I 
110TH CONGRESS 
2D SESSION 
H. R. 6353 
To amend the Controlled Substances Act to address online pharmacies. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 24, 2008 
Mr. STUPAK (for himself, Mr. SMITH of Texas, Mrs. BONO MACK, Mr. DAN-
IEL E. LUNGREN of California, Mr. GALLEGLY, Mr. FEENEY, Mr. 
CHABOT, Mr. WALZ of Minnesota, and Mr. BOUCHER) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on the Judiciary, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend the Controlled Substances Act to address online 
pharmacies. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Ryan Haight Online 
Pharmacy Consumer Protection Act of 2008’’. 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(ii) Nothing in clause (i) shall be con-
strued to imply that 1 in-person medical evalua-
tion demonstrates that a prescription has been 
issued for a legitimate medical purpose within 
the usual course of professional practice. 
‘‘(C) The term ‘covering practitioner’ 
means, with respect to a patient, a practitioner 
who conducts a medical evaluation (other than 
an in-person medical evaluation) at the request 
of a practitioner who— 
‘‘(i) has conducted at least 1 in-per-
son medical evaluation of the patient or an 
evaluation of the patient through the prac-
tice of telemedicine, within the previous 24 
months; and 
‘‘(ii) is temporarily unavailable to con-
duct the evaluation of the patient. 
‘‘(3) Nothing in this subsection shall apply to— 
‘‘(A) the delivery, distribution, or dis-
pensing of a controlled substance by a practi-
tioner engaged in the practice of telemedicine; 
or 
‘‘(B) the dispensing or selling of a con-
trolled substance pursuant to practices as deter-
mined by the Attorney General by regulation, 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
which shall be consistent with effective controls 
against diversion.’’. 
SEC. 3. AMENDMENTS TO THE CONTROLLED SUBSTANCES 
ACT RELATING TO THE DELIVERY OF CON-
TROLLED SUBSTANCES BY MEANS OF THE 
INTERNET. 
(a) IN GENERAL.—Section 102 of the Controlled 
Substances Act (21 U.S.C. 802) is amended by adding at 
the end the following: 
‘‘(50) The term ‘Internet’ means collectively the 
myriad of computer and telecommunications facili-
ties, including equipment and operating software, 
which comprise the interconnected worldwide net-
work of networks that employ the Transmission 
Control Protocol/Internet Protocol, or any prede-
cessor or successor protocol to such protocol, to com-
municate information of all kinds by wire or radio. 
‘‘(51) The term ‘deliver, distribute, or dispense 
by means of the Internet’ refers, respectively, to any 
delivery, distribution, or dispensing of a controlled 
substance that is caused or facilitated by means of 
the Internet. 
‘‘(52) The term ‘online pharmacy’— 
‘‘(A) means a person, entity, or Internet 
site, whether in the United States or abroad, 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
that knowingly or intentionally delivers, distrib-
utes, or dispenses, or offers or attempts to de-
liver, distribute, or dispense, a controlled sub-
stance by means of the Internet; and 
‘‘(B) does not include— 
‘‘(i) manufacturers or distributors 
registered under subsection (a), (b), (c), or 
(d) of section 303 who do not dispense 
controlled substances to an unregistered 
individual or entity; 
‘‘(ii) nonpharmacy practitioners who 
are registered under section 303(f) and 
whose activities are authorized by that reg-
istration; 
‘‘(iii) any hospital or other medical fa-
cility that is operated by an agency of the 
United 
States 
(including 
the 
Armed 
Forces), provided such hospital or other fa-
cility is registered under section 303(f); 
‘‘(iv) a health care facility owned or 
operated by an Indian tribe or tribal orga-
nization, only to the extent such facility is 
carrying out a contract or compact under 
the Indian Self-Determination and Edu-
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
cation Assistance Act (25 U.S.C. 450 et 
seq.); 
‘‘(v) any agent or employee of any 
hospital or facility referred to in clause (iii) 
or (iv), provided such agent or employee is 
lawfully acting in the usual course of busi-
ness or employment, and within the scope 
of the official duties of such agent or em-
ployee, with such hospital or facility, and, 
with respect to agents or employees of 
health care facilities specified in clause 
(iv), only to the extent such individuals are 
furnishing services pursuant to the con-
tracts or compacts described in such 
clause; 
‘‘(vi) mere advertisements that do not 
attempt to facilitate an actual transaction 
involving a controlled substance; 
‘‘(vii) a person, entity, or Internet site 
that is not in the United States and does 
not facilitate the delivery, distribution, or 
dispensing of a controlled substance by 
means of the Internet to any person in the 
United States; 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(viii) a pharmacy registered under 
section 303(f) whose dispensing of con-
trolled substances via the Internet consists 
solely of— 
‘‘(I) ‘refilling prescriptions for 
controlled substances in schedule III, 
IV, or V’, as defined in paragraph 
(55); or 
‘‘(II) ‘filling new prescriptions for 
controlled substances in schedule III, 
IV, or V’, as defined in paragraph 
(56); or 
‘‘(ix) any other persons for whom the 
Attorney General and the Secretary have 
jointly, by regulation, found it to be con-
sistent with effective controls against diver-
sion and otherwise consistent with the pub-
lic health and safety to exempt from the 
definition of an ‘online pharmacy’. 
