Prescription drug monitoring changes advance

Lawmakers gave first-round approval Jan. 27 to a bill intended to enhance Nebraska’s Prescription Drug Monitoring Program (PDMP).

As introduced last session by Omaha Sen. Sara Howard, LB471 would strengthen the program by:
• prohibiting patients from opting out of the system;
• allowing prescribers and dispensers to access the system at no cost;
• requiring all controlled substance prescriptions to be entered into the system; and
• capturing information relating to all payers, including Medicaid.

Howard said the bill would close loopholes in the existing PDMP without a cost to the state.

LB471 originally included a $500,000 fiscal note to cover the cost of developing a new platform to implement the changes, Howard said, but that cost would be eliminated by two grants secured by the state Department of Health and Human Services.

“We will have about $500,000 for the next two years to fund this,” she said, adding that Douglas County alone estimates that 90 to 100 deaths in the county each year can be attributed to opioid painkiller overdose.

A Health and Human Services Committee amendment, adopted 46-0, would require prescription dispensers to report to the system and specifically lists the information to be reported.

Lincoln Sen. Kathy Campbell, chairperson of the committee, said the amendment would better address the problem of drug-seeking patients, which has been a concern of the committee for a number of years.

“Lest we think that prescription drug overdoses are not happening in Nebraska,” she said, “we are the same, as this is a national epidemic.”

Heartwell Sen. John Kuehn, a veterinarian, brought an amendment that replaced the bill while incorporating the original proposal and the committee amendment. In addition, his amendment would include veterinarians under the bill’s provisions beginning Jan. 1, 2018.

Kuehn noted that veterinarians are able to obtain a Drug Enforcement Administration number, which allows them to prescribe and dispense controlled substances. As a result, he said, veterinarians should be a part of the state’s PDMP.

“I think it is critical that as we address the issue of prescription drugs, and the diversion of controlled substances, that all providers be on the same footing,” Kuehn said.

The amendment also would establish a 10-member Veterinary Prescription Monitoring Program Task Force. The task force would study and develop recommendations regarding which controlled substances veterinarians should report under the system, as well as appropriate reporting procedures.

Membership would include three senators, six licensed veterinarians and a representative of the PDMP. The task force would report its findings and recommendations to the Health and Human Services Committee by Dec. 1, 2016.

Sen. Robert Hilkemann of Omaha supported the proposal, calling it long overdue.

“Nebraska is just about dead last—49th in the country—in dealing with this issue,” he said. “This is important legislation that we should have had a long time ago.”

Bellevue Sen. Sue Crawford agreed, saying Nebraska has become a magnet for drug seekers because of current loopholes in the state’s monitoring system.

“The bill and the grants together will help us create an effective information system to tackle prescription drug overdoses and prescription drug diversion and to address this important issue in our state,” Crawford said.

Sen. Mark Kolterman of Seward also supported the bill, saying he has seen the result of painkiller addiction first-hand in his family.

“There are a lot of people on the streets today who have the same story and it’s time we do something about it,” he said. “We’re never going to eliminate the problem, but we’re going to do what we can.”

Following adoption of the Kuehn amendment on a 46-0 vote, lawmakers advanced the bill to select file 47-0.

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