H.F. 192 Section 1. NEW SECTION . 146A.1 Medical abortions —— 1 restrictions —— protocol —— penalties. 2 1. A person shall not knowingly give, sell, dispense, 3 administer, otherwise provide, or prescribe any medication to 4 another person for the purpose of inducing a medical abortion 5 in the person or enabling the other person to induce a medical 6 abortion in another person, unless the person who gives, sells, 7 dispenses, administers, or otherwise provides or prescribes the 8 medication meets all of the following requirements: 9 a. Is a licensed physician. 10 b. The physician satisfies all the criteria established by 11 federal law that a physician must satisfy in order to provide 12 such medication for inducing medical abortions. 13 c. The physician provides the medication to the other person 14 for the purpose of inducing a medical abortion in accordance 15 with all provisions of federal law that govern the use of such 16 medication for inducing medical abortions. 17 2. A person who gives, sells, dispenses, administers, 18 otherwise provides, or prescribes medication to another person 19 as described in subsection 1 shall not be prosecuted based on 20 a violation of the criteria contained in this section unless 21 the person knows that the person is not a licensed physician, 22 that the person did not satisfy all the specified criteria 23 established by federal law, or that the person did not provide 24 the medication in accordance with the specified provisions of 25 federal law, whichever is applicable. 26 3. A physician who provides medication to another for 27 the purpose of inducing a medical abortion as authorized 28 under subsection 1 shall not knowingly fail to comply with 29 the applicable requirements of any federal law that pertain 30 to follow-up examinations or care for persons to whom or for 31 whom such medication is provided for the purpose of inducing a 32 medical abortion. 33 4. a. If a physician provides medication to another person 34 for the purpose of inducing a medical abortion as authorized 35 -1- LSB 1169YH (4) 84 pf/nh 1/ 5

H.F. 192 under subsection 1, and the physician knows that the person 1 who uses the medication for the purpose of inducing a medical 2 abortion experiences during or after the use an incomplete 3 abortion, severe bleeding, or an adverse reaction to the 4 medication, or is hospitalized, receives a transfusion, or 5 experiences any other serious event, the physician shall 6 provide a written report of the incomplete abortion, severe 7 bleeding, adverse reaction, hospitalization, transfusion, or 8 serious event to the department. The department shall compile 9 and retain all reports the department receives under this 10 section. Except as otherwise provided in this section, all 11 reports the department receives under this section are public 12 records. However, the department shall not release to any 13 person the name or any other personal identifying information 14 regarding a person who uses medication for the purpose of 15 inducing a medical abortion and who is the subject of a report 16 the department receives under this section. 17 b. A physician who provides medication to another for the 18 purpose of inducing a medical abortion as authorized under 19 subsection 1 shall not knowingly fail to file a report required 20 under paragraph “a” . 21 5. A physician shall only diagnose and prescribe a medical 22 abortion in person, and shall not utilize other means, such as 23 an internet web camera, to do so. 24 6. A physician shall not give, sell, dispense, administer, 25 otherwise provide, or prescribe a medication for the purpose of 26 inducing a medical abortion for a minor without first complying 27 with chapter 135L. 28 7. If a physician prescribes medication to induce a medical 29 abortion after the gestational limit of forty-nine days 30 recommended by the United States food and drug administration, 31 the physician shall ensure that the woman has access to 32 emergency care that is available twenty-four hours per day, 33 seven days per week, and shall report any emergency care 34 provided from complications arising from such prescription to 35 -2- LSB 1169YH (4) 84 pf/nh 2/ 5