‘‘(53) The term ‘homepage’ means the opening 
or main page or screen of the website of an online 
pharmacy that is viewable on the Internet. 
‘‘(54) The term ‘practice of telemedicine’ 
means, for purposes of this title, the practice of 
medicine in accordance with applicable Federal and 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
State laws by a practitioner (other than a phar-
macist) who is at a location remote from the patient 
and is communicating with the patient, or health 
care professional who is treating the patient, using 
a telecommunications system referred to in section 
1834(m) of the Social Security Act (42 U.S.C. 
1395m(m)), and that— 
‘‘(A) is being conducted— 
‘‘(i) while the patient is being treated 
by, and physically located in, a hospital or 
clinic registered under section 303(f); and 
‘‘(ii) by a practitioner— 
‘‘(I) acting in the usual course of 
professional practice; 
‘‘(II) acting in accordance with 
applicable State law; and 
‘‘(III) registered under section 
303(f) in the State in which the pa-
tient is located, unless the practi-
tioner— 
‘‘(aa) is exempted from such 
registration in all States under 
section 302(d); or 
‘‘(bb) is— 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(AA) an employee or 
contractor of the Depart-
ment of Veterans Affairs 
who is acting in the scope of 
such employment or con-
tract; and 
‘‘(BB) registered under 
section 303(f) in any State 
or is utilizing the registra-
tion of a hospital or clinic 
operated by the Department 
of Veterans Affairs reg-
istered under section 303(f); 
‘‘(B) is being conducted while the patient 
is being treated by, and in the physical presence 
of, a practitioner— 
‘‘(i) acting in the usual course of pro-
fessional practice; 
‘‘(ii) acting in accordance with appli-
cable State law; and 
‘‘(iii) registered under section 303(f) 
in the State in which the patient is located, 
unless the practitioner— 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(I) is exempted from such reg-
istration in all States under section 
302(d); or 
‘‘(II) is— 
‘‘(aa) an employee or con-
tractor of the Department of Vet-
erans Affairs who is acting in the 
scope of such employment or con-
tract; and 
‘‘(bb) registered under sec-
tion 303(f) in any State or is 
using the registration of a hos-
pital or clinic operated by the 
Department of Veterans Affairs 
registered under section 303(f); 
‘‘(C) is being conducted by a practi-
tioner— 
‘‘(i) who is an employee or contractor 
of the Indian Health Service, or is working 
for an Indian tribe or tribal organization 
under its contract or compact with the In-
dian Health Service under the Indian Self- 
Determination and Education Assistance 
Act (25 U.S.C. 450 et seq.); 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(ii) acting within the scope of the 
employment, contract, or compact de-
scribed in clause (i); and 
‘‘(iii) who is designated as an Internet 
Eligible Controlled Substances Provider by 
the Secretary under section 311(g)(2); 
‘‘(D)(i) is being conducted during a public 
health emergency declared by the Secretary 
under section 319 of the Public Health Service 
Act (42 U.S.C. 247d); and 
‘‘(ii) involves patients located in such 
areas, and such controlled substances, as the 
Secretary, with the concurrence of the Attorney 
General, designates, provided that such designa-
tion shall not be subject to the procedures pre-
scribed by subchapter II of chapter 5 of title 5, 
United States Code; 
‘‘(E) is being conducted by a practitioner 
who has obtained from the Attorney General a 
special registration under section 311(h); 
‘‘(F) is being conducted— 
‘‘(i) in a medical emergency situa-
tion— 
‘‘(I) that prevents the patient 
from being in the physical presence of 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
a practitioner registered under section 
303(f) who is an employee or con-
tractor of the Veterans Health Admin-
istration acting in the usual course of 
business and employment and within 
the scope of the official duties or con-
tract of that employee or contractor; 
‘‘(II) that prevents the patient 
from being physically present at a 
hospital or clinic operated by the De-
partment of Veterans Affairs reg-
istered under section 303(f); 
‘‘(III) during which the primary 
care practitioner of the patient or a 
practitioner otherwise practicing tele-
medicine within the meaning of this 
paragraph is unable to provide care or 
consultation; and 
‘‘(IV) that requires immediate 
intervention by a health care practi-
tioner using controlled substances to 
prevent what the practitioner reason-
ably believes in good faith will be im-
minent 
and 
serious 
clinical 
con-
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
sequences, such as further injury or 
death; and 
‘‘(ii) by a practitioner that— 
‘‘(I) is an employee or contractor 
