[Congressional Record Volume 161, Number 128 (Tuesday, September 8, 2015)]
[House]
[Pages H5796-H5798]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       NATIONAL ALL SCHEDULES PRESCRIPTION ELECTRONIC REPORTING 
                      REAUTHORIZATION ACT OF 2015

  Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1725) to amend and reauthorize the controlled substance 
monitoring program under section 399O of the Public Health Service Act, 
and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 1725

       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 
     2015''.

     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)--
       (A) in paragraph (1)--
       (i) in subparagraph (A), by striking ``or'';
       (ii) in subparagraph (B), by striking the period at the end 
     and inserting ``; or''; and
       (iii) by adding at the end the following:
       ``(C) to maintain and operate an existing State-controlled 
     substance monitoring program.''; and
       (B) in paragraph (3), by inserting ``by the Secretary'' 
     after ``Grants awarded'';
       (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).'';
       (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'';
       (iii) by redesignating clauses (iii) and (iv) as clauses 
     (iv) and (v), respectively;
       (iv) by inserting after clause (ii) the following:
       ``(iii) a plan to apply the latest advances in health 
     information technology in order to incorporate prescription 
     drug monitoring

[[Page H5797]]

     program data directly into the workflow of prescribers and 
     dispensers to ensure timely access to patients' controlled 
     prescription drug history;'';
       (v) in clause (iv), as redesignated, by inserting before 
     the semicolon at the end ``and at least one health 
     information technology system such as an electronic health 
     records system, a health information exchange, or an e-
     prescribing system''; and
       (vi) in clause (v), as redesignated, 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 striking the period at the end and inserting ``and 
     include timelines for full implementation of such 
     interoperability. The State shall also describe the manner in 
     which it will achieve interoperability between its monitoring 
     program and health information technology systems, as 
     allowable under State law, and include timelines for 
     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).''; and
       (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 subsection (d)--
       (A) in the matter preceding paragraph (1)--
       (i) by striking ``In implementing or improving'' and all 
     that follows through ``(a)(1)(B)'' 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 subparagraph (B) or (C) of subsection (a)(1)''; 
     and
       (ii) by striking ``public health'' and inserting ``public 
     health or public safety''; and
       (B) by adding at the end the following:
       ``(5) The State shall report to the Secretary on--
       ``(A) as appropriate, interoperability with the controlled 
     substance monitoring programs of Federal departments and 
     agencies;
       ``(B) as appropriate, interoperability with health 
     information technology systems such as electronic health 
     records systems, health information exchanges, and e-
     prescribing systems; and
       ``(C) whether or not the State provides automatic, real-
     time or daily information about a patient when a practitioner 
     (or the designee of a practitioner, where permitted) requests 
     information about such patient.'';
       (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)--
       (i) in subparagraph (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
       (ii) in subparagraph (D), by inserting ``a State substance 
     abuse agency,'' after ``a State health department,''; and
       (B) by adding 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 (l)(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 (j) through (p), respectively;
       (8) in subsections (c)(1)(A)(iv) and (d)(4), by striking 
     ``subsection (h)'' each place it appears and inserting 
     ``subsection (j)'';
       (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 and dispenser use of the 
     State's controlled substance monitoring system;
       ``(2) educate prescribers and dispensers on the benefits of 
     the system both to them and society; and
       ``(3) facilitate linkage to the State substance abuse 
     agency and substance abuse disorder services.
       ``(i) Consultation With Attorney General.--In carrying out 
     this section, the Secretary shall consult with the Attorney 
     General of the United States and other relevant Federal 
     officials to--
       ``(1) ensure maximum coordination of controlled substance 
     monitoring programs and related activities; and
       ``(2) minimize duplicative efforts and funding.'';
       (10) in subsection (l)(2)(A), as redesignated by paragraph 
     (7)--
       (A) in clause (ii), by inserting ``; established or 
     strengthened initiatives to ensure linkages to substance use 
     disorder services;'' before ``or affected patient access''; 
     and
       (B) in clause (iii), by inserting ``and between controlled 
     substance monitoring programs and health information 
     technology systems'' before ``, including an assessment'';
       (11) by striking subsection (m) (relating to preference), 
     as redesignated by paragraph (7);
       (12) by redesignating subsections (n) through (p), as 
     redesignated by paragraph (7), as subsections (m) through 
     (o), respectively;
       (13) in subsection (m)(1), as redesignated by paragraph 
     (12), by striking ``establishment, implementation, or 
     improvement'' and inserting ``establishment, improvement, or 
     maintenance'';
       (14) in subsection (n), as redesignated by paragraph (12)--
       (A) in paragraph (5)--
       (i) by striking ``means the ability'' and inserting the 
     following: ``means--
       ``(A) the ability'';
       (ii) by striking the period at the end and inserting ``; 
     or''; and
       (iii) by adding at the end the following:
       ``(B) sharing of State controlled substance monitoring 
     program information with a health information technology 
     system such as an electronic health records system, a health 
     information exchange, or an e-prescribing system.'';
       (B) in paragraph (7), by striking ``pharmacy'' and 
     inserting ``pharmacist''; and
       (C) in paragraph (8), by striking ``and the District of 
     Columbia'' and inserting ``, the District of Columbia, and 
     any commonwealth or territory of the United States''; and
       (15) by amending subsection (o), as redesignated by 
     paragraph (12), to read as follows:
       ``(o) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated $10,000,000 
     for each of fiscal years from 2016 through 2020.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Kentucky (Mr. Guthrie) and the gentleman from Texas (Mr. Gene Green) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Kentucky.


