H.F. 570 DIVISION I 1 FAMILY PLANNING AND ABORTION REDUCTION POLICY 2 Section 1. FAMILY PLANNING AND ABORTION REDUCTION POLICY. 3 1. a. In 2011, nearly two million eight hundred thousand 4 pregnancies, or forty-five percent of pregnancies, were 5 unintended, meaning that the pregnancy occurred when a woman 6 wanted to become pregnant in the future but not at the time she 7 became pregnant, or the woman became pregnant when she did not 8 want to become pregnant then or at any time in the future. 9 b. The rate of unintended pregnancies is higher among 10 women with incomes below two hundred percent of the federal 11 poverty level (FPL), women eighteen to twenty-four years of 12 age, cohabiting women, and women of color, and is lowest among 13 higher-income women, white women, college graduates, and 14 married women. With respect to the outcome of an unintended 15 pregnancy, in 2011, women with incomes below one hundred 16 percent of the FPL had an unplanned birth rate nearly seven 17 times that of women at or above two hundred percent of the FPL. 18 2. a. Between 2008 and 2011, the unintended pregnancy 19 rate in the United States declined by eighteen percent, the 20 lowest level in three decades. During this time, the rates 21 of both abortion and unplanned births fell substantially by 22 thirteen percent and eighteen percent, respectively. Abortion 23 rates have continued to decline and although states enacted new 24 restrictions on abortions between 2012 and 2014, these states 25 only accounted for thirty-eight percent of the total abortion 26 rate decline between 2011 and 2014. Conversely, sixty-two 27 percent of the decline in the abortion rate was attributable 28 to states and jurisdictions that did not pass restrictive 29 abortion laws during this same time period. This suggests that 30 the decline in the abortion rate during both periods was not 31 due to an increase in unplanned births or increased abortion 32 restrictions. 33 b. During these periods, however, there was improvement 34 in contraceptive use, including the use of highly effective 35 -1- LSB 2399YH (6) 89 pf/rh 1/ 15

H.F. 570 long-acting reversible contraceptives. Based on this data, 1 researchers have concluded that the decline in abortions was 2 driven by the steep decline in unintended pregnancy, which in 3 turn was most plausibly explained by improved contraceptive 4 use, not because fewer women decided to end an unwanted 5 pregnancy. 6 3. a. According to the centers for disease control and 7 prevention of the United States department of health and human 8 services (CDC), two million three hundred thousand cases of 9 chlamydia, gonorrhea, and syphilis were reported in the United 10 States in 2017, the highest number ever, and two hundred 11 thousand more than in 2016. Of these cases, the population 12 aged fifteen to twenty-four accounted for more than one-half 13 of all new sexually transmitted infections (STIs) each year, 14 even though that population makes up only one-quarter of the 15 sexually active population. Sexually transmitted infections 16 are disproportionately more common in young and marginalized 17 people. 18 b. If left undiagnosed and untreated, STIs can have serious 19 health consequences, resulting in infertility, life-threatening 20 ectopic pregnancies, stillbirths in infants, and miscarriages, 21 and an increased risk for human immunodeficiency virus 22 transmission. Additionally, STIs may result in adverse 23 pregnancy outcomes including preterm birth, low-birth 24 weight, and children with physical and mental developmental 25 disabilities. 26 c. The CDC identifies budgetary cuts in STI prevention 27 efforts, societal stigma, insufficient awareness of the 28 importance of screening among some health care providers, lack 29 of comprehensive sex education, and barriers to health care 30 services as playing roles in the increase in STIs. 31 4. a. The CDC and the United States office of population 32 affairs recommend that family planning services include 33 providing contraception to help men and women plan and space 34 births, prevent unintended pregnancies, and reduce the number 35 -2- LSB 2399YH (6) 89 pf/rh 2/ 15