of the Veterans Health Administration 
acting within the scope of that em-
ployment or contract; 
‘‘(II) is registered under section 
303(f) in any State or is utilizing the 
registration of a hospital or clinic op-
erated by the Department of Veterans 
Affairs 
registered 
under 
section 
303(f); and 
‘‘(III) issues a controlled sub-
stance prescription in this emergency 
context that is limited to a maximum 
of a 5-day supply which may not be 
extended or refilled; or 
‘‘(G) is being conducted under any other 
circumstances that the Attorney General and 
the Secretary have jointly, by regulation, deter-
mined to be consistent with effective controls 
against diversion and otherwise consistent with 
the public health and safety. 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(55) The term ‘refilling prescriptions for con-
trolled substances in schedule III, IV, or V’— 
‘‘(A) means the dispensing of a controlled 
substance in schedule III, IV, or V in accord-
ance with refill instructions issued by a practi-
tioner as part of a valid prescription that meets 
the requirements of subsection (b) or (c) of sec-
tion 309, as appropriate; and 
‘‘(B) does not include the issuance of a 
new prescription to an individual for a con-
trolled substance that individual was previously 
prescribed. 
‘‘(56) The term ‘filling new prescriptions for 
controlled substances in schedule III, IV, or V’ 
means a prescription for an individual for a con-
trolled substance in schedule III, IV, or V, if— 
‘‘(A) the pharmacy dispensing that pre-
scription has previously dispensed to the patient 
that same controlled substance other than by 
means of the Internet and pursuant to the valid 
prescription of a practitioner that meets the ap-
plicable requirements of sections 309(b) or (c) 
(in this paragraph referred to as the ‘original 
prescription’); 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(B) the pharmacy contacts the practi-
tioner who issued the original prescription at 
the request of that individual to determine 
whether the practitioner will authorize the 
issuance of a new prescription for that indi-
vidual for the controlled substance described in 
subparagraph (A); and 
‘‘(C) the practitioner, acting in the usual 
course of professional practice, determines there 
is a legitimate medical purpose for the issuance 
of the new prescription.’’. 
(b) REGISTRATION REQUIREMENTS.—Section 303(f) 
of the Controlled Substances Act (21 U.S.C. 823(f)) is 
amended in the matter preceding paragraph (1)— 
(1) in the first sentence, by adding after 
‘‘schedule II, III, IV, or V’’ the following: ‘‘and shall 
modify the registrations of pharmacies so registered 
to authorize them to dispense controlled substances 
by means of the Internet’’; and 
(2) in the second sentence, by striking ‘‘if he 
determines that the issuance of such registration’’ 
and inserting ‘‘or such modification of registration if 
the Attorney General determines that the issuance of 
such registration or modification’’. 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
(c) REPORTING REQUIREMENTS.—Section 307(d) of 
the Controlled Substances Act (21 U.S.C. 827(d)) is 
amended by— 
(1) designating the text as paragraph (1); and 
(2) inserting after paragraph (1), as so des-
ignated by this Act, the following: 
‘‘(2) Each pharmacy with a modified registra-
tion under section 303(f) that authorizes the dis-
pensing of controlled substances by means of the 
Internet shall report to the Attorney General the 
controlled substances it dispenses, in the amount 
specified, and in such time and manner as the Attor-
ney General by regulation shall require, except that 
the Attorney General, under this paragraph, may 
not require any pharmacy to report any information 
other than the total quantity of each controlled sub-
stance that the pharmacy has dispensed each month. 
For purposes of this subsection, no reporting shall 
be required unless the pharmacy has met 1 of the 
following thresholds in the month for which the re-
porting is required: 
‘‘(A) 100 or more prescriptions dispensed. 
‘‘(B) 5,000 or more dosage units of all 
controlled substances combined.’’. 
(d) ONLINE PRESCRIPTION REQUIREMENTS.— 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
(1) IN GENERAL.—The Controlled Substances 
Act is amended by inserting after section 310 (21 
U.S.C. 830) the following: 
‘‘ADDITIONAL REQUIREMENTS RELATING TO ONLINE 
PHARMACIES AND TELEMEDICINE 
‘‘SEC. 311. (a) IN GENERAL.—An online pharmacy 
shall display in a visible and clear manner on its homepage 
a statement that it complies with the requirements of this 
section with respect to the delivery or sale or offer for sale 
of controlled substances and shall at all times display on 
the homepage of its Internet site a declaration of compli-
ance in accordance with this section. 
