I
107TH CONGRESS
2D SESSION
H. R. 4836
To amend title 38, United States Code, to establish policies for any require-
ment by the Department of Veterans Affairs that veterans be required
to split their medications as a cost-saving measure.
IN THE HOUSE OF REPRESENTATIVES
MAY 23, 2002
Mr. CARDIN introduced the following bill; which was referred to the
Committee on Veterans’ Affairs
A BILL
To amend title 38, United States Code, to establish policies
for any requirement by the Department of Veterans Af-
fairs that veterans be required to split their medications
as a cost-saving measure.
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 ‘‘Veterans Safe Medica-
tions Act.’’.
SEC. 2. DEPARTMENT OF VETERANS AFFAIRS POLICY ON
TABLET SPLITTING OF MEDICATIONS.
(a) REQUIRED POLICY.—Section 1712 of title 38,
United States Code, is amended by adding at the end the
following new subsection:
‘‘(f)(1) The Secretary shall prescribe a policy for use
by health care providers and pharmacies of the Depart-
ment of the practice of prescribing or dispensing tablet
medication in a form that requires tablet splitting by the
patient. Such policy shall require that a Department phar-
macy may provide a medication to a veteran in tablet form
in a dosage so as to require tablet splitting only if each
of the conditions specified in paragraph (2) is met. Noth-
ing in this subsection shall be construed so as to encourage
or require prescribing or dispensing medicine in a form
that requires tablet splitting.
‘‘(2) The conditions referred to in paragraph (1) are
the following:
‘‘(A) A health care professional has determined
that the patient has the mental and physical ability
to properly use a table splitter.
‘‘(B) The tablets dispensed are in a form re-
ferred to as ‘scored’.
‘‘(C) The tablets are not sustained-release tab-
lets.
‘‘(D) The tablets are intended to be taken every
48 hours or more frequently.
‘‘(E) A tablet splitter that the Secretary has de-
termined to be effective has been provided to the pa-
tient.
‘‘(3) If the prescriber of a medication determines that
a particular patient should not be required to use tablet
splitting, the prescriber may specify that medication for
that patient prescribed by that prescriber be dispensed in
a form that does not require tablet splitting. Any such
specification shall be honored by Department pharmacies.
‘‘(4) For patients who demonstrate the ability to per-
form tablet splitting, the Secretary shall provide appro-
priate instruction in written form (as determined by the
Secretary). Such instruction shall include informing the
patient to split a tablet immediately before use so that
the remaining portion is not exposed for a period greater
than 48 hours.
‘‘(5) The Secretary shall require that any adverse
events that are directly attributable to the practice of
splitting tablets be reported to the Under Secretary for
Health on a monthly basis.
‘‘(6) The Under Secretary for Health shall establish
a national formulary of medications that have been ap-
proved for tablet splitting. The list of medications in the
formulary shall be made available, upon request, to pa-
tients and their families. The Under Secretary shall review
the formulary annually to determine if patient or financial
outcomes through the use of tablet splitting validate con-
tinuation of specific medications on the formulary.
‘‘(7) In this subsection, the term ‘tablet splitting’
means, in the case of a medication that is dispensed in
a tablet form in a dosage that is twice the prescribed dos-
age, action by the patient to split the tablet in half for
consumption.’’.
(b) EFFECTIVE DATE.—The policy required by the
amendment made by subsection (a) shall be prescribed not
later than 60 days after the date of the enactment of this
Act.
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