medical providers about the benefits of the systems and facilitate 
their use of them; requiring, States to report aggregate data to the 
Secretary to allow for evaluation of the success of the program; 
allowing participation by the territories; and permitting the 
Department of Veterans Affairs to share information about the use of 
controlled substance by veterans with State PDMPs.
  Reauthorizing the NASPER program for another 5 years with these 
changes to improve its operation will assist States in combating abuse 
and misuse of prescription drugs. This common-sense legislation has 
bipartisan support, and I look forward to working with my colleagues to 
enact it into law.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3575

       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 Reauthorization Act of 
     2010''.

     SEC. 2. AMENDMENT TO PURPOSE.

       Paragraph (1) of section 2 of the National All Schedules 
     Prescription Electronic Reporting Act of 2005 (Public Law 
     109-60) is amended to read as follows:
       ``(1) foster the establishment of State-administered 
     controlled substance monitoring systems in order to ensure 
     that--
       ``(A) health care providers have access to the accurate, 
     timely prescription history information that they may use as 
     a tool for the early identification of patients at risk for 
     addiction in order to initiate appropriate medical 
     interventions and avert the tragic personal, family, and 
     community consequences of untreated addiction; and
       ``(B) appropriate law enforcement, regulatory, and State 
     professional licensing authorities have access to 
     prescription history information for the purposes of 
     investigating drug diversion and prescribing and dispensing 
     practices of errant prescribers or pharmacists; and''.

     SEC. 3. AMENDMENTS TO CONTROLLED SUBSTANCE MONITORING 
                   PROGRAM.

       Section 399O of the Public Health Service Act (42 U.S.C. 
     280g-3) is amended--
       (1) in subsection (a)(1)--
       (A) in subparagraph (A), by striking ``or'';
       (B) in subparagraph (B), by striking the period at the end 
     and inserting ``; or''; and
       (C) by adding at the end the following:
       ``(C) to maintain and operate an existing State controlled 
     substance monitoring program.'';
       (2) by amending subsection (b) to read as follows:
       ``(b) Minimum Requirements.--The Secretary shall maintain 
     and, as appropriate, supplement or revise (after publishing 
     proposed additions and revisions in the Federal Register and 
     receiving public comments thereon) minimum requirements for 
     criteria to be used by States for purposes of clauses (ii), 
     (v), (vi), and (vii) of subsection (c)(1)(A).'';

[[Page S5792]]

       (3) in subsection (c)--
       (A) in paragraph (1)(B)--
       (i) in the matter preceding clause (i), by striking 
     ``(a)(1)(B)'' and inserting ``(a)(1)(B) or (a)(1)(C)'';
       (ii) in clause (i), by striking ``program to be improved'' 
     and inserting ``program to be improved or maintained''; and
       (iii) in clause (iv), by striking ``public health'' and 
     inserting ``public health or public safety'';
       (B) in paragraph (3)--
       (i) by striking ``If a State that submits'' and inserting 
     the following:
       ``(A) In general.--If a State that submits'';
       (ii) by inserting before the period at the end ``and 
     include timelines for full implementation of such 
     interoperability''; and
       (iii) by adding at the end the following:
       ``(B) Monitoring of efforts.--The Secretary shall monitor 
     State efforts to achieve interoperability, as described in 
     subparagraph (A).'';
       (C) in paragraph (5)--
       (i) by striking ``implement or improve'' and inserting 
     ``establish, improve, or maintain''; and
       (ii) by adding at the end the following: ``The Secretary 
     shall redistribute any funds that are so returned among the 
     remaining grantees under this section in accordance with the 
     formula described in subsection (a)(2)(B).'';
       (4) in the matter preceding paragraph (1) in subsection 
     (d), by striking ``In implementing or improving'' all that 
     follows through ``with the following:'' and inserting ``In 
     establishing, improving, or maintaining a controlled 
     substance monitoring program under this section, a State 
     shall comply, or with respect to a State that applies for a 
     grant under subsection (a)(1)(B) or (C) submit to the 
     Secretary for approval a statement of why such compliance is 
     not feasible and a plan for bringing the State into 
     compliance, with the following:'';
       (5) in subsections (e), (f)(1), and (g), by striking 
     ``implementing or improving'' each place it appears and 
     inserting ``establishing, improving, or maintaining'';
       (6) in subsection (f)--
       (A) in paragraph (1)(B) by striking ``misuse of a schedule 
     II, III, or IV substance'' and inserting ``misuse of a 
     controlled substance included in schedule II, III, or IV of 
     section 202(c) of the Controlled Substance Act''; and
       (B) add at the end the following:
       ``(3) Evaluation and reporting.--Subject to subsection (g), 
     a State receiving a grant under subsection (a) shall provide 
     the Secretary with aggregate data and other information 
     determined by the Secretary to be necessary to enable the 
     Secretary--
       ``(A) to evaluate the success of the State's program in 
     achieving its purposes; or
       ``(B) to prepare and submit the report to Congress required 
     by subsection (k)(2).
       ``(4) Research by other entities.--A department, program, 
     or administration receiving nonidentifiable information under 
     paragraph (1)(D) may make such information available to other 
     entities for research purposes.'';
       (7) by redesignating subsections (h) through (n) as 
     subsections (i) through (o), respectively;
       (8) in subsections (c)(1)(A)(iv) and (d)(4), by striking 
     ``subsection (h)'' each place it appears and inserting 
     ``subsection (i)'';
       (9) by inserting after subsection (g) the following:
       ``(h) Education and Access to the Monitoring System.--A 
     State receiving a grant under subsection (a) shall take steps 
     to--
       ``(1) facilitate prescriber use of the State's controlled 
     substance monitoring system; and
       ``(2) educate prescribers on the benefits of the system 
     both to them and society.'';
       (10) in subsection (m)(1), as redesignated, by striking 
     ``establishment, implementation, or improvement'' and 
     inserting ``establishment, improvement, or maintenance'';
       (11) in subsection (n)(8), as redesignated, by striking 
     ``and the District of Columbia'' and inserting ``, the 
     District of Columbia, and any commonwealth or territory of 
     the United States''; and
       (12) by amending subsection (o), as redesignated, to read 
     as follows:
       ``(o) Authorization of Appropriation.--To carry out this 
     section, there are authorized to be appropriated $15,000,000 
     for fiscal year 2011 and $10,000,000 for each of fiscal years 
     2012 through 2015.''.