‘‘(b) LICENSURE.—Each online pharmacy shall com-
ply with the requirements of State law concerning the li-
censure of pharmacies in each State from which it, and 
in each State to which it, delivers, distributes, or dispenses 
or offers to deliver, distribute, or dispense controlled sub-
stances by means of the Internet, pursuant to applicable 
licensure requirements, as determined by each such State. 
‘‘(c) INTERNET PHARMACY SITE DISCLOSURE IN-
FORMATION.—Each online pharmacy shall post in a visible 
and clear manner on the homepage of each Internet site 
it operates, or on a page directly linked thereto in which 
the hyperlink is also visible and clear on the homepage, 
the following information for each pharmacy that delivers, 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
distributes, or dispenses controlled substances pursuant to 
orders made on, through, or on behalf of, that website: 
‘‘(1) The name and address of the pharmacy as 
it appears on the pharmacy’s Drug Enforcement Ad-
ministration certificate of registration. 
‘‘(2) The pharmacy’s telephone number and 
email address. 
‘‘(3) The name, professional degree, and States 
of licensure of the pharmacist-in-charge, and a tele-
phone number at which the pharmacist-in-charge 
can be contacted. 
‘‘(4) A list of the States in which the pharmacy 
is licensed to dispense controlled substances. 
‘‘(5) A certification that the pharmacy is reg-
istered under this part to deliver, distribute, or dis-
pense by means of the Internet controlled sub-
stances. 
‘‘(6) The name, address, telephone number, 
professional degree, and States of licensure of any 
practitioner who has a contractual relationship to 
provide medical evaluations or issue prescriptions for 
controlled substances, through referrals from the 
website or at the request of the owner or operator 
of the website, or any employee or agent thereof. 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(7) The following statement, unless revised by 
the Attorney General by regulation: ‘This online 
pharmacy will only dispense a controlled substance 
to a person who has a valid prescription issued for 
a legitimate medical purpose based upon a medical 
relationship with a prescribing practitioner. This in-
cludes at least one prior in-person medical evalua-
tion or medical evaluation via telemedicine in accord-
ance with applicable requirements of section 309 of 
the Controlled Substances Act (21 U.S.C. 829).’. 
‘‘(d) NOTIFICATION.—(1) Thirty days prior to offer-
ing a controlled substance for sale, delivery, distribution, 
or dispensing, the online pharmacy shall notify the Attor-
ney General, in the form and manner as the Attorney Gen-
eral shall determine, and the State boards of pharmacy 
in any States in which the online pharmacy offers to sell, 
deliver, distribute, or dispense controlled substances. 
‘‘(2) The notification required under paragraph (1) 
shall include— 
‘‘(A) the information required to be posted on 
the online pharmacy’s Internet site under subsection 
(c) and shall notify the Attorney General and the 
applicable State boards of pharmacy, under penalty 
of perjury, that the information disclosed on its 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
Internet site under subsection (c) is true and accu-
rate; 
‘‘(B) the online pharmacy’s Internet site ad-
dress and a certification that the online pharmacy 
shall notify the Attorney General of any change in 
the address at least 30 days in advance; and 
‘‘(C) the Drug Enforcement Administration 
registration numbers of any pharmacies and practi-
tioners referred to in subsection (c), as applicable. 
‘‘(3) An online pharmacy that is already operational 
as of the effective date of this section, shall notify the At-
torney General and applicable State boards of pharmacy 
in accordance with this subsection not later than 30 days 
after the effective date of this section. 
‘‘(e) DECLARATION OF COMPLIANCE.—On and after 
the date on which it makes the notification under sub-
section (d), each online pharmacy shall display on the 
homepage of its Internet site, in such form as the Attorney 
General shall by regulation require, a declaration that it 
has made such notification to the Attorney General. 
‘‘(f) REPORTS.—Any statement, declaration, notifica-
tion, or disclosure required under this section shall be con-
sidered a report required to be kept under this part. 
‘‘(g) NOTICE AND DESIGNATIONS CONCERNING IN-
DIAN TRIBES.— 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(1) IN GENERAL.—For purposes of sections 
102(52) and 512(c)(6)(B), the Secretary shall notify 
the Attorney General, at such times and in such 
manner as the Secretary and the Attorney General 
determine appropriate, of the Indian tribes or tribal 
organizations with which the Secretary has con-
tracted or compacted under the Indian Self-Deter-
mination and Education Assistance Act (25 U.S.C. 