H.F. 570 of abortions; offer pregnancy testing and counseling; help 1 clients who want to conceive; provide basic infertility 2 services; provide preconception health service to improve 3 infant and maternal outcomes, and improve women’s and men’s 4 health; and provide STI screening and treatment services to 5 prevent tubal infertility and improve the health of women, men, 6 and infants. 7 b. In 2014, of the sixty-seven million women of reproductive 8 age, ages thirteen to forty-four, thirty-eight million were in 9 need of contraceptive care, and twenty million were in need of 10 publicly funded services and supplies due to being low-income 11 or being younger than twenty years of age. 12 c. In 2015, public expenditures for family planning client 13 services totaled two billion one hundred million dollars 14 with Medicaid accounting for seventy-five percent, state 15 appropriations accounting for twelve percent, and funding 16 through Tit. X of the federal Public Health Services Act (Tit. 17 X) accounting for ten percent. Tit. X subsidizes services for 18 men and women who do not meet the eligibility requirements for 19 Medicaid, maintains the national network of family planning 20 centers, and sets the standards for provision of family 21 planning services. 22 d. Although total public funding for family planning in 23 actual dollars increased by more than one billion seven hundred 24 million dollars between 1980 and 2015, after adjusting for 25 inflation, funding levels were essentially the same in 2015 as 26 in 1980. 27 e. In 2010, every one dollar invested in publicly funded 28 family planning services saved over seven dollars in Medicaid 29 expenditures that would otherwise have been necessary to pay 30 the medical costs of pregnancy, delivery, and early childhood 31 care; and the nationwide public investment in family planning 32 services resulted in over thirteen billion dollars in net 33 savings, helping women avoid unintended pregnancies and a range 34 of other negative reproductive health outcomes. 35 -3- LSB 2399YH (6) 89 pf/rh 3/ 15

H.F. 570 f. In 2014, publicly funded family planning services helped 1 women to avoid two million unintended pregnancies, which would 2 potentially have resulted in nearly nine hundred thousand 3 unplanned births and nearly seven hundred thousand abortions. 4 g. Publicly funded family planning has well-documented 5 health benefits for women, newborns, families, and communities. 6 The ability to delay and space out childbearing is crucial to 7 women’s social and economic advancement. A woman’s ability to 8 obtain and effectively use contraceptives has a positive impact 9 on their education and workforce participation, as well as on 10 subsequent outcomes related to income, family stability, mental 11 health and happiness, and children’s well-being. Evidence 12 suggests that the most disadvantaged women in the United States 13 do not fully share in these benefits which is why unintended 14 pregnancy prevention efforts should be grounded in broader 15 anti-poverty and social justice efforts. 16 h. Publicly funded family planning services help women to 17 avoid pregnancies they do not want and to plan pregnancies they 18 do want. Supporting and expanding women’s access to family 19 planning services not only protects women’s health, it also 20 reduces abortion rates. The clear implication for policymakers 21 who wish to see fewer abortions occur is to focus on making 22 family planning services and contraceptive care more available 23 and on increasing funding to these services. 24 DIVISION II 25 MEDICAID —— IOWA FAMILY PLANNING NETWORK 26 Sec. 2. MEDICAID —— IOWA FAMILY PLANNING NETWORK. 27 1. The Medicaid 1115 demonstration waiver provided family 28 planning services, at various time periods, from February 2006 29 through June 2017, to men and women ages twelve to fifty-four 30 with incomes not exceeding three hundred percent of the federal 31 poverty level, through the Iowa family planning network. 32 Services provided by the Iowa family planning network during 33 this time did all of the following: 34 a. Resulted in an estimated midpoint number of averted 35 -4- LSB 2399YH (6) 89 pf/rh 4/ 15

