SSB 3169 (LSB 6155XC (3) 87)

SENATE FILE _____ 

BY  (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON SEGEBART)

A BILL FOR

An Act relating to the prescribing and dispensing of self-administered oral hormonal contraceptives including by pharmacists and providing insurance coverage for such contraceptives prescribed and dispensed.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 155A.3, Code 2018, is amended by adding the following new subsection:
   NEW SUBSECTION.  42A.  “Self-administered oral hormonal contraceptive” means a drug composed of a combination of hormones that is approved by the United States food and drug administration to prevent pregnancy and that the patient to whom the drug is prescribed may take orally.
    Sec. 2.  NEW SECTION.  155A.46  Prescribing and dispensing of self-administered oral hormonal contraceptives.

   1.  Notwithstanding any provision of law to the contrary, a pharmacist may prescribe and dispense self-administered oral hormonal contraceptives to a person regardless of whether the person has evidence of a previous prescription from a practitioner for a self-administered oral hormonal contraceptive.
   2.  a.  The department of public health in consultation with the Iowa pharmacy association and the Iowa medical society, and in consideration of the guidelines established by the American college of obstetricians and gynecologists, shall adopt by rule a statewide protocol for the prescribing and dispensing of self-administered oral hormonal contraceptives by pharmacists.
   b.  The rules adopted under this subsection shall require a pharmacist to do all of the following:
   (1)  Complete a standardized training program approved by the department of public health that is related to prescribing self-administered oral hormonal contraceptives and includes education regarding all contraceptive methods approved by the United States food and drug administration.
   (2)  Provide a standardized self-screening risk assessment tool to the patient for completion prior to the pharmacist’s prescribing of the self-administered oral hormonal contraceptive.
   (3)  Prior to prescribing and dispensing the self-administered oral hormonal contraceptive, provide the patient with education regarding all contraceptive methods approved by the United States food and drug administration.
   (4)  Upon prescribing and dispensing the self-administered oral hormonal contraceptive, provide the patient with a written record of the prescribed and dispensed self-administered oral hormonal contraceptive, and refer the patient to the patient’s primary practitioner or women’s health care practitioner for preventive visits. 
   (5)  Dispense the self-administered oral hormonal contraceptive to the patient as soon as practicable after the pharmacist issues the prescription.
   c.  The rules adopted under this subsection shall require a pharmacist to prescribe and dispense an initial three-month supply of the self-administered oral hormonal contraceptive, and shall authorize a pharmacist, upon verification of no adverse effects, to issue a prescription for and dispense up to a one-year supply of self-administered oral hormonal contraceptives to the patient at one time.
   d.  The rules adopted under this subsection shall prohibit a pharmacist from requiring a patient to schedule an appointment with the pharmacist for the prescribing of a self-administered oral hormonal contraceptive.
   3.  All state and federal laws governing insurance coverage of contraceptive drugs, devices, products, and services shall apply to a self-administered oral hormonal contraceptive prescribed by a pharmacist under this section.
    Sec. 3.  Section 514C.19, subsection 1, paragraph a, Code 2018, is amended to read as follows:
   a.  Exclude or restrict benefits for prescription contraceptive drugs or prescription contraceptive devices which prevent conception and which are approved by the United States food and drug administration, or generic equivalents approved as substitutable by the United States food and drug administration, if such policy or contract provides benefits for other outpatient prescription drugs or devices.  Such policy or contract shall specifically provide for payment of up to a one-year supply, dispensed at one time, of self-administered oral hormonal contraceptives as defined in section 155A.3, which are prescribed by a practitioner authorized to prescribe drugs in this state, including a pharmacist pursuant to section 155A.46.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill authorizes a pharmacist to prescribe and dispense self-administered oral hormonal contraceptives. Under the bill, a pharmacist may prescribe and dispense these items to a person whether or not the person has evidence of a previous prescription from a practitioner for self-administered oral hormonal contraceptives.
   The department of public health in consultation with the Iowa pharmacy association and the Iowa medical society, and in consideration of the guidelines established by the American congress of obstetricians and gynecologists, is directed to adopt a statewide protocol for the prescribing and dispensing of self-administered oral hormonal contraceptives by pharmacists. 
   The bill prescribes what the rules are to require a pharmacist to do and what a pharmacist is prohibited from doing. The rules shall require a pharmacist to complete a standardized training program approved by the department of public health that is related to prescribing self-administered oral hormonal contraceptives and includes education regarding all contraceptive methods approved by the United States food and drug administration (FDA); to provide a standardized self-screening risk assessment tool to the patient for completion prior to the pharmacist’s prescribing of the self-administered oral hormonal contraceptive; prior to prescribing and dispensing the self-administered oral hormonal contraceptive, to provide the patient with education regarding all contraceptive methods approved by the FDA; upon prescribing and dispensing the self-administered oral hormonal contraceptive, to provide the patient with a written record of the prescribed and dispensed self-administered oral hormonal contraceptive, and refer the patient to the patient’s primary practitioner or women’s health care practitioner for preventive visits; and to dispense the self-administered oral hormonal contraceptive to the patient as soon as practicable after the pharmacist issues the prescription. The bill provides that the rules adopted are to require a pharmacist to prescribe and dispense an initial three-month supply of the self-administered oral hormonal contraceptive and authorize a pharmacist, upon verification of no adverse effects, to issue a prescription for and dispense up to a one-year supply of self-administered oral hormonal contraceptives to the patient at one time. The rules shall prohibit a pharmacist from requiring a patient to schedule an appointment with the pharmacist for prescribing the self-administered oral hormonal contraceptive.
   All state and federal laws governing insurance coverage of contraceptive drugs, devices, products, and services apply to a self-administered oral hormonal contraceptive prescribed by a pharmacist under the bill.
   The bill amends prescription contraceptive coverage provisions to require that a group policy or contract providing for third-party payment or prepayment of health or medical expenses, and by reference individual policies as well, shall specifically provide for payment of up to a one-year supply, dispensed at one time, of self-administered oral hormonal contraceptives which are prescribed by a practitioner authorized to prescribe drugs in this state, including a pharmacist pursuant to Code section 155A.46.