450 et seq.) for the tribes or tribal organizations to 
provide pharmacy services. 
‘‘(2) DESIGNATIONS.— 
‘‘(A) IN
GENERAL.—The Secretary may 
designate a practitioner described in subpara-
graph (B) as an Internet Eligible Controlled 
Substances Provider. Such designations shall be 
made only in cases where the Secretary has 
found that there is a legitimate need for the 
practitioner to be so designated because the 
population served by the practitioner is in a 
sufficiently remote location that access to med-
ical services is limited. 
‘‘(B) PRACTITIONERS.—A practitioner de-
scribed in this subparagraph is a practitioner 
who is an employee or contractor of the Indian 
Health Service, or is working for an Indian 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
tribe or tribal organization under its contract or 
compact under the Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 450 
et seq.) with the Indian Health Service. 
‘‘(h) SPECIAL REGISTRATION FOR TELEMEDICINE.— 
‘‘(1) IN GENERAL.—The Attorney General may 
issue to a practitioner a special registration to en-
gage in the practice of telemedicine for purposes of 
section 102(54)(E) if the practitioner, upon applica-
tion for such special registration— 
‘‘(A) demonstrates a legitimate need for 
the special registration; and 
‘‘(B) is registered under section 303(f) in 
the State in which the patient will be located 
when receiving the telemedicine treatment, un-
less the practitioner— 
‘‘(i) is exempted from such registra-
tion in all States under section 302(d); or 
‘‘(ii) is an employee or contractor of 
the Department of Veterans Affairs who is 
acting in the scope of such employment or 
contract and is registered under section 
303(f) in any State or is utilizing the reg-
istration of a hospital or clinic operated by 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
the Department of Veterans Affairs reg-
istered under section 303(f). 
‘‘(2) REGULATIONS.—The Attorney General 
shall, with the concurrence of the Secretary, promul-
gate regulations specifying the limited circumstances 
in which a special registration under this subsection 
may be issued and the procedures for obtaining such 
a special registration. 
‘‘(3) DENIALS.—Proceedings to deny an appli-
cation for registration under this subsection shall be 
conducted in accordance with section 304(c). 
‘‘(i) REPORTING OF TELEMEDICINE BY VHA DUR-
ING MEDICAL EMERGENCY SITUATIONS.— 
‘‘(1) IN GENERAL.—Any practitioner issuing a 
prescription for a controlled substance under the au-
thorization to conduct telemedicine during a medical 
emergency situation described in section 102(54)(F) 
shall report to the Secretary of Veterans Affairs the 
authorization of that emergency prescription, in ac-
cordance with such requirements as the Secretary of 
Veterans Affairs shall, by regulation, establish. 
‘‘(2) TO ATTORNEY GENERAL.—Not later than 
30 days after the date that a prescription described 
in subparagraph (A) is issued, the Secretary of Vet-
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00023
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
erans Affairs shall report to the Attorney General 
the authorization of that emergency prescription. 
‘‘(j) CLARIFICATION
CONCERNING
PRESCRIPTION 
TRANSFERS.—Any transfer between pharmacies of infor-
mation relating to a prescription for a controlled substance 
shall meet the applicable requirements under regulations 
promulgated by the Attorney General under this Act.’’. 
(2) TECHNICAL
AND
CONFORMING
AMEND-
MENTS.—The table of contents for the Comprehen-
sive Drug Abuse Prevention and Control Act of 
1970 (Public Law 91–513; 84 Stat. 1236) is amend-
ed by inserting after the item relating to section 310 
the following: 
‘‘Sec. 311. Additional requirements relating to online pharmacies and telemedi-
cine.’’. 
(e) OFFENSES
INVOLVING
CONTROLLED
SUB-
STANCES IN SCHEDULES III, IV, AND V.—Section 401(b) 
of the Controlled Substances Act (21 U.S.C. 841(b)) is 
amended— 
(1) in paragraph (1)— 
(A) in subparagraph (C), by striking ‘‘1 
gram of’’ before ‘‘flunitrazepam’’; 
(B) in subparagraph (D), by striking ‘‘or 
in the case of any controlled substance in 
schedule III (other than gamma hydroxybutyric 
acid), or 30 milligrams of flunitrazepam’’; and 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00024
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
(C) by adding at the end the following: 
‘‘(E)(i) In the case of any controlled sub-
stance in schedule III, such person shall be sen-
tenced to a term of imprisonment of not more 
than 10 years and if death or serious bodily in-
jury results from the use of such substance 
shall be sentenced to a term of imprisonment of 
not more than 20 years, a fine not to exceed 
the greater of that authorized in accordance 
with the provisions of title 18, United States 
Code, or $500,000 if the defendant is an indi-
vidual or $2,500,000 if the defendant is other 
than an individual, or both. 