                             General Leave

  Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Kentucky?
  There was no objection.
  Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
  I rise today in support of H.R. 1725, the National All Schedules 
Prescription Electronic Reporting Reauthorization Act of 2015, 
introduced by my colleagues Mr. Whitfield, Mr. Kennedy, Mr. Bucshon, 
and Mr. Pallone.
  Prescription drug abuse is an epidemic in this country, and, sadly, 
Kentucky is impacted by high rates of prescription drug abuse. Every 
year, there are 15,000 overdose deaths from prescription pain 
relievers. For every overdose death, there are an estimated 10 
addiction treatment admissions and 32 emergency department visits. One 
important tool we have as a nation to combat this epidemic is 
Prescription Drug Monitoring Programs. They prevent doctor shopping and 
help physicians make more informed clinical decisions.
  Reauthorizing NASPER would provide grant support to States to 
establish Prescription Drug Monitoring Programs. Healthcare providers 
can access a patient's prescription history through the PDMP to help 
them identify patients at risk for addiction or those who are abusing 
prescription drugs. NASPER also helps identify best practices for new 
PDMPs and ways to improve existing monitoring programs.
  Mr. Speaker, I urge my colleagues to support this bill, and I reserve 
the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  I rise in support of H.R. 1725, the National All Schedules 
Prescription Electronic Reporting Reauthorization Act. This important 
legislation is sponsored by Ranking Member Pallone, Representatives Joe 
Kennedy and Ed Whitfield, and Congressman Larry Bucshon.
  The reauthorization of NASPER is urgently needed to ensure that 
physicians have patient-specific information through Prescription Drug 
Monitoring

[[Page H5798]]

Programs, PDMPs, at the point of care. As its name suggests, PDMPs help 
physicians and other providers make appropriate prescribing decisions 
while ensuring that patients with legitimate pain management needs have 
access to necessary care. We are in the middle of an epidemic of 
prescription drug opioid misuse and overdose. According to the Centers 
for Disease Control and Prevention, in 2013, more than 16,000 Americans 
died from an opioid-related overdose.
  PDMPs are an integral part of our Nation's effort to combat the 
ongoing opioid and prescription drug epidemic. They allow for the early 
identification of at-risk patients and timely intervention to prevent 
prescription drug abuse. States have recognized that PDMPs are a vital 
tool to address this public health crisis as demonstrated by their 
universal adoption amongst the States.
  H.R. 1725 reauthorizes grants to States to enhance their PDMPs, and 
it makes further improvements to the programs. Funding for PDMPs is 
needed to help States utilize this effective tool, to incentivize 
information sharing across State lines, and to further the 
implementation of best practices.
  I want to thank Ranking Member Pallone and Representatives Kennedy, 
Whitfield, and Bucshon for their leadership. I also want to thank my 
colleagues on the Energy and Commerce Committee for their commitment to 
addressing our Nation's opioid epidemic. I urge my colleagues to 
support H.R. 1725.
  I reserve the balance of my time.

