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[House Report 115-684]
[From the U.S. Government Publishing Office]

115th Congress }                                          { REPORT
                        HOUSE OF REPRESENTATIVES
  2d Session   }                                          { 115-684

======================================================================
 
                  VETERANS OPIOID ABUSE PREVENTION ACT

                                _______
                                

  May 18, 2018.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Roe of Tennessee, from the Committee on Veterans' Affairs, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 3832]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Veterans' Affairs, to whom was referred 
the bill (H.R. 3832) to direct the Secretary of Veterans 
Affairs to enter into a memorandum of understanding with the 
executive director of a national network of State-based 
prescription monitoring programs under which Department of 
Veterans Affairs health care providers shall query such 
network, and for other purposes, having considered the same, 
reports favorably thereon with amendments and recommends that 
the bill as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     4
Background and Need for Legislation..............................     4
Hearings.........................................................     5
Subcommittee Consideration.......................................     5
Committee Consideration..........................................     5
Committee Votes..................................................     6
Committee Oversight Findings.....................................     6
Statement of General Performance Goals and Objectives............     6
New Budget Authority, Entitlement Authority, and Tax Expenditures     6
Earmarks and Tax and Tariff Benefits.............................     6
Committee Cost Estimate..........................................     6
Congressional Budget Office Estimate.............................     6
Federal Mandates Statement.......................................     8
Advisory Committee Statement.....................................     8
Constitutional Authority Statement...............................     8
Applicability to Legislative Branch..............................     8
Statement on Duplication of Federal Programs.....................     8
Disclosure of Directed Rulemaking................................     8
Section-by-Section Analysis of the Legislation...................     8
Changes in Existing Law Made by the Bill as Reported.............     9

    The amendments are as follows:
      Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Veterans Opioid Abuse Prevention 
Act''.

SEC. 2. DEPARTMENT OF VETERANS AFFAIRS PARTICIPATION IN NATIONAL 
                    NETWORK OF STATE-BASED PRESCRIPTION DRUG MONITORING 
                    PROGRAMS.

  (a) In General.--Chapter 17 of title 38, United States Code, is 
amended by inserting after section 1730A the following new section:

``Sec. 1730B. Access to State prescription drug monitoring programs

  ``(a) Access to Programs.--(1) Any licensed health care provider or 
delegate of such a provider shall be considered an authorized recipient 
or user for the purpose of querying and receiving data from the 
national network of State-based prescription drug monitoring programs 
to support the safe and effective prescribing of controlled substances 
to covered patients.
  ``(2) Under the authority granted by paragraph (1)--
          ``(A) licensed health care providers or delegates of such 
        providers shall query such network in accordance with 
        applicable regulations and policies of the Veterans Health 
        Administration; and
          ``(B) notwithstanding any general or specific provision of 
        law, rule, or regulation of a State, no State may restrict the 
        access of licensed health care providers or delegates of such 
        providers from accessing that State's prescription drug 
        monitoring programs.
  ``(3) No State shall deny or revoke the license, registration, or 
certification of a licensed health care provider or delegate who 
otherwise meets that State's qualifications for holding the license, 
registration, or certification on the basis that the licensed health 
care provider or delegate has queried or received data, or attempt to 
query or receive data, from the national network of State-based 
prescription drug monitoring programs under this section.
  ``(b) Covered Patients.--For purposes of this section, a covered 
patient is a patient who--
          ``(1) receives a prescription for a controlled substance; and
          ``(2) is not receiving palliative care or enrolled in hospice 
        care.
  ``(c) Definitions.--In this section:
          ``(1) The term `controlled substance' has the meaning given 
        such term in section 102(6) of the Controlled Substances Act 
        (21 U.S.C. 802(6)).
          ``(2) The term `delegate' means a person or automated system 
        accessing the national network of State-based prescription 
        monitoring programs at the direction or under the supervision 
        of a licensed health care provider.
          ``(3) The term `licensed health care provider' means a health 
        care provider employed by the Department who is licensed, 
        certified, or registered within any State to fill or prescribe 
        medications within the scope of his or her practice as a 
        Department employee.
          ``(4) The term `national network of State-based prescription 
        monitoring programs' means an interconnected nation-wide system 
        that facilitates the transfer to State prescription drug 
        monitoring program data across State lines.
          ``(5) The term `State' means a State, as defined in section 
        101(20) of this title, or a political subdivision of a 
        State.''.
  (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 of such title is amended by inserting after the item 
relating to section 1730A the following new item:

``1730B. Access to State prescription drug monitoring programs.''.
    Amend the title so as to read:
    A bill to amend title 38, United States Code, to provide 
for access by Department of Veterans Affairs health care 
providers to State prescription drug monitoring programs.

  Amendment in the Nature of a Substitute to H.R. 3832 Offered by Mr. 
                            Dunn of Florida

  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Veterans Opioid Abuse 
Prevention Act''.

SEC. 2. DEPARTMENT OF VETERANS AFFAIRS PARTICIPATION IN NATIONAL 
                    NETWORK OF STATE-BASED PRESCRIPTION DRUG MONITORING 
                    PROGRAMS.

  (a) In General.--Chapter 17 of title 38, United States Code, 
is amended by inserting after section 1730A the following new 
section:

``Sec. 1730B. Access to State prescription drug monitoring programs

  ``(a) Access to Programs.--(1) Any licensed health care 
provider or delegate of such a provider shall be considered an 
authorized recipient or user for the purpose of querying and 
receiving data from the national network of State-based 
prescription drug monitoring programs to support the safe and 
effective prescribing of controlled substances to covered 
patients.
  ``(2) Under the authority granted by paragraph (1)--
          ``(A) licensed health care providers or delegates of 
        such providers shall query such network in accordance 
        with applicable regulations and policies of the 
        Veterans Health Administration; and
          ``(B) notwithstanding any general or specific 
        provision of law, rule, or regulation of a State, no 
        State may restrict the access of licensed health care 
        providers or delegates of such providers from accessing 
        that State's prescription drug monitoring programs.
  ``(3) No State shall deny or revoke the license, 
registration, or certification of a licensed health care 
provider or delegate who otherwise meets that State's 
qualifications for holding the license, registration, or 
certification on the basis that the licensed health care 
provider or delegate has queried or received data, or attempt 
to query or receive data, from the national network of State-
based prescription drug monitoring programs under this section.
  ``(b) Covered Patients.--For purposes of this section, a 
covered patient is a patient who--
          ``(1) receives a prescription for a controlled 
        substance; and
          ``(2) is not receiving palliative care or enrolled in 
        hospice care.
  ``(c) Definitions.--In this section:
          ``(1) The term `controlled substance' has the meaning 
        given such term in section 102(6) of the Controlled 
        Substances Act (21 U.S.C. 802(6)).
          ``(2) The term `delegate' means a person or automated 
        system accessing the national network of State-based 
        prescription monitoring programs at the direction or 
        under the supervision of a licensed health care 
        provider.
          ``(3) The term `licensed health care provider' means 
        a health care provider employed by the Department who 
        is licensed, certified, or registered within any State 
        to fill or prescribe medications within the scope of 
        his or her practice as a Department employee.
          ``(4) The term `national network of State-based 
        prescription monitoring programs' means an 
        interconnected nation-wide system that facilitates the 
        transfer to State prescription drug monitoring program 
        data across State lines.
          ``(5) The term `State' means a State, as defined in 
        section 101(20) of this title, or a political 
        subdivision of a State.''.
  (b) Clerical Amendment.--The table of sections at the 
beginning of chapter 17 of such title is amended by inserting 
after the item relating to section 1730A the following new 
item:

``1730B. Access to State prescription drug monitoring programs.''.

  Amend the title so as to read: ``A bill to amend title 38, 
United States Code, to provide for access by Department of 
Veterans Affairs health care providers to State prescription 
drug monitoring programs.''.

                          Purpose and Summary

    H.R. 3832, as amended, the ``Veterans Opioid Abuse 
Prevention Act'' would allow for the greater sharing of 
information between the Department of Veterans Affairs (VA) and 
state-based prescription drug monitoring programs (PDMPs). 
Representative Neal Dunn of Florida introduced H.R. 3832 on 
September 26, 2017.