‘‘(ii) If any person commits such a viola-
tion after a prior conviction for a felony drug 
offense has become final, such person shall be 
sentenced to a term of imprisonment of not 
more than 20 years and if death or serious bod-
ily injury results from the use of such substance 
shall be sentenced to a term of imprisonment of 
not more than 30 years, a fine not to exceed 
the greater of twice that authorized in accord-
ance with the provisions of title 18, United 
States Code, or $1,000,000 if the defendant is 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00025
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
an individual or $5,000,000 if the defendant is 
other than an individual, or both. 
‘‘(iii) Any sentence imposing a term of im-
prisonment under this subparagraph shall, in 
the absence of such a prior conviction, impose 
a term of supervised release of at least 2 years 
in addition to such term of imprisonment and 
shall, if there was such a prior conviction, im-
pose a term of supervised release of at least 4 
years in addition to such term of imprison-
ment.’’; 
(2) in paragraph (2)— 
(A) by striking ‘‘3 years’’ and inserting ‘‘5 
years’’; 
(B) by striking ‘‘6 years’’ and inserting 
‘‘10 years’’; 
(C) by striking ‘‘after one or more prior 
convictions’’ and all that follows through ‘‘have 
become final,’’ and inserting ‘‘after a prior con-
viction for a felony drug offense has become 
final,’’; and 
(3) in paragraph (3)— 
(A) by striking ‘‘2 years’’ and inserting ‘‘6 
years’’; 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00026
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
(B) by striking ‘‘after one or more convic-
tions’’ and all that follows through ‘‘have be-
come final,’’ and inserting ‘‘after a prior convic-
tion for a felony drug offense has become 
final,’’; and 
(C) by adding at the end the following 
‘‘Any sentence imposing a term of imprison-
ment under this paragraph may, if there was a 
prior conviction, impose a term of supervised 
release of not more than 1 year, in addition to 
such term of imprisonment.’’. 
(f) OFFENSES INVOLVING DISPENSING
OF CON-
TROLLED SUBSTANCES BY MEANS OF THE INTERNET.— 
Section 401 of the Controlled Substances Act (21 U.S.C. 
841) is amended by adding at the end the following: 
‘‘(g) OFFENSES INVOLVING DISPENSING OF CON-
TROLLED SUBSTANCES BY MEANS OF THE INTERNET.— 
(1) It shall be unlawful for any person to knowingly or 
intentionally— 
‘‘(A) deliver, distribute, or dispense a controlled 
substance by means of the Internet, except as au-
thorized by this title; or 
‘‘(B) aid or abet (as such terms are used in sec-
tion 2 of title 18, United States Code) any activity 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00027
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
described in subparagraph (A) that is not authorized 
by this title. 
‘‘(2) Examples of activities that violate paragraph (1) 
include, but are not limited to, knowingly or inten-
tionally— 
‘‘(A) delivering, distributing, or dispensing a 
controlled substance by means of the Internet by an 
online pharmacy that is not validly registered with 
a modification authorizing such activity as required 
by section 303(f) (unless exempt from such registra-
tion); 
‘‘(B) writing a prescription for a controlled sub-
stance for the purpose of delivery, distribution, or 
dispensation by means of the Internet in violation of 
section 309(e); 
‘‘(C) serving as an agent, intermediary, or other 
entity that causes the Internet to be used to bring 
together a buyer and seller to engage in the dis-
pensing of a controlled substance in a manner not 
authorized by sections 303(f) or 309(e); 
‘‘(D) offering to fill a prescription for a con-
trolled substance based solely on a consumer’s com-
pletion of an online medical questionnaire; and 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00028
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(E) making a material false, fictitious, or 
fraudulent statement or representation in the sub-
mission to the Attorney General under section 311. 
‘‘(3)(A) This subsection does not apply to— 
‘‘(i) the delivery, distribution, or dispensation of 
controlled substances by nonpractitioners to the ex-
tent authorized by their registration under this title; 
‘‘(ii) the placement on the Internet of material 
that merely advocates the use of a controlled sub-
stance or includes pricing information without at-
tempting to propose or facilitate an actual trans-
action involving a controlled substance; or 
‘‘(iii) except as provided in subparagraph (B), 
any activity that is limited to— 
‘‘(I) the provision of a telecommunications 
service, or of an Internet access service or 
Internet information location tool (as those 
terms are defined in section 231 of the Commu-
nications Act of 1934 (47 U.S.C. 231)); or 
‘‘(II) the transmission, storage, retrieval, 
hosting, formatting, or translation (or any com-
bination thereof) of a communication, without 
selection or alteration of the content of the 
communication, except that deletion of a par-
ticular communication or material made by an-
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00029
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
other person in a manner consistent with sec-
tion 230(c) of the Communications Act of 1934 
(47 U.S.C. 230(c)) shall not constitute such se-
lection or alteration of the content of the com-
munication. 
