[Congressional Record (Bound Edition), Volume 154 (2008), Part 4]
[Senate]
[Pages 4625-4630]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           TEXT OF AMENDMENTS

  SA 4381. Ms. MIKULSKI (for herself, Mr. Kennedy, and Mr. Harkin) 
submitted an amendment intended to be proposed by her to the bill H.R. 
3221, moving the United States toward greater energy independence and 
security, developing innovative new technologies, reducing carbon 
emissions, creating green jobs, protecting consumers, increasing clean 
renewable energy production, and modernizing our energy infrastructure, 
and to amend the Internal Revenue Code of 1986 to provide tax 
incentives for the production of renewable energy and energy 
conservation; which was ordered to lie on the table, as follows:

       On page 13, line 8, strike ``$200,000,000,000'' and insert 
     ``$237,500,000''.
       On page 13, line 13, strike the period and insert the 
     following: ``: Provided, That, of such amounts $37,500,000 
     shall be used by the Neighborhood Reinvestment Corporation 
     (referred to in this section as the `NRC') to (1) make grants 
     to counseling intermediaries approved by the Department of 
     Housing and

[[Page 4626]]

     Urban Development or the NRC to hire attorneys trained and 
     capable of assisting homeowners of owner-occupied homes with 
     mortgages in default, in danger of default, or subject to or 
     at risk of foreclosure who have legal issues that cannot be 
     handled by counselors already employed by such 
     intermediaries, and (2) support NRC partnerships with State 
     and local legal organizations and organizations described in 
     section 501(c)(3) of the Internal Revenue Code of 1986 and 
     exempt from tax under section 501(a) of that Code with 
     demonstrated relevant legal experience in home foreclosure 
     law, as such experience is determined by the Chief Executive 
     Officer of NRC: Provided further, That for the purpose of the 
     prior proviso the term `relevant experience' means experience 
     representing homeowners in negotiations and or legal 
     proceedings aimed at preventing or mitigating foreclosure or 
     providing legal research and technical legal expertise to 
     community based organizations whose goal is to reduce, 
     prevent, or mitigate foreclosure: Provided further, That of 
     the amounts provided for in the prior provisos the NRC shall 
     give priority consideration to counseling intermediaries and 
     legal organizations that (1) provide legal assistance in the 
     100 metropolitan statistical areas (as defined by the 
     Director of the Office of Management and Budget) with the 
     highest home foreclosure rates, and (2) have the capacity to 
     begin using the financial assistance within 90 days after 
     receipt of the assistance.''.
       On page 13, between lines 13 and 14, insert the following:

     SEC. 302. LEGAL ASSISTANCE RELATED TO HOME OWNERSHIP 
                   PRESERVATION AND FORECLOSURE PREVENTION.

       (a) Appropriation.--
       (1) In general.--There is authorized to be appropriated and 
     there is appropriated to the Legal Services Corporation 
     $37,500,000 to provide legal assistance related to home 
     ownership preservation, home foreclosure prevention, and 
     tenancy associated with home foreclosure.
       (2) Availability.--Such funds shall remain available until 
     expended.
       (b) Funding Requirements.--Each limitation on expenditures, 
     and each term or condition, that applies to funds 
     appropriated to the Legal Services Corporation under the 
     Commerce, Justice, Science, and Related Agencies 
     Appropriations Act, 2008, shall apply to funds appropriated 
     to the Corporation under subsection (a), except as provided 
     in subsections (a)(1) and (c).
       (c) Priority.--In providing financial assistance from the 
     funds appropriated under subsection (a), the Corporation 
     shall give priority to eligible entities and individuals 
     that--
       (1) provide legal assistance in the 100 metropolitan 
     statistical areas (as defined by the Director of the Office 
     of Management and Budget) with the highest home foreclosure 
     rates; and
       (2) have the capacity to begin using the financial 
     assistance within 90 days after receipt of the assistance.
                                 ______
                                 
  SA 4382. Mrs. LINCOLN (for herself, Mr. Smith, Mr. Kerry, Ms. 
Stabenow, and Mr. Levin) submitted an amendment intended to be proposed 
by her to the bill H.R. 3221, moving the United States toward greater 
energy independence and security, developing innovative new 
technologies, reducing carbon emissions, creating green jobs, 
protecting consumers, increasing clean renewable energy production, and 
modernizing our energy infrastructure, and to amend the Internal 
Revenue Code of 1986 to provide tax incentives for the production of 
renewable energy and energy conservation; which was ordered to lie on 
the table, as follows:

       At the end of title III add the following:

     SEC. 302. EXCLUSION FOR AMOUNTS RECEIVED UNDER QUALIFIED 
                   GROUP LEGAL SERVICES PLANS RESTORED, EXTENDED, 
                   AND MODIFIED.