                  Background and Need for Legislation

    The Centers for Disease Control and Prevention (CDC) 
defines a PDMP as an electronic database that tracks controlled 
substance prescriptions in a state and provides information 
about prescribing and patient patterns and behaviors.\1\ PDMPs 
have been shown to improve prescribing, inform clinical 
practice, protect at-risk patients, and decrease substance 
abuse treatment admissions.\2\
---------------------------------------------------------------------------
    \1\What States Need to Know about PDMPs. Centers for Disease 
Control and Prevention. https://www.cdc.gov/drugoverdose/pdmp/
states.html. Accessed April 30, 2018.
    \2\Ibid.
---------------------------------------------------------------------------
    In 2011, the National Association of Boards of Pharmacy 
(NABP) developed and launched the Prescription Monitoring 
Program (PMP) InterConnect to facilitate the secure exchange of 
information across state lines by PDMPs.\3\ According to NABP, 
PDMPs are, ``. . . are enhanced by PMP InterConnect because 
[it] provides the means for physicians and pharmacists to more 
easily identify patients with prescription drug abuse and 
misuse problems, especially if those patients are crossing 
state lines to obtain drugs.''\4\ Currently 44 states and 
Washington, D.C. participate in PMP InterConnect with several 
additional states intending to begin sharing data using PMP 
InterConnect.\5\\6\
---------------------------------------------------------------------------
    \3\NABP PMP InterConnect: The Only National Network of State-Based 
PMPs. National Association of Boards of Pharmacy. https://
nabp.pharmacy/initiatives/pmp-interconnect/. Accessed April 30, 2018.
    \4\Ibid.
    \5\United States Cong. House Committee on Veterans' Affairs. 
Legislative Hearing. April 17, 2018. 115th Cong. 2nd sess. Washington: 
GPO, 2018 (statement from the Honorable Neal Dunn, U.S. House of 
Representatives, 2nd District, Florida).
    \6\NABP PMP InterConnect: The Only National Network of State-Based 
PMPs. National Association of Boards of Pharmacy. https://
nabp.pharmacy/initiatives/pmp-interconnect/. Accessed April 30, 2018.
---------------------------------------------------------------------------
    Section 5701(l) of title 38 United States Code (U.S.C.) 
requires VA to disclose information to PDMPs for either a 
veteran or the dependent of a veteran who is prescribed a 
controlled substance through VA ``to the extent necessary to 
prevent misuse or diversion of prescription medications.'' 
Veterans Health Administration (VHA) Directive 1306 provides VA 
national policy for querying PDMPs.\7\ It requires PDMPs to be 
queried prior to initiating therapy with a controlled 
substance, annually at a minimum, and more often when 
clinically indicated unless the patient is enrolled in hospice 
care or receives a controlled substance prescription for five 
days or less without refills.\8\ The results of such query are 
required to be documented in the patient's medical record and 
are subject to limitations imposed by state law, in which case 
providers and prescribers are required to conform to the 
policies and recommendations of their state licensure.\9\ 
According to VA, this policy allows providers to identify 
patients receiving controlled substances from multiple 
providers which may assist in preventing accidental or 
intentional misuse or diversion and in the detection, 
prevention, and early treatment of substance use disorders.\10\ 
However, the policy does not allow VA to track controlled 
substance prescriptions across multiple states since VA lacks 
the authority to use a system like PMP InterConnect.
---------------------------------------------------------------------------
    \7\VHA Directive 1306. Query State Prescription Drug Monitoring 
Programs. October 19, 2016.
    \8\Ibid.
    \9\Ibid.
    \10\Ibid.
---------------------------------------------------------------------------
    Section 2 of the bill would require VA to enter into an 
agreement with a national network of PDMPs to allow for the 
monitoring of controlled substance prescriptions written in 
participating states. It would also require VA health care 
providers practicing in states that do not have a PDMP to join 
the network of the closest state that does have a PDMP.