‘‘(B) The exceptions under subclauses (I) and (II) of 
subparagraph (A)(iii) shall not apply to a person acting 
in concert with a person who violates paragraph (1). 
‘‘(4) Any person who knowingly or intentionally vio-
lates this subsection shall be sentenced in accordance with 
subsection (b) of this section.’’. 
(g) PUBLICATION.—Section 403(c) of the Controlled 
Substances Act (21 U.S.C. 843(c)) is amended by— 
(1) designating the text as paragraph (1); and 
(2) adding at the end the following: 
‘‘(2)(A) Except as authorized by this title, it shall be 
unlawful for any person by means of the Internet to know-
ingly advertise the sale or distribution of, or to offer to 
sell, distribute, or dispense, a controlled substance. 
‘‘(B) Examples of activities that violate subparagraph 
(A) include, but are not limited to, knowingly or inten-
tionally causing the placement on the Internet of an adver-
tisement that refers to or directs prospective buyers to 
Internet sellers of controlled substances who are not reg-
istered with a modification under section 303(f). 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00030
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(C) Subparagraph (A) does not apply to material 
that either— 
‘‘(i) merely advertises the distribution of con-
trolled substances by nonpractitioners to the extent 
authorized by their registration under this title; or 
‘‘(ii) merely advocates the use of a controlled 
substance or includes pricing information without at-
tempting to facilitate an actual transaction involving 
a controlled substance.’’. 
(h) INJUNCTIVE RELIEF.—Section 512 of the Con-
trolled Substances Act (21 U.S.C. 882) is amended by 
adding at the end the following: 
‘‘(c) STATE CAUSE OF ACTION PERTAINING TO ON-
LINE PHARMACIES.—(1) In any case in which the State 
has reason to believe that an interest of the residents of 
that State has been or is being threatened or adversely 
affected by the action of a person, entity, or Internet site 
that violates the provisions of section 303(f), 309(e), or 
311, the State may bring a civil action on behalf of such 
residents in a district court of the United States with ap-
propriate jurisdiction— 
‘‘(A) to enjoin the conduct which violates this 
section; 
‘‘(B) to enforce compliance with this section; 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00031
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
‘‘(C) to obtain damages, restitution, or other 
compensation, including civil penalties under section 
402(b); and 
‘‘(D) to obtain such other legal or equitable re-
lief as the court may find appropriate. 
‘‘(2)(A) Prior to filing a complaint under paragraph 
(1), the State shall serve a copy of the complaint upon 
the Attorney General and upon the United States Attor-
ney for the judicial district in which the complaint is to 
be filed. In any case where such prior service is not fea-
sible, the State shall serve the complaint on the Attorney 
General and the appropriate United States Attorney on 
the same day that the State’s complaint is filed in Federal 
district court of the United States. Such proceedings shall 
be independent of, and not in lieu of, criminal prosecutions 
or any other proceedings under this title or any other laws 
of the United States. 
‘‘(B) Upon receiving notice respecting a civil action 
pursuant to this section, the United States shall have the 
right to intervene in such action, upon so intervening, to 
be heard on all matters arising therein, and to file peti-
tions for appeal. 
‘‘(C) Service of a State’s complaint on the United 
States as required in this paragraph shall be made in ac-
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00032
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
cord with the requirements of rule 4(i)(1) of the Federal 
Rule of Civil Procedure. 
‘‘(3) For purposes of bringing any civil action under 
paragraph (1), nothing in this Act shall prevent an attor-
ney general of a State from exercising the powers con-
ferred on the attorney general of a State by the laws of 
such State to conduct investigations or to administer oaths 
or affirmations or to compel the attendance of witnesses 
of or the production of documentary or other evidence. 
‘‘(4) Any civil action brought under paragraph (1) in 
a district court of the United States may be brought in 
the district in which the defendant is found, is an inhab-
itant, or transacts business or wherever venue is proper 
under section 1391 of title 28, United States Code. Proc-
ess in such action may be served in any district in which 
the defendant is an inhabitant or in which the defendant 
may be found. 
‘‘(5) No private right of action is created under this 
subsection. 