       (a) Removal of Dollar Limitation.--Section 120(a) of the 
     Internal Revenue Code of 1986 (relating to exclusion by 
     employee for contributions and legal services provided by 
     employer) is amended by striking the last sentence.
       (b) Real Estate Matters Emphasized.--Section 120(c) of the 
     Internal Revenue Code of 1986 (relating to requirements) is 
     amended by adding at the end the following new paragraph:
       ``(6) Benefits.--The plan shall provide, at a minimum, 
     legal services for real estate matters relating to family or 
     personal residences, including document review of real estate 
     sales, purchases, closings, mortgages, and foreclosures.''.
       (c) Extension.--Section 120(e) of the Internal Revenue Code 
     of 1986 is amended to read as follows:
       ``(e) Application.--This section and section 501(c)(20) 
     shall apply to taxable years beginning after December 31, 
     2007, and before January 1, 2010.''.
       (d) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2007.
                                 ______
                                 
  SA 4383. Mr. NELSON of Florida (for Mrs. Feinstein (for herself, Mr. 
Sessions, Mr. Biden, Mr. Cornyn, Mr. Coleman, and Mr. Leahy) proposed 
an amendment to the bill S. 980, to amend the Controlled Substances Act 
to address online pharmacies; as follows:

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Ryan Haight Online Pharmacy 
     Consumer Protection Act of 2008''.

     SEC. 2. REQUIREMENT OF A VALID PRESCRIPTION FOR CONTROLLED 
                   SUBSTANCES DISPENSED BY MEANS OF THE INTERNET.

       Section 309 of the Controlled Substances Act (21 U.S.C. 
     829) is amended by adding at the end the following:
       ``(e) Controlled Substances Dispensed by Means of the 
     Internet.--
       ``(1) No controlled substance may be delivered, 
     distributed, or dispensed by means of the Internet without a 
     valid prescription.
       ``(2) As used in this subsection:
       ``(A) The term `valid prescription' means a prescription 
     that is issued for a legitimate medical purpose in the usual 
     course of professional practice by--
       ``(i) a practitioner who has conducted at least 1 in-person 
     medical evaluation of the patient; or
       ``(ii) a covering practitioner.
       ``(B)(i) The term `in-person medical evaluation' means a 
     medical evaluation that is conducted with the patient in the 
     physical presence of the practitioner, without regard to 
     whether portions of the evaluation are conducted by other 
     health professionals.
       ``(ii) Nothing in clause (i) shall be construed to imply 
     that 1 in-person medical evaluation demonstrates that a 
     prescription has been issued for a legitimate medical purpose 
     within the usual course of professional practice.
       ``(C) The term `covering practitioner' means, with respect 
     to a patient, a practitioner who conducts a medical 
     evaluation (other than an in-person medical evaluation) at 
     the request of a practitioner who--
       ``(i) has conducted at least 1 in-person medical evaluation 
     of the patient or an evaluation of the patient through the 
     practice of telemedicine, within the previous 24 months; and
       ``(ii) is temporarily unavailable to conduct the evaluation 
     of the patient.
       ``(3) Nothing in this subsection shall apply to--
       ``(A) the delivery, distribution, or dispensing of a 
     controlled substance by a practitioner engaged in the 
     practice of telemedicine; or
       ``(B) the dispensing or selling of a controlled substance 
     pursuant to practices as determined by the Attorney General 
     by regulation, which shall be consistent with effective 
     controls against diversion.''.

     SEC. 3. AMENDMENTS TO THE CONTROLLED SUBSTANCES ACT RELATING 
                   TO THE DELIVERY OF CONTROLLED SUBSTANCES BY 
                   MEANS OF THE INTERNET.

       (a) In General.--Section 102 of the Controlled Substances 
     Act (21 U.S.C. 802) is amended by adding at the end the 
     following:
       ``(50) The term `Internet' means collectively the myriad of 
     computer and telecommunications facilities, including 
     equipment and operating software, which comprise the 
     interconnected worldwide network of networks that employ the 
     Transmission Control Protocol/Internet Protocol, or any 
     predecessor or successor protocol to such protocol, to 
     communicate information of all kinds by wire or radio.
       ``(51) The term `deliver, distribute, or dispense by means 
     of the Internet' refers, respectively, to any delivery, 
     distribution, or dispensing of a controlled substance that is 
     caused or facilitated by means of the Internet.
       ``(52) The term `online pharmacy'--
       ``(A) means a person, entity, or Internet site, whether in 
     the United States or abroad, that knowingly or intentionally 
     delivers, distributes, or dispenses, or offers or attempts to 
     deliver, distribute, or dispense, a controlled substance by 
     means of the Internet; and
       ``(B) does not include--
       ``(i) manufacturers or distributors registered under 
     subsection (a), (b), (c), or (d) of section 303 who do not 
     dispense controlled substances to an unregistered individual 
     or entity;
       ``(ii) nonpharmacy practitioners who are registered under 
     section 303(f) and whose activities are authorized by that 
     registration;
       ``(iii) any hospital or other medical facility that is 
     operated by an agency of the United States (including the 
     Armed Forces), provided such hospital or other facility is 
     registered under section 303(f);
       ``(iv) a health care facility owned or operated by an 
     Indian tribe or tribal organization, only to the extent such 
     facility is carrying out a contract or compact under the 
     Indian Self-Determination and Education Assistance Act (25 
     U.S.C. 450 et seq.);
       ``(v) any agent or employee of any hospital or facility 
     referred to in clause (iii) or (iv), provided such agent or 
     employee is lawfully acting in the usual course of business 
     or employment, and within the scope of the official duties of 
     such agent or employee, with

[[Page 4627]]

     such hospital or facility, and, with respect to agents or 
     employees of health care facilities specified in clause (iv), 
     only to the extent such individuals are furnishing services 
     pursuant to the contracts or compacts described in such 
     clause;
       ``(vi) mere advertisements that do not attempt to 
     facilitate an actual transaction involving a controlled 
     substance;
       ``(vii) a person, entity, or Internet site that is not in 
     the United States and does not facilitate the delivery, 
     distribution, or dispensing of a controlled substance by 
     means of the Internet to any person in the United States;
       ``(viii) a pharmacy registered under section 303(f) whose 
     dispensing of controlled substances via the Internet consists 
     solely of--