                                Hearings

    On April 17, 2018, the Subcommittee on Health conducted a 
legislative hearing on a number of bills including H.R. 3832.
    The following witnesses testified:
          The Honorable Beto O'Rourke, U.S. House of 
        Representatives, 16th District, Texas; The Honorable 
        Tim Walberg, U.S. House of Representatives, 7th 
        District, Michigan; The Honorable Neal Dunn, U.S. House 
        of Representatives, 2nd District, Florida; The 
        Honorable Luis Correa, U.S. House of Representatives, 
        46th District, California; The Honorable Mike Coffman, 
        U.S. House of Representatives, 6th District, Colorado; 
        Louis J. Celli, Director, National Veterans Affairs and 
        Rehabilitation Division, The American Legion; Adrian M. 
        Atizado, Deputy National Legislative Director, Disabled 
        American Veterans; Sarah S. Dean, Associate Legislative 
        Director, Paralyzed Veterans of America; and Kayda 
        Keleher, Associate Director, National Legislative 
        Service, Veterans of Foreign Wars of the United States.
    Statements for the record were submitted by:
          The Elizabeth Dole Foundation; the Independence Fund; 
        Veteran Cannabis Project; Wounded Warrior Project; and 
        Iraq and Afghanistan Veterans of America.

                       Subcommittee Consideration

    There was no Subcommittee consideration of H.R. 3832.

                        Committee Consideration

    On May 8, 2018, the full Committee met in open markup 
session, a quorum being present, and ordered H.R. 3832, as 
amended, to be reported favorably to the House of 
Representatives by voice vote. During consideration of the 
bill, the following amendment was considered and agreed to by 
voice vote:
          An amendment in the nature of a substitute offered by 
        Representative Neal Dunn of Florida.

                            Committee Votes

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, there were no recorded votes 
taken on amendments or in connection with ordering H.R. 3832, 
as amended, reported to the House. A motion by Representative 
Tim Walz of Minnesota, Ranking Member of the Committee on 
Veterans' Affairs, to report H.R. 3832, as amended, favorably 
to the House of Representatives was agreed to by voice vote.

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII and clause 
(2)(b)(1) of rule X of the Rules of the House of 
Representatives, the Committee's oversight findings and 
recommendations are reflected in the descriptive portions of 
this report.

         Statement of General Performance Goals and Objectives

    In accordance with clause 3(c)(4) of rule XIII of the Rules 
of the House of Representatives, the Committee's performance 
goals and objectives are to improve communication between VA 
and state-based prescription drug monitoring programs in order 
to ensure the safe, effective, and appropriate prescribing of 
controlled substances to veteran patients.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee adopts as its 
own the estimate of new budget authority, entitlement 
authority, or tax expenditures or revenues contained in the 
cost estimate prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

                  Earmarks and Tax and Tariff Benefits

    H.R. 3832, as amended, does not contain any Congressional 
earmarks, limited tax benefits, or limited tariff benefits as 
defined in clause 9 of rule XXI of the Rules of the House of 
Representatives.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate on H.R. 
3832, as amended, prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

               Congressional Budget Office Cost Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
for H.R. 3832, as amended, provided by the Director of the 
Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                      Washington, DC, May 11, 2018.
Hon. Phil Roe, M.D.,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 3832, the Veterans 
Opioid Abuse Prevention Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Ann E. 
Futrell.
            Sincerely,
                                                Keith Hall,
                                                          Director.
    Enclosure.