‘‘(6) No civil action may be brought under paragraph 
(1) against— 
‘‘(A) the United States; 
‘‘(B) an Indian Tribe or tribal organization, to 
the extent such tribe or tribal organization is law-
fully carrying out a contract or compact under the 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00033
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
Indian Self-Determination and Education Assistance 
Act; or 
‘‘(C) any employee of the United States or such 
Indian tribe or tribal organization, provided such 
agent or employee is acting in the usual course of 
business or employment, and within the scope of the 
official duties of such agent or employee therewith.’’. 
(i) FORFEITURE
OF FACILITATING PROPERTY
IN 
DRUG CASES.—Section 511(a)(4) of the Controlled Sub-
stances Act (21 U.S.C. 881(a)(4)) is amended to read as 
follows: 
‘‘(4) Any property, real or personal, tangible or 
intangible, used or intended to be used to commit, 
or to facilitate the commission, of a violation of this 
title or title III, and any property traceable there-
to.’’. 
(j) IMPORT AND EXPORT ACT.—Section 1010(b) of 
the Controlled Substances Import and Export Act (21 
U.S.C. 960(b)) is amended— 
(1) in paragraph (4)— 
(A) by striking ‘‘or any quantity of a con-
trolled substance in schedule III, IV, or V, (ex-
cept a violation involving flunitrazepam and ex-
cept a violation involving gamma hydroxy-
butyric acid)’’; 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00034
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
laws by a practitioner (as that term is defined 
in section 102 of the Controlled Substances Act 
(21 U.S.C. 802)) (other than a pharmacist) 
who is at a location remote from the patient 
and is communicating with the patient, or 
health care professional who is treating the pa-
tient, using a telecommunications system re-
ferred to in section 1834(m) of the Social Secu-
rity Act (42 U.S.C. 1395m(m)), if the practi-
tioner is using an interactive telecommuni-
cations system that satisfies the requirements 
of section 410.78(a)(3) of title 42, Code of Fed-
eral Regulations. 
(C) RULE OF CONSTRUCTION.—Nothing in 
this subsection may be construed to create a 
precedent that any specific course of conduct 
constitutes the ‘‘practice of telemedicine’’ (as 
that term is defined in section 102(54) of the 
Controlled Substances Act, as amended by this 
Act) after the end of the period specified in 
subparagraph (A). 
(l) GUIDELINES AND REGULATIONS.— 
(1) IN GENERAL.—The Attorney General may 
promulgate and enforce any rules, regulations, and 
procedures which may be necessary and appropriate 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00037
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
for the efficient execution of functions under this 
Act or the amendments made by this Act, and, with 
the concurrence of the Secretary of Health and 
Human Services where this Act or the amendments 
made by this Act so provides, promulgate any in-
terim rules necessary for the implementation of this 
Act or the amendments made by this Act, prior to 
its effective date. 
(2) SENTENCING
GUIDELINES.—The United 
States Sentencing Commission, in determining 
whether to amend, or establish new, guidelines or 
policy statements, to conform the Federal sentencing 
guidelines and policy statements to this Act and the 
amendments made by this Act— 
(A) shall consult with the Department of 
Justice, experts and other affected parties con-
cerning which penalties for scheduled sub-
stances amended by this Act should be reflected 
in the Federal sentencing guidelines; and 
(B) should not construe any change in the 
maximum penalty for a violation involving a 
controlled substance in a particular schedule as 
being the sole reason to amend a, or establish 
a new, guideline or policy statement. 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00038
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
(m) ANNUAL REPORT.—Not later than 180 days 
after the date of enactment of this Act, and annually for 
2 years after the initial report, the Drug Enforcement Ad-
ministration, in consultation with the Department of 
State, shall submit to Congress a report describing— 
(1) the foreign supply chains and sources of 
controlled substances offered for sale without a valid 
prescription on the Internet; 
(2) the efforts and strategy of the Drug En-
forcement Administration to decrease the foreign 
supply chain and sources of controlled substances of-
fered for sale without a valid prescription on the 
Internet; and 
(3) the efforts of the Drug Enforcement Ad-
ministration to work with domestic and multi-
national pharmaceutical companies and others to 
build international cooperation and a commitment to 
fight on a global scale the problem of distribution of 
controlled substances over the Internet without a 
valid prescription. 
SEC. 4. RULE OF CONSTRUCTION. 
Nothing in this Act or the amendments made by this 
Act shall be construed as authorizing, prohibiting, or lim-
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00039
Fmt 6652
Sfmt 6201
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS
iting the use of electronic prescriptions for controlled sub-
stances. 
Æ 
VerDate Aug 31 2005 
01:00 Jun 26, 2008
Jkt 069200
PO 00000
Frm 00040
Fmt 6652
Sfmt 6301
E:\BILLS\H6353.IH
H6353
jbell on PROD1PC69 with BILLS