     SEC. 4. AMENDMENTS TO TITLE 38.

       (a) Exception With Respect to Confidential Nature of 
     Claims.--Section 5701 of title 38, United States Code, is 
     amended by adding at the end the following new subsection:
       ``(l) Under regulations the Secretary shall prescribe, the 
     Secretary may disclose information about a veteran or the 
     dependant of a veteran to a State controlled substance 
     monitoring program, including a program approved by the 
     Secretary of Health and Human Services under section 399O of 
     the Public Health Service Act (42 U.S.C. 280g-3), to the 
     extent necessary to prevent misuse and diversion of 
     prescription medicines.''.
       (b) Exception With Respect to Confidentiality of Certain 
     Medical Records.--Section 7332(b)(2) of such title is amended 
     by adding at the end the following new subparagraph:
       ``(G) To a State controlled substance monitoring program, 
     including a program approved by the Secretary of Health and 
     Human Services under section 399O of the Public Health 
     Service Act (42 U.S.C. 280g-3), to the extent necessary to 
     prevent misuse and diversion of prescription medicines.''.
       (c) Report.--
       (1) In general.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to Congress a report on the participation of the 
     Department of Veterans Affairs in State controlled substance 
     monitoring programs, including programs approved by the 
     Secretary of Health and Human Services under section 399O of 
     the Public Health Service Act (42 U.S.C. 280g-3).
       (2) Elements.--The report required by paragraph (1) shall 
     include the following:
       (A) A summary of the activities of the Department of 
     Veterans Affairs relating to programs described in paragraph 
     (1).
       (B) A list of the programs described in paragraph (1) in 
     which the Department is participating.
       (C) A description of how the Secretary determines which 
     programs described in paragraph (1) in which to participate.
       (D) The status of the regulations, if any, prescribed by 
     the Secretary under section 5701(l) of title 38, United 
     States Code, as added by subsection (a) of this section.

  Mr. DODD. Mr. President, I rise today in support of reauthorization 
of the National All Schedules Prescription Electronic Drug Reporting 
Act, NASPER, program critical to combating the abuse of prescription 
drugs in our Nation. I am proud to once again join my colleagues 
Senators Dick Durbin, Jeff Sessions, and Sherrod Brown on this 
important legislation which would reauthorize the NASPER program.
  In 2008, over 15 million Americans abused prescription drugs and 
nearly 2 million of those Americans were between the ages of 12 and 17. 
Further, the National Institute on Drug Abuse at the National 
Institutes of Health found that last year more than 1 in 10 high school 
seniors used a narcotic for nonmedical purposes. These statistics are 
simply unacceptable. We must do more to address the issue of 
prescription drug abuse in this country.
  When used under the supervision of a medical professional 
prescription drugs can be life saving but when they are abused they can 
become life-threatening. NASPER will help prevent unnecessary deaths by 
allowing credentialed professionals access to key information regarding 
prescriptions for many controlled substances. This access will help 
prevent doctor shopping and will help health professionals to more 
closely monitor the prescriptions being issued to their patients.
  NASPER is a valuable tool available to states to help detect and 
prevent abuse of prescription drugs. Reauthorization of this program 
will allow states to establish, maintain, and grow their own electronic 
prescription drug monitoring programs. Beyond this it will help states 
establish linkages to surrounding states so that information can be 
more easily shared, making doctor shopping across state lines more 
difficult.
  I am proud of the work that is going on in my own state of 
Connecticut around this issue. Our Drug Control Division within the 
Department of Consumer Protection has worked tirelessly to build a 
successful prescription drug monitoring program. This program has 
helped to not only prevent abuse of prescription drugs but it has 
helped to detect and prevent abuse of critical programs such as 
Medicare and Medicaid. In one case, an investigation of a pharmacist 
fraudulently billing Medicaid and Medicare resulted in a settlement 
with the government for $340,000.
  As you can see NASPER is an important tool we cannot afford to lose 
and I urge my colleagues to join me in supporting this important 
legislation.

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