Pubdate: Tue, 30 Sep 2003
Source: Lexington Herald-Leader (KY)
Copyright: 2003 Lexington Herald-Leader
Contact:  http://www.kentucky.com/mld/heraldleader/
Details: http://www.mapinc.org/media/240
Author: Charles B. Camp

MEDICAL DATABASE WOULD BE WATCHED

Bill's Purpose Closer Eye On Prescriptions

FRANKFORT - Health cabinet officials would be required to scour Kentucky's 
prescription-drug database for patterns of pill abuse and report them to 
regulators, law enforcement, and in some cases the public, under a proposed 
bill approved yesterday by a legislative task force.

But, in contrast to earlier proposals, the final draft, if approved by the 
2004 General Assembly, wouldn't permit such statistical studies to target 
specific doctors, pharmacists or patients for investigation.

In early September, when the task force set its objectives for the bill, it 
left open the possibility of using the database to identify "high-risk" 
physicians and patients by comparing their prescription-drug histories with 
benchmark numbers.

Using those yardsticks, health officials could have referred names of 
people falling outside the norm to regulators or to law enforcement for 
further inquiry.

The 2003 General Assembly created the Prescription Drug Abuse Task Force to 
explore new ways of using the Kentucky All Schedule Prescription Electronic 
Reporting System, or KASPER, to fight illicit pill use. It required the 
group to present proposed legislation to the next session.

KASPER contains 35 million records of prescriptions for pain pills and 
other addictive drugs, going back to 1999. It is used by law officers and 
regulators to investigate drug cases, and by doctors and pharmacists to 
monitor patients.

Though the task force's proposed bill wouldn't authorize the use of KASPER 
to pinpoint suspect individuals, it would still greatly broaden the scope 
of the database, which operates under strict privacy and limited-access 
rules. Misuse of that data could be punished as a felony.

Among other things, the measure would:

. Require health cabinet officials who now operate KASPER to run 
statistical analyses to discover pockets or local areas of suspected abuse, 
saving regulators and law officers time and work. The cabinet would be 
required to run some studies quarterly and make them public. Others could 
be created at the request of law officers or regulatory bodies, and would 
remain secret.

. Permit law officers from different agencies working on the same case to 
share reports. Currently, strict privacy rules force each officer to seek a 
separate report for the same information. It also would allow sharing with 
law enforcement in states that have similar systems.

. Extend the reach of the Kentucky Board of Medical Licensure, by allowing 
it to automatically expand an investigation of one doctor to other 
physicians in the same office or community if a pattern of illegal activity 
is suspected.

. Speed up the reporting of data from pharmacies from twice monthly to 
weekly, and impose tougher standards on accuracy.

The proposed bill won praise from some lawmakers and regulators. "It has an 
excellent chance of passage," possibly without change by lawmakers, House 
Majority Leader Greg Stumbo, D-Prestonsburg, co-chairman of the task force, 
said after yesterday's meeting.

He acknowledged the new statistical studies might require some additional 
personnel, but predicted the cost would be low and the money would be approved.

Dr. Danny Clark, president of the Kentucky Board of Medical Licensure, said 
the measure would help find nests of doctors and "doctor-shoppers" who feed 
pain pills and other dangerous narcotics into a specific region.

"The sooner we can find people who are doing the wrong thing, the sooner we 
can do something about it," Clark said.

However, the expansion of access to KASPER data drew some criticism. Task 
force member Jerry Cox, a Mount Vernon defense lawyer who expressed civil 
rights concerns earlier, filed a statement warning that the current process 
granting access to private medical records might violate Fourth Amendment 
protections against illegal searches.

He recommended that, to obtain a KASPER record, law officers be required to 
show "probable cause," as is required for a search warrant. The task force 
voted to include his statement in its minutes -- but not the report to the 
General Assembly.
- ---
MAP posted-by: Beth +++++++