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.