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Lawmakers still wrangling PDMP

JEFFERSON CITY, Mo. — Senate and House lawmakers in Missouri have each advanced bills to create a prescription drug monitoring database in Missouri, but the bills contain significant differences that will need to be reconciled before sending anything to Gov. Jay Nixon’s desk.

Missouri is the only state in the country with no statewide database monitoring prescription drugs, which proponents say cuts down on fraud like “doctor shopping” — patients who get multiple prescriptions of the same drug, like painkillers. But opponents say a statewide database with the private health information of citizens is simply ripe for improper use by government officials or breach by hackers.

The House passed their version of the bill last month by 107-48, just a few votes shy of a veto-proof majority. The Senate debated their own version of the bill for hours into last Monday night, finally approving a compromise measure with nearly a dozen amendments by a 23-9 vote. It would appear that supporters are rallying around the Senate as the primary vehicle for the bill.

Proponents of the bill face perhaps the stiffest opposition in the Senate. Sen. Rob Schaaf, R-St. Joseph, a physician, has long blocked any votes on the issue, citing privacy concerns. But Schaaf has come to the negotiating table this year according to the bill’s handlers and his willingness to even let the matter come to a vote, regardless of his own personal vote on the matter, is a major coup for proponents of the legislation. After all, he successfully killed the bill in 2008 as a House member and, last year, he refused to let the measure come to a vote on the floor.

“Without Senator Schaaf willing to come and work on this bill together, I don’t think we could have gotten this done,” said Sen. David Sater, who is pushing the legislation in the upper chamber. Sater said the next week or so would be important in the life of the bill. Sater doesn’t want any of the amendments added in the senate to explode the cost of the bill, and says lawmakers are still feeling out differences in each chamber.

That process will get harder as the most conservative wing of the Republican Party is cranking up their opposition to the bill. The Missouri Alliance for Freedom’s Ryan Johnson joined conservative radio host Jamie Allman on 97.1 to blast the bill as an invasion of privacy. Johnson and a number of conservative lawmakers are hoping to torpedo the Senate legislation as it makes its way back through the House.

Rep. Holly Rehder, a Republican, has worked for several years in the House to advance the measure. Rehder said Schaaf’s involvement was key in moving the issue forward this year and that opponents typically exaggerated concerns. She also said the bill represented a series of common sense compromises. The Senate version of the bill, sponsored by Sen. David Sater, R-Barry County, reflects language negotiated between Schaaf, Sater, Rehder and other invested parties.

“It is interesting because doctor’s groups support this,” Rehder said. “But the doctors we have in this legislature don’t seem to support it. Forty-nine other states have done this. You can’t tell me we are the only ones who have figured this out.”

Complicating matters perhaps even more is 2013’s CCW scandal that saw the state release hundreds of thousands of names of CCW permit holders to the federal government in violation of state statute. Republicans hammered the Department of Revenue for not taking better care of the information and opponents of a drug database say the debacle should give the entire state trepidation about future government-run databases.

“Nobody wants to go through what we had with CCW’s,” Sater said. “And so in working with Sen. Schaaf, the focus was always to keep the data as secure as possible.”

Senators amended SB63 to create a 2020 sunset that will need a legislative vote to renew the program, required prescription data be deleted after 180 days, and mandated that the entire database be encrypted against cyber attacks.

Several of these changes will be points of friction as Rehder and Sater move to find language they can send to Nixon’s desk, but both lawmakers said that this year’s negotiations progressed farther than any in the past. Sater expressed what he called “quiet optimism” that the bill would become law.

“All the compromise that’s gone into this bill and the time, if we can get it to the governor’s desk I believe he’ll sign it, and I’m still optimistic we can be successful,” Sater said.