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Doctors' group: Proposed Pennsylvania bill pushes medical privacy boundaries

| Tuesday, Oct. 8, 2013, 12:03 a.m.

A bill pending in Harrisburg gives law enforcement agencies too much access to confidential medical information on patients and physicians who may be overprescribing opiates and other pain medications, according to the Pennsylvania Medical Society.

The Legislature could vote this month on four bills that would establish a statewide monitoring system to track physicians and how much pain medication they prescribe as part of an effort to stem the rising tide of drug overdose deaths.

The bill with the best chance of passage is House Bill 1694, sponsored by state Rep. Matthew Baker, R-Tioga, said society spokesman Chuck Moran. A vote could come after Oct. 15, when the General Assembly reconvenes. The medical society opposes an amendment to the bill, arguing it violates doctor-patient confidentiality.

The amendment introduced Oct. 2 would have triggered an automated response to the attorney general and county district attorneys if irregularities or illegal patterns of dispensing were detected.

“We raised a lot of concerns, and it was pulled,” Moran said. “We're hoping to find middle ground with law enforcement. That amendment went beyond what we would envision.”

Baker said he has been working with the medical society to address their concerns and hopes to reach an agreement.

“It is my hope we will have a vote that week as 47 other states have some form of law in place. But we do not, and we are ranked 10th in the nation as having the highest drug addiction rates,” he said.

Jeffrey Levi, executive director of the Trust for America's Health in Washington, said a study released on Monday, “Prescription Drug Abuse: Strategies to Stop the Epidemic,” reports that a drug monitoring program in the state “is critical.”

Pennsylvania has the 14th highest overdose death rate in the nation, the study shows.

Levi said Pennsylvania is one of 34 states that do not require mandatory use of a drug monitoring program and one of 33 that do not require pharmacists to check identification before a prescription can be filled.

Moran said if police and other law enforcement want to see a patient's prescription records, they should obtain a search warrant based on probable cause.

Baker's measure would allow broader access to the information, including by researchers, doctors, pharmacists, medical examiners and coroners, professional licensing boards and the Department of Public Welfare.

Gary Tennis, state secretary of Drug and Alcohol Programs, said a drug monitoring program would reduce overprescribing, prevent diversion of drugs for illegal sale and protect patients who suffer from legitimate ailments.

“The interests behind this legislation are complex. We understand the General Assembly will need to take the time to examine and balance privacy concerns, while also providing law enforcement access within the legislation,” Tennis said.

Attorney Tom Plaitano, who operates methadone clinics in Greensburg and Blairsville, supports Baker's bill. When his clinic opened in 2006, it treated 100 addicts per month. That number has grown to 600, he said.

“This is a direct result of the proliferation of cheap and plentiful opiate pain medication,” he said.

Drug overdose deaths have soared in Westmoreland County, according to the coroner's office. Since January 2012, the office has investigated 100 overdose deaths from heroin, pain medications and other drugs.

Plaitano said the medical society is exaggerating the privacy issue.

“This is a smokescreen that detractors are using. The database only permits a search that is already permitted by the attorney general or DEA now to be done in a modern manner,” he said.

Sen. Kim Ward, R-Hempfield, author of a similar bill in the Senate, said the lack of prescription oversight is “creating legalized addicts.”

“These physicians who do this, and know what they're doing, are worse than a drug dealer,” said Ward, who is married to a physician. “We're enriching people who shouldn't be enriched.”

Her measure would require pharmacies to enter the prescription information into a database within seven days, including the doctor's name and Drug Enforcement Agency number; the date the order was filled; the payment method; the patient's name, age and birth date; and the quantity and strength of the drugs.

Cumberland County District Attorney David Freed, president of the Pennsylvania District Attorneys Association, said the state has one of the weakest drug monitoring programs in the nation.

“We should not be surprised at the prescription drug abuse epidemic in our state, because our existing database system is inadequate,” he wrote last month in support of Baker's bill.

Freed said the state monitors only Schedule II narcotics, while other states monitor a wider array of pain medications, and doctors and pharmacists can't access the information.

Schedule II drugs include opiates such as hydrocodone, morphine, opium, cocaine and oxycodone under the federal Controlled Substances Act. Schedule III includes drugs such as LSD, Secobarbital and steroids.

Attorney General Kathleen Kane supports formation of an electronic database. Kane has the regulatory authority to monitor drug prescriptions and uses a private collection agency to compile the data so agents can see the number of prescriptions doctors are writing and whether narcotics are being diverted. But pharmacies are required to submit information only monthly, said spokesman Joe Peters.

“While there will be some amendments, I think everyone is in agreement — the more we can monitor abuse, the more lives we can save,” he said.

Richard Gazarik is a staff writer for Trib Total Media. He can be reached at 724-830-6292 or rgazarik@tribweb.com.

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