Missouri recently became the last state to implement a prescription drug monitoring program or PDMP as it is more commonly referred. A PDMP is a state run electronic database to track the prescribing and dispensing of certain classes of prescription drugs in order to curb or eliminate abuse. PDMP’s are typically implemented to address the growing opioid abuse crisis in the country, however many legislators, particularly here in Missouri, have serious concerns regarding patient privacy. These concerns are in large part the reason for the stalemate in years past of getting a bill to the Governer’s desk that establishes this type of program. A contingent of Missouri legislators has successfully blocked implementation of PDMP based almost solely on this concern. They argue that a person’s health information, specifically drugs they are prescribed, is information best left to the patient and their doctor and pharmacist. While these legislators have offered some level of compromises including time limited data retention, limited access to the database and/or the scattering of data so that large levels of patient data are not easily hacked into, most of these compromises have been labeled as being too much an impediment to the effectiveness of the program. These opposing forces have clashed year after year ultimately resulting in Missouri being the last state in the union to implement some sort of program. To date the Missouri legislature has not passed a bill for the implementation of a PDMP. However, the state now has begun implementation anyway…

The Governor had pushed hard during regular session for the passage of some version of a PDMP.  After the legislature failed to comply he had threatened something not typically used for these sorts of issues and that is a special session. After one successful special session regarding a time sensitive economic development issue the legislature appears to have slowed the gears to a halt with during the second special session pertaining to issues of abortion. It would seem as though the governors strategy of forcing the legislature to deal with specific issues in the confines of his special calls may have come to an end.  Thus, Governor Greitens has decided to go down a seemingly more popular means of affecting policy by the executive branch by issuing executive order 17-18 (linked here). Governor Greitens ever mindful of putting what he considers wins on the scoreboard sees has raised the ire of the legislature enough that the decision was obviously made to go it alone and enact a broad PDMP of which rules are to be promulgated by the Department of Health and Senior Services.

The legislature has already been reacting to the order from calling out the “Obama style tactics” to digging deeper into the policy flaws that plagued the program while being debated in the legislature. We will all have to wait and see what the concrete response this order will be. Will the legislature pass their own bill next session undoing any work that has been done by the EO? Will someone bring suit as to the constitutionality of the order? Or could the rules promulgated by the department get bogged down and challenged in JCAR? One thing is for certain in American government, when one branch feels as though its authority has been encroached upon the issue at hand has a harder road ahead than it likely would have by going through the traditional procedures.