National All Schedules Prescription Electronic Reporting Act of 2005

NATIONAL ALL SCHEDULES PRESCRIPTION ELECTRONIC REPORTING ACT OF 2005 -- (House of Representatives - July 27, 2005)

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Mr. MARKEY. Mr. Speaker, I rise to express my strong concerns about the lack of adequate patient privacy protections in H.R. 1132--the National All Schedules Prescription Electronic Reporting, NASPER, Act of 2005. H.R. 1132 is being considered on the House Floor under suspension of the rules; therefore it cannot be amended. Because of the absence of urgently needed patient privacy safeguards, I oppose this bill, and I urge my colleagues to vote no on this legislation.

H.R. 1132 is intended to support States' efforts to prevent the abuse of certain controlled substances through the provision of Federal grants to the States for the purpose of establishing and implementing controlled substance monitoring programs. States would use the grants to develop and maintain an electronic database containing information about the type of medication prescribed, quantity dispensed, number of refills, and similar product information. The database also would collect personal information about each patient receiving prescriptions of the covered controlled substances, such as the patient's name, address and telephone number.

The abuse of controlled substances such as oxycontin and amphetamines is a serious problem that plagues many Americans. In response to the seriousness of the problem of prescription drug abuse, more than 20 States, including Massachusetts, have taken steps to prevent such abuse through the establishment of reporting requirements on pharmacists and the creation of drug monitoring databases similar to those contemplated by H.R. 1132. In Massachusetts, for example, pharmacies are required to report the prescriptions they fill for substances in Schedules I and II to the State's department of Public Health.

The problem is that H.R. 1132 does not provide the safeguards that are required to shield patients--the vast majority of whom will be law-abiding citizens receiving medications as part of a legitimate plan of care--from unauthorized disclosure of their personal medical information. Instead, the legislation provides the States broad leeway to establish databases of patients' private medical records with little guidance on the privacy protections that must be in place in order to quality for the grants.

For example, H.R. 1132 permits disclosure of individually-identifiable patient information in the database to a wide range of professionals in addition to practitioners and law enforcement personnel, including any local, State or Federal ``narcotics control, licensure, disciplinary or program authority'' who can make specific certifications as to the need for access to the information. Any ``agent of another state'' with a monitoring program approved by the bill also could gain access to patient records in the database, provided that the purpose of the access is for ``implementing the state's controlled substance monitoring program.'' Such easy access puts the privacy of potentially hundreds of thousands of law-abiding citizens at risk of unauthorized disclosure.

Additional privacy protections that are missing from H.R. 1132 include: a requirement that States receiving grants under the terms of the bill periodically notify patients whose information in the database has been lost, stolen or used for an unauthorized purpose; a mandate that States inform patients before dispensing medications covered by the bill's reporting requirement that their name, address, and phone number will be stored in a State-run database, potentially in perpetuity, as a result of the dispensing of the medication; and a requirement at the States purge the database of information about any particular prescription after a limited amount of time.

While I strongly support efforts to prevent the abuse of controlled substances, H.R. 1132 does not contain sufficient guidance to the states on the level of privacy protections that they must provide in the creation and maintenance of the databases authorized under the legislation. Since that breach of 145,000 personal records form the databases of data profiler ChoicePoint in February 2005, 50 million records with private information have been leaked from public companies, hospitals, universities and other organizations. During consideration of this legislation in the Energy and Commerce Committee, I offered a reasonable amendment to incorporate a fundamental privacy protection in the bill. My amendment was supported by the American Conservative Union, the American Psychoanalytic Association, the American Psychiatric Association, the American Association of Practicing Psychiatrists and the Massachusetts Medical Society. While my amendment would have simply required patient notification if their information in these databases were lost, stolen or used for an unauthorized purpose, it was defeated.

Without such fundamental protections for patients, this bill is not worthy of support. This bill--which is opposed by a broad, bipartisan coalition--does not belong on the suspension calendar, where it is not subject to amendment.

I urge my colleagues to oppose H.R. 1132. Send it back to committee, where the needed privacy protections can be added. The important goals of this bill can be accomplished without sacrificing the privacy of law-abiding patients.

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