       ``(I) `refilling prescriptions for controlled substances in 
     schedule III, IV, or V', as defined in paragraph (55); or
       ``(II) `filling new prescriptions for controlled substances 
     in schedule III, IV, or V', as defined in paragraph (56); or

       ``(ix) any other persons for whom the Attorney General and 
     the Secretary have jointly, by regulation, found it to be 
     consistent with effective controls against diversion and 
     otherwise consistent with the public health and safety to 
     exempt from the definition of an `online pharmacy'.
       ``(53) The term `homepage' means the opening or main page 
     or screen of the website of an online pharmacy that is 
     viewable on the Internet.
       ``(54) The term `practice of telemedicine' means, for 
     purposes of this title, the practice of medicine in 
     accordance with applicable Federal and State laws by a 
     practitioner (other than a pharmacist) who is at a location 
     remote from the patient and is communicating with the 
     patient, or health care professional who is treating the 
     patient, using a telecommunications system referred to in 
     section 1834(m) of the Social Security Act (42 U.S.C. 
     1395m(m)), and that--
       ``(A) is being conducted--
       ``(i) while the patient is being treated by, and physically 
     located in, a hospital or clinic registered under section 
     303(f); and
       ``(ii) by a practitioner--

       ``(I) acting in the usual course of professional practice;
       ``(II) acting in accordance with applicable State law; and
       ``(III) registered under section 303(f) in the State in 
     which the patient is located, unless the practitioner--

       ``(aa) is exempted from such registration in all States 
     under section 302(d); or
       ``(bb) is--
       ``(AA) an employee or contractor of the Department of 
     Veterans Affairs who is acting in the scope of such 
     employment or contract; and
       ``(BB) registered under section 303(f) in any State or is 
     utilizing the registration of a hospital or clinic operated 
     by the Department of Veterans Affairs registered under 
     section 303(f);
       ``(B) is being conducted while the patient is being treated 
     by, and in the physical presence of, a practitioner--
       ``(i) acting in the usual course of professional practice;
       ``(ii) acting in accordance with applicable State law; and
       ``(iii) registered under section 303(f) in the State in 
     which the patient is located, unless the practitioner--

       ``(I) is exempted from such registration in all States 
     under section 302(d); or
       ``(II) is--

       ``(aa) an employee or contractor of the Department of 
     Veterans Affairs who is acting in the scope of such 
     employment or contract; and
       ``(bb) registered under section 303(f) in any State or is 
     using the registration of a hospital or clinic operated by 
     the Department of Veterans Affairs registered under section 
     303(f);
       ``(C) is being conducted by a practitioner--
       ``(i) who is an employee or contractor of the Indian Health 
     Service, or is working for an Indian tribe or tribal 
     organization under its contract or compact with the Indian 
     Health Service under the Indian Self-Determination and 
     Education Assistance Act (25 U.S.C. 450 et seq.);
       ``(ii) acting within the scope of the employment, contract, 
     or compact described in clause (i); and
       ``(iii) who is designated as an Internet Eligible 
     Controlled Substances Provider by the Secretary under section 
     311(g)(2);
       ``(D)(i) is being conducted during a public health 
     emergency declared by the Secretary under section 319 of the 
     Public Health Service Act (42 U.S.C. 247d); and
       ``(ii) involves patients located in such areas, and such 
     controlled substances, as the Secretary, with the concurrence 
     of the Attorney General, designates, provided that such 
     designation shall not be subject to the procedures prescribed 
     by subchapter II of chapter 5 of title 5, United States Code;
       ``(E) is being conducted by a practitioner who has obtained 
     from the Attorney General a special registration under 
     section 311(h);
       ``(F) is being conducted--
       ``(i) in a medical emergency situation--

       ``(I) that prevents the patient from being in the physical 
     presence of a practitioner registered under section 303(f) 
     who is an employee or contractor of the Veterans Health 
     Administration acting in the usual course of business and 
     employment and within the scope of the official duties or 
     contract of that employee or contractor;
       ``(II) that prevents the patient from being physically 
     present at a hospital or clinic operated by the Department of 
     Veterans Affairs registered under section 303(f);
       ``(III) during which the primary care practitioner of the 
     patient or a practitioner otherwise practicing telemedicine 
     within the meaning of this paragraph is unable to provide 
     care or consultation; and
       ``(IV) that requires immediate intervention by a health 
     care practitioner using controlled substances to prevent what 
     the practitioner reasonably believes in good faith will be 
     imminent and serious clinical consequences, such as further 
     injury or death; and

       ``(ii) by a practitioner that--

       ``(I) is an employee or contractor of the Veterans Health 
     Administration acting within the scope of that employment or 
     contract;
       ``(II) is registered under section 303(f) in any State or 
     is utilizing the registration of a hospital or clinic 
     operated by the Department of Veterans Affairs registered 
     under section 303(f); and
       ``(III) issues a controlled substance prescription in this 
     emergency context that is limited to a maximum of a 5-day 
     supply which may not be extended or refilled; or