H.R. 3832--Veterans Opioid Abuse Prevention Act

    H.R. 3832 would require medical providers at the Department 
of Veterans Affairs (VA) who prescribe controlled substances to 
veterans to seek information regarding those veterans from 
state programs that monitor prescription drug use. Under 
current policy, VA medical providers are required to query 
those state programs when prescribing such drugs. This bill 
would, therefore, codify VA's existing practice. As a result, 
CBO estimates that implementing the bill would cost less than 
$500,000 over the 2019-2023 period, primarily to prepare the 
necessary regulations. That spending would be subject to the 
availability of appropriated funds.
    Enacting H.R. 3832 would not affect direct spending or 
revenues; therefore, pay-as-you-go procedures do not apply.
    CBO estimates that enacting H.R. 3832 would not increase 
net direct spending or on-budget deficits in any of the four 
consecutive 10-year periods beginning in 2029.
    H.R. 3832 would impose intergovernmental mandates as 
defined in the Unfunded Mandates Reform Act (UMRA). The bill 
would require state-operated prescription drug monitoring 
programs (PDMPs) to allow VA personnel to access the databases 
and would preempt state laws by limiting states' authority to 
revoke or deny medical licenses of VA personnel who access PDMP 
data. CBO estimates that the incremental cost to provide access 
to PDMP databases by VA personnel would be minimal because 
PDMPs are already operational in nearly every state and 
servicing new users would not require significant changes to 
the programs. Although the preemption would limit the 
application of state laws, it would impose no duty on states 
that would result in additional spending or loss of a revenues. 
Therefore, the costs of the mandates would not exceed the 
threshold established in UMRA ($80 million in 2018, adjusted 
annually for inflation).
    The bill contains no private-sector mandates as defined in 
UMRA.
    The CBO staff contact for this estimate is Ann E. Futrell 
(for federal costs) and Andrew Laughlin (for mandates). The 
estimate was reviewed by Leo Lex, Deputy Assistant Director for 
Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates regarding H.R. 3832, as amended, prepared by the 
Director of the Congressional Budget Office pursuant to section 
423 of the Unfunded Mandates Reform Act.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act would be created by H.R. 
3832, as amended.

                 Statement of Constitutional Authority

    Pursuant to Article I, section 8 of the United States 
Constitution, H.R. 3832, as amended, is authorized by Congress' 
power to ``provide for the common Defense and general Welfare 
of the United States.''

                  Applicability to Legislative Branch

    The Committee finds that H.R. 3832, as amended, does not 
relate to the terms and conditions of employment or access to 
public services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

              Statement on Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that no provision 
of H.R. 3832, as amended, establishes or reauthorizes a program 
of the Federal Government known to be duplicative of another 
Federal program, a program that was included in any report from 
the Government Accountability Office to Congress pursuant to 
section 21 of Public Law 111-139, or a program related to a 
program identified in the most recent Catalog of Federal 
Domestic Assistance.

                   Disclosure of Directed Rulemaking

    Pursuant to section 3(i) of H. Res. 5, 115th Cong. (2017), 
the Committee estimates that H.R. 3832, as amended, contains no 
directed rulemaking that would require the Secretary to 
prescribe regulations.

             Section-by-Section Analysis of the Legislation

Section 1. Short title

    Section 1 of the bill would establish a short title for 
3832, as amended, of the ``Veterans Opioid Abuse Prevention 
Act.''

Section 2. Department of Veterans Affairs participation in national 
        network of State-based prescription drug monitoring programs

    Section 2(a) of the bill would amend Chapter 17 of title 38 
U.S.C. by inserting after section 1730A a new section ``1730B. 
Access to State prescription drug monitoring programs.''
    The new section 1730B(a) would require that any licensed 
health care provider or delegate of such provider is required 
to be considered an authorized recipient or user for the 
purpose of querying and receiving data from the national 
network of State-based prescription drug monitoring programs to 
support the safe and effective prescribing of controlled 
substances to covered patients. It would also require licensed 
health care providers or delegates of such providers to query 
such network in accordance with applicable VHA regulations and 
policies and, notwithstanding any general or specific provision 
of law, rule, or regulation of a State, no State is authorized 
to restrict the access of licensed health care providers or 
delegates of such providers from accessing that State's 
prescription drug monitoring programs. It would further require 
that no State deny or revoke the license, registration, or 
certification of a licensed health care provider or delegate 
who otherwise meets that State's qualifications for holding the 
license, registration, or certification on the basis that the 
licensed health care provider or delegate has queried or 
received data, or attempt to query or receive data, from the 
national network of State-based prescription drug monitoring 
programs under this section.
    The new section 1730B(b) would stipulate that, for the 
purpose of this section, a covered patient is a patient who 
receives a prescription for a controlled substance and is not 
receiving palliative care or enrolled in hospice care.
    The new section 1730B(c) would define the term: 
``controlled substance'' as having the meaning given such term 
in section 102(6) of the Controlled Substances Act (21 U.S.C. 
802(6)); ``delegate'' as meaning a person or automated system 
accessing the national network of State-based prescription 
monitoring programs at the direction or under the supervision 
of a licensed health care provider; ``licensed health care 
provider'' as meaning a health care provider employed by VA who 
is licensed, certified, or registered within any State to fill 
or prescribe medications within the scope of his or her 
practice as a VA employee; ``national network of State-based 
prescription monitoring programs'' as meaning an interconnected 
nation-wide system that facilitates the transfer to State 
prescription drug monitoring program data across State lines; 
``State'' as meaning a State as defined in section 101(20) of 
title 38 U.S.C. or a political subdivision of a State.
    Section 2(b) of the bill would amend the table of sections 
at the beginning of chapter 17 of title 38 U.S.C. by inserting 
after the item relating to section 1730A the following new 
item: ``1730B. Access to State prescription drug monitoring 
programs.''.