                              {time}  1615

  Mr. GUTHRIE. Mr. Speaker, I yield 4 minutes to the gentleman from 
Kentucky (Mr. Whitfield), who has worked tirelessly on these issues in 
the Energy and Commerce Committee and back home to try to address the 
prescription drug problem in our State.
  Mr. WHITFIELD. Mr. Speaker, I rise today in support of H.R. 1725, the 
National All Schedules Prescription Electronic Reporting 
Reauthorization Act, as we call it, NASPER.
  I introduced this legislation earlier this year with my colleagues, 
Congressman Larry Bucshon of Indiana, Frank Pallone of New Jersey, and 
Joe Kennedy of Massachusetts.
  I want to thank Chairman Upton, Ranking Member Pallone, as well as 
Subcommittee Chair Pitts, Ranking Member Green, and Congressman Guthrie 
for helping move this bill through the committee and subcommittee.
  It has already been stated, the importance of this legislation to 
reauthorize NASPER. Prescription drug overdose death is reaching an 
epidemic proportion. Tragically, it has increased in America by 
fivefold since 1980, and drug overdose now kills more Americans than 
automobile accidents.
  In my home State of Kentucky, more than 1,000 individuals die each 
year from prescription drug overdose, which is the third highest rate 
in the country.
  Ten years ago NASPER was signed into law to assist States in 
combating prescription drug abuse through the creation and improvement 
of prescription drug-monitoring programs, which experts agree are one 
of the most promising clinical tools to address this epidemic.
  So today we come to the floor to reauthorize this important 
legislation, and I hope that we can continue our efforts to obtain 
adequate funding from the Appropriations Committee for NASPER.
  While there is no silver bullet to solve the problem, we do have an 
opportunity to make a difference by advancing this reauthorization act. 
I urge my colleagues to join me in supporting that effort.
  Mr. GENE GREEN of Texas. Mr. Speaker, I reserve the balance of my 
time.
  Mr. GUTHRIE. Mr. Speaker, I yield 2 minutes to the gentleman from 
Indiana (Mr. Bucshon), a colleague, friend, neighbor--our districts are 
joined on the Ohio River--who is a physician who understands these 
issues.
  Mr. BUCSHON. Mr. Speaker, I rise today as an original coauthor of 
this legislation, H.R. 1725. The reauthorization of NASPER would allow 
SAMHSA to provide grants to States for the establishment, 
implementation, and improvement of prescription drug-monitoring 
programs, or PDMPs, offering timely access to accurate prescription 
information for healthcare providers.
  As a physician, I understand this is critical to a provider's ability 
to screen and treat patients at risk for addiction.
  The NASPER program also promotes greater information sharing among 
States by requiring grantees to facilitate these monitoring programs 
with at least one bordering State while simultaneously protecting 
against unauthorized access to patient records.
  This reauthorization language would also encourage States to explore 
ways to incorporate access to their PDMPs into provider workflow 
systems, such as electronic health records and e-prescribing. Given the 
growing problem of prescription drug abuse, this is a commonsense 
measure to protect the public.
  I want to thank Mr. Whitfield, Mr. Kennedy, and Ranking Member 
Pallone for their work on this legislation.
  I urge all of my colleagues to support this important bill.
  Mr. GENE GREEN of Texas. Mr. Speaker, I have no further speakers.
  I yield back the balance of my time.
  Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
  I appreciate Mr. Whitfield, Dr. Bucshon, certainly Mr. Kennedy, and 
Mr. Pallone for bringing this forward. It is important. It is important 
to my State, and it is important to our neighboring States and citizens 
throughout this country.
  I urge my colleagues to vote for H.R. 1725.
  I yield back the balance of my time.
  Mr. PALLONE. Mr. Speaker, I am pleased to support H.R. 1725, the 
``National All Schedules Prescription Electronic Reporting (NASPER) 
Reauthorization Act,'' which helps States establish and maintain 
prescription drug monitoring programs in order to combat prescription 
drug abuse, a public health crisis affecting communities across the 
country. I have been a long-time champion of this bill with my 
colleague Representative Whitfield and I am pleased that 
Representatives Kennedy and Bucshon joined our efforts this Congress to 
reauthorize the NASPER program.
  Prescription drug monitoring programs help prescribers, pharmacists, 
and law enforcement track and prevent the misuse of prescription drugs. 
Forty nine states currently have laws authorizing these programs and 
they are playing a critical role in our efforts to combat the opioid 
crisis. This bill, however, once passed into law, will need funding and 
investment by appropriators in order to be effective. I urge Members to 
ensure that investment is met.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Kentucky (Mr. Guthrie) that the House suspend the rules 
and pass the bill, H.R. 1725, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________