       ``(G) is being conducted under any other circumstances that 
     the Attorney General and the Secretary have jointly, by 
     regulation, determined to be consistent with effective 
     controls against diversion and otherwise consistent with the 
     public health and safety.
       ``(55) The term `refilling prescriptions for controlled 
     substances in schedule III, IV, or V'--
       ``(A) means the dispensing of a controlled substance in 
     schedule III, IV, or V in accordance with refill instructions 
     issued by a practitioner as part of a valid prescription that 
     meets the requirements of subsection (b) or (c) of section 
     309, as appropriate; and
       ``(B) does not include the issuance of a new prescription 
     to an individual for a controlled substance that individual 
     was previously prescribed.
       ``(56) The term `filling new prescriptions for controlled 
     substances in schedule III, IV, or V' means a prescription 
     for an individual for a controlled substance in schedule III, 
     IV, or V, if--
       ``(A) the pharmacy dispensing that prescription has 
     previously dispensed to the patient that same controlled 
     substance other than by means of the Internet and pursuant to 
     the valid prescription of a practitioner that meets the 
     applicable requirements of sections 309(b) or (c) (in this 
     paragraph referred to as the `original prescription');
       ``(B) the pharmacy contacts the practitioner who issued the 
     original prescription at the request of that individual to 
     determine whether the practitioner will authorize the 
     issuance of a new prescription for that individual for the 
     controlled substance described in subparagraph (A); and
       ``(C) the practitioner, acting in the usual course of 
     professional practice, determines there is a legitimate 
     medical purpose for the issuance of the new prescription.''.
       (b) Registration Requirements.--Section 303(f) of the 
     Controlled Substances Act (21 U.S.C. 823(f)) is amended in 
     the matter preceding paragraph (1)--
       (1) in the first sentence, by adding after ``schedule II, 
     III, IV, or V'' the following: ``and shall modify the 
     registrations of pharmacies so registered to authorize them 
     to dispense controlled substances by means of the Internet''; 
     and
       (2) in the second sentence, by striking ``if he determines 
     that the issuance of such registration'' and inserting ``or 
     such modification of registration if the Attorney General 
     determines that the issuance of such registration or 
     modification''.
       (c) Reporting Requirements.--Section 307(d) of the 
     Controlled Substances Act (21 U.S.C. 827(d)) is amended by--
       (1) designating the text as paragraph (1); and
       (2) inserting after paragraph (1), as so designated by this 
     Act, the following:
       ``(2) Each pharmacy with a modified registration under 
     section 303(f) that authorizes the dispensing of controlled 
     substances by means of the Internet shall report to the 
     Attorney General the controlled substances it dispenses, in 
     the amount specified, and in such time and manner as the 
     Attorney General by regulation shall require, except that the 
     Attorney General, under this paragraph, may not require any 
     pharmacy to report any information other than the total 
     quantity of each controlled substance that the pharmacy has 
     dispensed each month. For purposes of this subsection, no 
     reporting shall be required unless the pharmacy has met 1 of 
     the following thresholds in the month for which the reporting 
     is required:
       ``(A) 100 or more prescriptions dispensed.
       ``(B) 5,000 or more dosage units of all controlled 
     substances combined.''.
       (d) Online Prescription Requirements.--
       (1) In general.--The Controlled Substances Act is amended 
     by inserting after section 310 (21 U.S.C. 830) the following:


      ``additional requirements relating to online pharmacies and 
                              telemedicine

       ``Sec. 311.  (a) In General.--An online pharmacy shall 
     display in a visible and clear manner on its homepage a 
     statement that it

[[Page 4628]]

