[Congressional Record (Bound Edition), Volume 156 (2010), Part 15]
[Senate]
[Pages 23518-23519]
[From the U.S. Government Publishing Office, www.gpo.gov]




                       CONTROLLED SUBSTANCES ACT

  Mr. KOHL. Mr. President, the basic outline of legislative changes to 
the Controlled Substances Act that we expect to receive from the 
Department of Justice are as follows:

       The legislation will deem certain nurses or other licensed 
     health care professionals, who are designated by the nursing 
     home as agents of DEA-licensed practitioners (practitioners 
     being the resident's attending physician or specialist), as 
     authorized to transmit the practitioner's order for a 
     controlled substance, specifically Schedule II drugs, to DEA-
     licensed pharmacies, either orally or by fax. The nursing 
     home, while not licensed by DEA, will be responsible for 
     designating those who are authorized to transmit a 
     practitioner's order, and for making a list of such 
     authorized agents available to the pharmacy.
       Whenever oral or faxed orders for controlled substances 
     come in from authorized agents, pharmacies will be required 
     to verify, based on the nursing home's list, that the nurse 
     is authorized to call or fax in the practitioner's order. 
     This chain-of-accountability process will allow the 
     practitioner to give oral instructions for ordering a 
     controlled substance to the resident's nurse over the phone. 
     In addition, practitioners will be permitted to opt out with 
     certain employees, should a practitioner have a problem with 
     a particular nurse or designee.
       Both practitioners and the nursing home will be required to 
     keep written logs, or records, of such oral (or faxed) orders 
     that are submitted by nurses. The nursing home will be 
     further required to keep the list of authorized nurses 
     current and to immediately notify the pharmacy of any changes 
     in this list. Nurses or other licensed health care 
     professionals who are authorized as agents by the nursing 
     home will be required to formally acknowledge their 
     responsibility for ordering and administering controlled

[[Page 23519]]

     substances by accepting liability in terms of certain 
     penalties that would apply under the Controlled Substances 
     Act if they engage in diversion or other unacceptable 
     practices.
       Pharmacies will also be required to maintain logs, or 
     records, of the orders that are placed by authorized nurse 
     agents. Pharmacies will be further required to make telephone 
     (or fax) contact with the resident's practitioner, under 
     whose authority the controlled substances were ordered, 
     within 48 hours of the time that the authorized agent 
     transmits the order. The pharmacy will then be required to 
     verify, and record, that the practitioner ordered a 
     controlled substance. The practitioner will also be required 
     to provide a written prescription to the pharmacy for the 
     controlled substance within 10 days of the time that the 
     authorized nurse agent transmits the order. Additional 
     reasonable safeguards may be included.

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