         Changes in Existing Law Made by the Bill, as Reported

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic and existing law in which no change is 
proposed is shown in roman):

TITLE 38, UNITED STATES CODE

           *       *       *       *       *       *       *

PART II--GENERAL BENEFITS

           *       *       *       *       *       *       *

   CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE

                          SUBCHAPTER I--GENERAL

Sec.
1701. Definitions.
     * * * * * * *

   SUBCHAPTER III--MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND 
           NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS

     * * * * * * *
1730B. Access to State prescription drug monitoring programs.

           *       *       *       *       *       *       *

   SUBCHAPTER III--MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND 
NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS

           *       *       *       *       *       *       *

Sec. 1730B. Access to State prescription drug monitoring programs

  (a) Access to Programs.--(1) Any licensed health care 
provider or delegate of such a provider shall be considered an 
authorized recipient or user for the purpose of querying and 
receiving data from the national network of State-based 
prescription drug monitoring programs to support the safe and 
effective prescribing of controlled substances to covered 
patients.
  (2) Under the authority granted by paragraph (1)--
          (A) licensed health care providers or delegates of 
        such providers shall query such network in accordance 
        with applicable regulations and policies of the 
        Veterans Health Administration; and
          (B) notwithstanding any general or specific provision 
        of law, rule, or regulation of a State, no State may 
        restrict the access of licensed health care providers 
        or delegates of such providers from accessing that 
        State's prescription drug monitoring programs.
  (3) No State shall deny or revoke the license, registration, 
or certification of a licensed health care provider or delegate 
who otherwise meets that State's qualifications for holding the 
license, registration, or certification on the basis that the 
licensed health care provider or delegate has queried or 
received data, or attempt to query or receive data, from the 
national network of State-based prescription drug monitoring 
programs under this section.
  (b) Covered Patients.--For purposes of this section, a 
covered patient is a patient who--
          (1) receives a prescription for a controlled 
        substance; and
          (2) is not receiving palliative care or enrolled in 
        hospice care.
  (c) Definitions.--In this section:
          (1) The term ``controlled substance'' has the meaning 
        given such term in section 102(6) of the Controlled 
        Substances Act (21 U.S.C. 802(6)).
          (2) The term ``delegate'' means a person or automated 
        system accessing the national network of State-based 
        prescription monitoring programs at the direction or 
        under the supervision of a licensed health care 
        provider.
          (3) The term ``licensed health care provider'' means 
        a health care provider employed by the Department who 
        is licensed, certified, or registered within any State 
        to fill or prescribe medications within the scope of 
        his or her practice as a Department employee.
          (4) The term ``national network of State-based 
        prescription monitoring programs'' means an 
        interconnected nation-wide system that facilitates the 
        transfer to State prescription drug monitoring program 
        data across State lines.
          (5) The term ``State'' means a State, as defined in 
        section 101(20) of this title, or a political 
        subdivision of a State.

           *       *       *       *       *       *       *

                                  [all]
```