     complies with the requirements of this section with respect 
     to the delivery or sale or offer for sale of controlled 
     substances and shall at all times display on the homepage of 
     its Internet site a declaration of compliance in accordance 
     with this section.
       ``(b) Licensure.--Each online pharmacy shall comply with 
     the requirements of State law concerning the licensure of 
     pharmacies in each State from which it, and in each State to 
     which it, delivers, distributes, or dispenses or offers to 
     deliver, distribute, or dispense controlled substances by 
     means of the Internet, pursuant to applicable licensure 
     requirements, as determined by each such State.
       ``(c) Internet Pharmacy Site Disclosure Information.--Each 
     online pharmacy shall post in a visible and clear manner on 
     the homepage of each Internet site it operates, or on a page 
     directly linked thereto in which the hyperlink is also 
     visible and clear on the homepage, the following information 
     for each pharmacy that delivers, distributes, or dispenses 
     controlled substances pursuant to orders made on, through, or 
     on behalf of, that website:
       ``(1) The name and address of the pharmacy as it appears on 
     the pharmacy's Drug Enforcement Administration certificate of 
     registration.
       ``(2) The pharmacy's telephone number and email address.
       ``(3) The name, professional degree, and States of 
     licensure of the pharmacist-in-charge, and a telephone number 
     at which the pharmacist-in-charge can be contacted.
       ``(4) A list of the States in which the pharmacy is 
     licensed to dispense controlled substances.
       ``(5) A certification that the pharmacy is registered under 
     this part to deliver, distribute, or dispense by means of the 
     Internet controlled substances.
       ``(6) The name, address, telephone number, professional 
     degree, and States of licensure of any practitioner who has a 
     contractual relationship to provide medical evaluations or 
     issue prescriptions for controlled substances, through 
     referrals from the website or at the request of the owner or 
     operator of the website, or any employee or agent thereof.
       ``(7) The following statement, unless revised by the 
     Attorney General by regulation: `This online pharmacy will 
     only dispense a controlled substance to a person who has a 
     valid prescription issued for a legitimate medical purpose 
     based upon a medical relationship with a prescribing 
     practitioner. This includes at least one prior in-person 
     medical evaluation or medical evaluation via telemedicine in 
     accordance with applicable requirements of section 309 of the 
     Controlled Substances Act (21 U.S.C. 829).'.
       ``(d) Notification.--(1) Thirty days prior to offering a 
     controlled substance for sale, delivery, distribution, or 
     dispensing, the online pharmacy shall notify the Attorney 
     General, in the form and manner as the Attorney General shall 
     determine, and the State boards of pharmacy in any States in 
     which the online pharmacy offers to sell, deliver, 
     distribute, or dispense controlled substances.
       ``(2) The notification required under paragraph (1) shall 
     include--
       ``(A) the information required to be posted on the online 
     pharmacy's Internet site under subsection (c) and shall 
     notify the Attorney General and the applicable State boards 
     of pharmacy, under penalty of perjury, that the information 
     disclosed on its Internet site under subsection (c) is true 
     and accurate;
       ``(B) the online pharmacy's Internet site address and a 
     certification that the online pharmacy shall notify the 
     Attorney General of any change in the address at least 30 
     days in advance; and
       ``(C) the Drug Enforcement Administration registration 
     numbers of any pharmacies and practitioners referred to in 
     subsection (c), as applicable.
       ``(3) An online pharmacy that is already operational as of 
     the effective date of this section, shall notify the Attorney 
     General and applicable State boards of pharmacy in accordance 
     with this subsection not later than 30 days after the 
     effective date of this section.
       ``(e) Declaration of Compliance.--On and after the date on 
     which it makes the notification under subsection (d), each 
     online pharmacy shall display on the homepage of its Internet 
     site, in such form as the Attorney General shall by 
     regulation require, a declaration that it has made such 
     notification to the Attorney General.
       ``(f) Reports.--Any statement, declaration, notification, 
     or disclosure required under this section shall be considered 
     a report required to be kept under this part.
       ``(g) Notice and Designations Concerning Indian Tribes.--
       ``(1) In general.--For purposes of sections 102(52) and 
     512(c)(6)(B), the Secretary shall notify the Attorney 
     General, at such times and in such manner as the Secretary 
     and the Attorney General determine appropriate, of the Indian 
     tribes or tribal organizations with which the Secretary has 
     contracted or compacted under the Indian Self-Determination 
     and Education Assistance Act (25 U.S.C. 450 et seq.) for the 
     tribes or tribal organizations to provide pharmacy services.
       ``(2) Designations.--
       ``(A) In general.--The Secretary may designate a 
     practitioner described in subparagraph (B) as an Internet 
     Eligible Controlled Substances Provider. Such designations 
     shall be made only in cases where the Secretary has found 
     that there is a legitimate need for the practitioner to be so 
     designated because the population served by the practitioner 
     is in a sufficiently remote location that access to medical 
     services is limited.
       ``(B) Practitioners.--A practitioner described in this 
     subparagraph is a practitioner who is an employee or 
     contractor of the Indian Health Service, or is working for an 
     Indian tribe or tribal organization under its contract or 
     compact under the Indian Self-Determination and Education 
     Assistance Act (25 U.S.C. 450 et seq.) with the Indian Health 
     Service.
       ``(h) Special Registration for Telemedicine.--
       ``(1) In general.--The Attorney General may issue to a 
     practitioner a special registration to engage in the practice 
     of telemedicine for purposes of section 102(54)(E) if the 
     practitioner, upon application for such special 
     registration--
       ``(A) demonstrates a legitimate need for the special 
     registration; and
       ``(B) is registered under section 303(f) in the State in 
     which the patient will be located when receiving the 
     telemedicine treatment, unless the practitioner--
       ``(i) is exempted from such registration in all States 
     under section 302(d); or
       ``(ii) is an employee or contractor of the Department of 
     Veterans Affairs who is acting in the scope of such 
     employment or contract and is registered under section 303(f) 
     in any State or is utilizing the registration of a hospital 
     or clinic operated by the Department of Veterans Affairs 
     registered under section 303(f).
       ``(2) Regulations.--The Attorney General shall, with the 
     concurrence of the Secretary, promulgate regulations 
     specifying the limited circumstances in which a special 
     registration under this subsection may be issued and the 
     procedures for obtaining such a special registration.
       ``(3) Denials.--Proceedings to deny an application for 
     registration under this subsection shall be conducted in 
     accordance with section 304(c).
       ``(i) Reporting of Telemedicine by VHA During Medical 
     Emergency Situations.--
       ``(1) In general.--Any practitioner issuing a prescription 
     for a controlled substance under the authorization to conduct 
     telemedicine during a medical emergency situation described 
     in section 102(54)(F) shall report to the Secretary of 
     Veterans Affairs the authorization of that emergency 
     prescription, in accordance with such requirements as the 
     Secretary of Veterans Affairs shall, by regulation, 
     establish.
       ``(2) To attorney general.--Not later than 30 days after 
     the date that a prescription described in subparagraph (A) is 
     issued, the Secretary of Veterans Affairs shall report to the 
     Attorney General the authorization of that emergency 
     prescription.
       ``(j) Clarification Concerning Prescription Transfers.--Any 
     transfer between pharmacies of information relating to a 
     prescription for a controlled substance shall meet the 
     applicable requirements under regulations promulgated by the 
     Attorney General under this Act.''.
       (2) Technical and conforming amendments.--The table of 
     contents for the Comprehensive Drug Abuse Prevention and 
     Control Act of 1970 (Public Law 91-513; 84 Stat. 1236) is 
     amended by inserting after the item relating to section 310 
     the following:

``Sec. 311. Additional requirements relating to online pharmacies and 
              telemedicine.''.
       (e) Offenses Involving Controlled Substances in Schedules 
     III, IV, and V.--Section 401(b) of the Controlled Substances 
     Act (21 U.S.C. 841(b)) is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (C), by striking ``1 gram of'' before 
     ``flunitrazepam'';
       (B) in subparagraph (D), by striking ``or in the case of 
     any controlled substance in schedule III (other than gamma 
     hydroxybutyric acid), or 30 milligrams of flunitrazepam''; 
     and
       (C) by adding at the end the following:
       ``(E)(i) In the case of any controlled substance in 
     schedule III, such person shall be sentenced to a term of 
     imprisonment of not more than 10 years and if death or 
     serious bodily injury results from the use of such substance 
     shall be sentenced to a term of imprisonment of not more than 
     20 years, a fine not to exceed the greater of that authorized 
     in accordance with the provisions of title 18, United States 
     Code, or $500,000 if the defendant is an individual or 
     $2,500,000 if the defendant is other than an individual, or 
     both.
       ``(ii) If any person commits such a violation after a prior 
     conviction for a felony drug offense has become final, such 
     person shall be sentenced to a term of imprisonment of not 
     more than 20 years and if death or serious bodily injury 
     results from the use of such substance shall be sentenced to 
     a term of imprisonment of not more than 30 years, a fine not 
     to exceed the greater of twice that authorized in accordance 
     with the provisions of title 18, United States Code, or 
     $1,000,000 if the defendant is an individual or $5,000,000 if 
     the defendant is other than an individual, or both.
       ``(iii) Any sentence imposing a term of imprisonment under 
     this subparagraph shall, in

[[Page 4629]]