H.F. 192 the department. 1 8. a. A person who violates this section is guilty of a 2 class “D” felony. 3 b. If a person who violates this section is professionally 4 licensed in this state, in addition to any other sanction 5 imposed by law for the offense, the person is subject to 6 sanctioning as provided by law by the regulatory or licensing 7 board or agency that has the administrative authority to 8 suspend or revoke the person’s professional license. 9 9. As used in this section, unless the context otherwise 10 requires: 11 a. “Department” means the department of public health. 12 b. “Federal law” means any law, rule, or regulation of the 13 United States or any drug approval letter of the food and drug 14 administration of the United States that governs or regulates 15 the use of mifepristone for the purpose of inducing abortions. 16 c. “Medical abortion” means the use of a medication 17 including but not limited to mifepristone or ulipristal acetate 18 to terminate a pregnancy. 19 d. “Minor” means a person under eighteen years of age who 20 has not been and is not married. 21 EXPLANATION 22 This bill provides the protocol related to a medical 23 abortion. 24 The bill prohibits a person from knowingly giving, selling, 25 dispensing, administering, or otherwise providing, or 26 prescribing a medication to another person for the purpose 27 of inducing a medical abortion in the person or enabling the 28 other person to induce a medical abortion in another person, 29 unless the person who gives, sells, dispenses, administers, 30 or otherwise provides or prescribes such medication meets 31 all of the following requirements: is a licensed physician; 32 satisfies all the criteria established by federal law that 33 a physician must satisfy in order to provide the medication 34 to induce the medical abortion; and provides the medication 35 -3- LSB 1169YH (4) 84 pf/nh 3/ 5

H.F. 192 to the other person for the purpose of inducing an abortion 1 in accordance with all provisions of federal law that govern 2 the use of medication to induce a medical abortion. However, 3 the bill provides that a person who gives, sells, dispenses, 4 administers, otherwise provides, or prescribes medication to 5 another person shall not be prosecuted based on a violation of 6 the criteria specified unless the person knows that the person 7 is not a licensed physician, that the person did not satisfy 8 all the specified criteria established by federal law, or 9 that the person did not provide the medication in accordance 10 with the specified provisions of federal law, whichever is 11 applicable. The bill also provides that a physician who 12 provides medication to another for the purpose of inducing 13 a medical abortion shall not knowingly fail to comply with 14 the applicable requirements of any federal law that pertain 15 to follow-up examinations or care for persons to whom or for 16 whom such medication is provided for the purpose of inducing a 17 medical abortion. 18 If a physician provides medication to induce a medical 19 abortion, and if the physician knows that the person who uses 20 the medication for the purpose of inducing a medical abortion 21 experiences during or after the use an incomplete abortion, 22 severe bleeding, or an adverse reaction to the medication or is 23 hospitalized, receives a transfusion, or experiences any other 24 serious event, the physician is required to provide a written 25 report of such result to the department of public health. 26 The department is directed to compile and retain all reports 27 the department receives, and such reports, unless otherwise 28 provided, are public records. However, the department is 29 prohibited from releasing the name or any other personal 30 identifying information regarding a person who uses medication 31 for the purpose of inducing a medical abortion and who is the 32 subject of a report the department receives. A physician who 33 provides medication to another for the purpose of inducing a 34 medical abortion is prohibited from knowingly failing to file 35 -4- LSB 1169YH (4) 84 pf/nh 4/ 5

H.F. 192 such a report. 1 The bill requires that a physician prescribe a medical 2 abortion only in person, and not utilize other means, such 3 as an internet web camera, to do so. The bill prohibits a 4 physician from giving, selling, dispensing, administering, 5 otherwise providing, or prescribing medication to induce a 6 medical abortion for a minor without first complying with Code 7 chapter 135L (notification requirements regarding pregnant 8 minors). Additionally, if a physician prescribes medication to 9 induce a medical abortion after the United States food and drug 10 administration recommended 49 days of pregnancy, the physician 11 shall ensure that the woman has access to emergency care that 12 is available 24 hours per day, seven days per week, and shall 13 report any emergency care provided from complications arising 14 from such prescription to the department. 15 A person who violates a provision of the bill is guilty 16 of a class “D” felony. A class “D” felony is punishable by 17 confinement for no more than five years and a fine of at least 18 $750 but not more than $7,500. Additionally, if a person 19 who violates the provisions of the bill is professionally 20 licensed, the person is subject to sanctioning as provided by 21 law by the regulatory or licensing board or agency that has 22 the administrative authority to suspend or revoke the person’s 23 professional license. 24 -5- LSB 1169YH (4) 84 pf/nh 5/ 5