     the absence of such a prior conviction, impose a term of 
     supervised release of at least 2 years in addition to such 
     term of imprisonment and shall, if there was such a prior 
     conviction, impose a term of supervised release of at least 4 
     years in addition to such term of imprisonment.'';
       (2) in paragraph (2)--
       (A) by striking ``3 years'' and inserting ``5 years'';
       (B) by striking ``6 years'' and inserting ``10 years'';
       (C) by striking ``after one or more prior convictions'' and 
     all that follows through ``have become final,'' and inserting 
     ``after a prior conviction for a felony drug offense has 
     become final,''; and
       (3) in paragraph (3)--
       (A) by striking ``2 years'' and inserting ``6 years'';
       (B) by striking ``after one or more convictions'' and all 
     that follows through ``have become final,'' and inserting 
     ``after a prior conviction for a felony drug offense has 
     become final,''; and
       (C) by adding at the end the following ``Any sentence 
     imposing a term of imprisonment under this paragraph may, if 
     there was a prior conviction, impose a term of supervised 
     release of not more than 1 year, in addition to such term of 
     imprisonment.''.
       (f) Offenses Involving Dispensing of Controlled Substances 
     by Means of the Internet.--Section 401 of the Controlled 
     Substances Act (21 U.S.C. 841) is amended by adding at the 
     end the following:
       ``(g) Offenses Involving Dispensing of Controlled 
     Substances by Means of the Internet.--(1) It shall be 
     unlawful for any person to knowingly or intentionally--
       ``(A) deliver, distribute, or dispense a controlled 
     substance by means of the Internet, except as authorized by 
     this title; or
       ``(B) aid or abet (as such terms are used in section 2 of 
     title 18, United States Code) any activity described in 
     subparagraph (A) that is not authorized by this title.
       ``(2) Examples of activities that violate paragraph (1) 
     include, but are not limited to, knowingly or intentionally--
       ``(A) delivering, distributing, or dispensing a controlled 
     substance by means of the Internet by an online pharmacy that 
     is not validly registered with a modification authorizing 
     such activity as required by section 303(f) (unless exempt 
     from such registration);
       ``(B) writing a prescription for a controlled substance for 
     the purpose of delivery, distribution, or dispensation by 
     means of the Internet in violation of section 309(e);
       ``(C) serving as an agent, intermediary, or other entity 
     that causes the Internet to be used to bring together a buyer 
     and seller to engage in the dispensing of a controlled 
     substance in a manner not authorized by sections 303(f) or 
     309(e);
       ``(D) offering to fill a prescription for a controlled 
     substance based solely on a consumer's completion of an 
     online medical questionnaire; and
       ``(E) making a material false, fictitious, or fraudulent 
     statement or representation in the submission to the Attorney 
     General under section 311.
       ``(3)(A) This subsection does not apply to--
       ``(i) the delivery, distribution, or dispensation of 
     controlled substances by nonpractitioners to the extent 
     authorized by their registration under this title;
       ``(ii) the placement on the Internet of material that 
     merely advocates the use of a controlled substance or 
     includes pricing information without attempting to propose or 
     facilitate an actual transaction involving a controlled 
     substance; or
       ``(iii) except as provided in subparagraph (B), any 
     activity that is limited to--
       ``(I) the provision of a telecommunications service, or of 
     an Internet access service or Internet information location 
     tool (as those terms are defined in section 231 of the 
     Communications Act of 1934 (47 U.S.C. 231)); or
       ``(II) the transmission, storage, retrieval, hosting, 
     formatting, or translation (or any combination thereof) of a 
     communication, without selection or alteration of the content 
     of the communication, except that deletion of a particular 
     communication or material made by another person in a manner 
     consistent with section 230(c) of the Communications Act of 
     1934 (47 U.S.C. 230(c)) shall not constitute such selection 
     or alteration of the content of the communication.
       ``(B) The exceptions under subclauses (I) and (II) of 
     subparagraph (A)(iii) shall not apply to a person acting in 
     concert with a person who violates paragraph (1).
       ``(4) Any person who knowingly or intentionally violates 
     this subsection shall be sentenced in accordance with 
     subsection (b) of this section.''.
       (g) Publication.--Section 403(c) of the Controlled 
     Substances Act (21 U.S.C. 843(c)) is amended by--
       (1) designating the text as paragraph (1); and
       (2) adding at the end the following:
       ``(2)(A) Except as authorized by this title, it shall be 
     unlawful for any person by means of the Internet to knowingly 
     advertise the sale or distribution of, or to offer to sell, 
     distribute, or dispense, a controlled substance.
       ``(B) Examples of activities that violate subparagraph (A) 
     include, but are not limited to, knowingly or intentionally 
     causing the placement on the Internet of an advertisement 
     that refers to or directs prospective buyers to Internet 
     sellers of controlled substances who are not registered with 
     a modification under section 303(f).
       ``(C) Subparagraph (A) does not apply to material that 
     either--
       ``(i) merely advertises the distribution of controlled 
     substances by nonpractitioners to the extent authorized by 
     their registration under this title; or
       ``(ii) merely advocates the use of a controlled substance 
     or includes pricing information without attempting to 
     facilitate an actual transaction involving a controlled 
     substance.''.
       (h) Injunctive Relief.--Section 512 of the Controlled 
     Substances Act (21 U.S.C. 882) is amended by adding at the 
     end the following:
       ``(c) State Cause of Action Pertaining to Online 
     Pharmacies.--(1) In any case in which the State has reason to 
     believe that an interest of the residents of that State has 
     been or is being threatened or adversely affected by the 
     action of a person, entity, or Internet site that violates 
     the provisions of section 303(f), 309(e), or 311, the State 
     may bring a civil action on behalf of such residents in a 
     district court of the United States with appropriate 
     jurisdiction--
       ``(A) to enjoin the conduct which violates this section;
       ``(B) to enforce compliance with this section;
       ``(C) to obtain damages, restitution, or other 
     compensation, including civil penalties under section 402(b); 
     and
       ``(D) to obtain such other legal or equitable relief as the 
     court may find appropriate.
       ``(2)(A) Prior to filing a complaint under paragraph (1), 
     the State shall serve a copy of the complaint upon the 
     Attorney General and upon the United States Attorney for the 
     judicial district in which the complaint is to be filed. In 
     any case where such prior service is not feasible, the State 
     shall serve the complaint on the Attorney General and the 
     appropriate United States Attorney on the same day that the 
     State's complaint is filed in Federal district court of the 
     United States. Such proceedings shall be independent of, and 
     not in lieu of, criminal prosecutions or any other 
     proceedings under this title or any other laws of the United 
     States.
       ``(B) Upon receiving notice respecting a civil action 
     pursuant to this section, the United States shall have the 
     right to intervene in such action, upon so intervening, to be 
     heard on all matters arising therein, and to file petitions 
     for appeal.
       ``(C) Service of a State's complaint on the United States 
     as required in this paragraph shall be made in accord with 
     the requirements of rule 4(i)(1) of the Federal Rule of Civil 
     Procedure.
       ``(3) For purposes of bringing any civil action under 
     paragraph (1), nothing in this Act shall prevent an attorney 
     general of a State from exercising the powers conferred on 
     the attorney general of a State by the laws of such State to 
     conduct investigations or to administer oaths or affirmations 
     or to compel the attendance of witnesses of or the production 
     of documentary or other evidence.
       ``(4) 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 
     action may be served in any district in which the defendant 
     is an inhabitant or in which the defendant may be found.
       ``(5) No private right of action is created under this 
     subsection.
       ``(6) No civil action may be brought under paragraph (1) 
     against--
       ``(A) the United States;
       ``(B) an Indian Tribe or tribal organization, to the extent 
     such tribe or tribal organization is lawfully carrying out a 
     contract or compact under the Indian Self-Determination and 
     Education Assistance Act; or
       ``(C) any employee of the United States or such Indian 
     tribe or tribal organization, provided such agent or employee 
     is acting in the usual course of business or employment, and 
     within the scope of the official duties of such agent or 
     employee therewith.''.
       (i) Forfeiture of Facilitating Property in Drug Cases.--
     Section 511(a)(4) of the Controlled Substances Act (21 U.S.C. 
     881(a)(4)) is amended to read as follows:
       ``(4) Any property, real or personal, tangible or 
     intangible, used or intended to be used to commit, or to 
     facilitate the commission, of a violation of this title or 
     title III, and any property traceable thereto.''.
       (j) Import and Export Act.--Section 1010(b) of the 
     Controlled Substances Import and Export Act (21 U.S.C. 
     960(b)) is amended--
       (1) in paragraph (4)--
       (A) by striking ``or any quantity of a controlled substance 
     in schedule III, IV, or V, (except a violation involving 
     flunitrazepam and except a violation involving gamma 
     hydroxybutyric acid)'';
       (B) by inserting ``, or'' before ``less than one kilogram 
     of hashish oil''; and
       (C) striking ``imprisoned'' and all that follows through 
     the end of the paragraph and inserting ``sentenced in 
     accordance with section 401(b)(1)(D) of this title (21 U.S.C. 
     841(b)(1)(E)).'';
       (2) by adding at the end the following:
       ``(5) In the case of a violation of subsection (a) of this 
     section involving a controlled substance in schedule III, 
     such person shall be

[[Page 4630]]

     sentenced in accordance with section 401(b)(1)(E).
       ``(6) In the case of a violation of subsection (a) of this 
     section involving a controlled substance in schedule IV 
     (except a violation involving flunitrazepam), such person 
     shall be sentenced in accordance with section 401(b)(2).
       ``(7) In the case of a violation of subsection (a) of this 
     section involving a controlled substance in schedule V, such 
     person shall be sentenced in accordance with section 
     401(b)(3).''; and
       (3) in paragraph (3), by striking ``, nor shall a person so 
     sentenced be eligible for parole during the term of such a 
     sentence'' in the final sentence.
       (k) Effective Date.--
       (1) In general.--Except as provided in paragraph (2), the 
     amendments made by this Act shall take effect 180 days after 
     the date of enactment of this Act.
       (2) Definition of practice of telemedicine.--
       (A) In general.--Until the earlier of 3 months after the 
     date on which regulations are promulgated to carry out 
     section 311(h) of the Controlled Substances Act, as amended 
     by this Act, or 15 months after the date of enactment of this 
     Act--
       (i) the definition of the term ``practice of telemedicine'' 
     in subparagraph (B) of this paragraph shall apply for 
     purposes of the Controlled Substances Act; and
       (ii) the definition of the term ``practice of 
     telemedicine'' in section 102(54) of the Controlled 
     Substances Act, as amended by this Act, shall not apply.
       (B) Temporary phase-in of telemedicine regulation.--During 
     the period specified in subparagraph (A), the term ``practice 
     of telemedicine'' means the practice of medicine in 
     accordance with applicable Federal and State laws by a 
     practitioner (as that term is defined in section 102 of the 
     Controlled Substances Act (21 U.S.C. 802)) (other than a 
     pharmacist) who is at a location remote from the patient and 
     is communicating with the patient, or health care 
     professional who is treating the patient, using a 
     telecommunications system referred to in section 1834(m) of 
     the Social Security Act (42 U.S.C. 1395m(m)), if the 
     practitioner is using an interactive telecommunications 
     system that satisfies the requirements of section 
     410.78(a)(3) of title 42, Code of Federal Regulations.
       (C) Rule of construction.--Nothing in this subsection may 
     be construed to create a precedent that any specific course 
     of conduct constitutes the ``practice of telemedicine'' (as 
     that term is defined in section 102(54) of the Controlled 
     Substances Act, as amended by this Act) after the end of the 
     period specified in subparagraph (A).
       (l) Guidelines and Regulations.--
       (1) In general.--The Attorney General may promulgate and 
     enforce any rules, regulations, and procedures which may be 
     necessary and appropriate for the efficient execution of 
     functions under this Act or the amendments made by this Act, 
     and, with the concurrence of the Secretary of Health and 
     Human Services where this Act or the amendments made by this 
     Act so provides, promulgate any interim rules necessary for 
     the implementation of this Act or the amendments made by this 
     Act, prior to its effective date.
       (2) Sentencing guidelines.--The United States Sentencing 
     Commission, in determining whether to amend, or establish 
     new, guidelines or policy statements, to conform the Federal 
     sentencing guidelines and policy statements to this Act and 
     the amendments made by this Act--
       (A) shall consult with the Department of Justice, experts 
     and other affected parties concerning which penalties for 
     scheduled substances amended by this Act should be reflected 
     in the Federal sentencing guidelines; and
       (B) should not construe any change in the maximum penalty 
     for a violation involving a controlled substance in a 
     particular schedule as being the sole reason to amend a, or 
     establish a new, guideline or policy statement.
       (m) Annual Report.--Not later than 180 days after the date 
     of enactment of this Act, and annually for 2 years after the 
     initial report, the Drug Enforcement Administration, in 
     consultation with the Department of State, shall submit to 
     Congress a report describing--
       (1) the foreign supply chains and sources of controlled 
     substances offered for sale without a valid prescription on 
     the Internet;
       (2) the efforts and strategy of the Drug Enforcement 
     Administration to decrease the foreign supply chain and 
     sources of controlled substances offered for sale without a 
     valid prescription on the Internet; and
       (3) the efforts of the Drug Enforcement Administration to 
     work with domestic and multinational pharmaceutical companies 
     and others to build international cooperation and a 
     commitment to fight on a global scale the problem of 
     distribution of controlled substances over the Internet 
     without a valid prescription.

     SEC. 4. RULE OF CONSTRUCTION.

       Nothing in this Act or the amendments made by this Act 
     shall be construed as authorizing, prohibiting, or limiting 
     the use of electronic prescriptions for controlled 
     substances.

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