H.F. 570 births, including by extension the reduction in unintended or 1 unwanted pregnancies and repeat teen births, of thirty-six 2 thousand one hundred sixty-nine. 3 b. Resulted in an estimated midpoint reduction in Medicaid 4 costs attributable to costs avoided for each averted birth 5 including costs for deliveries, births, and first years of life 6 of four hundred eighty-five million dollars, not including the 7 continuing costs for children who remain on Medicaid beyond 8 their first birthday. Approximately forty percent of children 9 who had a Medicaid-paid birth will remain on Medicaid for five 10 or more years. 11 c. Resulted in a total estimated net savings in Medicaid 12 costs of over four hundred seventy-six million dollars. 13 d. Provided a cost-effective mechanism to allow men and 14 women access to family planning services which resulted in 15 averted births and reduced costs to the state with the ninety 16 percent federal match for such services. 17 2. Conversely, the most recent available data reported 18 regarding the state family planning program established July 1, 19 2017, and funded exclusively with state general fund moneys, 20 indicates that from April through June of 2018, there was a 21 seventy-three percent decline in services compared with April 22 through June 2017, the last three months of the Iowa family 23 planning network, and patient enrollment in the new program 24 fell by more than half. 25 3. If family planning services were once again provided 26 under the Medicaid program through a Medicaid state plan 27 amendment, with the same benefits, eligibility requirements, 28 and other provisions included in the former Iowa family 29 planning network demonstration waiver, the state would be able 30 to do all of the following: 31 a. Utilize the additional state funds available to 32 expand efforts to continue to reduce abortions and improve 33 reproductive and overall health for men and women in the state 34 through broad-based family planning services, age-appropriate 35 -5- LSB 2399YH (6) 89 pf/rh 5/ 15

H.F. 570 sexual health education efforts such as the personal 1 responsibility and education program, programs for pregnant and 2 parenting teens, increased access to family planning services 3 including contraceptives to men and women, Medicaid-enhanced 4 prenatal services for members determined to be at high risk, 5 and the Tit. X family planning program. 6 b. Utilize the entire family planning services provider 7 network to expand access to reach those in need of publicly 8 funded services, including those women for whom rates of 9 unintended pregnancies are higher including low-income, 10 younger, and less-formally educated women, and women of color. 11 c. Continue to provide necessary family planning services 12 that have resulted in declining unintended pregnancies and 13 fewer abortions, and that would result in additional resources 14 being available to enhance the quality of life for children 15 after they are born including through the head start program, 16 prekindergarten programs, child care assistance, properly 17 funded schools, foster and adoptive programs, hawk-i, and other 18 programs that support and enrich the lives of children and 19 families in the state. 20 Sec. 3. IOWA FAMILY PLANNING NETWORK —— MEDICAID STATE 21 PLAN AMENDMENT. The department of human services shall submit 22 a Medicaid state plan amendment to the centers for Medicare 23 and Medicaid services of the United States department of 24 health and human services for approval to establish the Iowa 25 family planning network with the same benefits, eligibility 26 requirements, and other provisions included in the Medicaid 27 Iowa family planning network waiver as approved by the centers 28 for Medicare and Medicaid services of the United States 29 department of health and human services in effect on June 30, 30 2017. 31 Sec. 4. EFFECTIVE DATE. This division of this Act, being 32 deemed of immediate importance, takes effect upon enactment. 33 DIVISION III 34 REPEAL OF STATE FAMILY PLANNING SERVICES PROGRAM 35 -6- LSB 2399YH (6) 89 pf/rh 6/ 15

H.F. 570 Sec. 5. REPEAL. Section 217.41B, Code 2021, is repealed. 1 Sec. 6. CONTINGENT EFFECTIVE DATE. The following takes 2 effect upon receipt of approval by the department of human 3 services from the centers for Medicare and Medicaid services 4 of the United States department of health and human services 5 of the Medicaid state plan amendment submitted pursuant to 6 division II of this Act to establish the Iowa family planning 7 network: 8 The section of this division of this Act repealing section 9 217.41B, Code 2021. 10 DIVISION IV 11 SELF-ADMINISTERED HORMONAL CONTRACEPTIVES 12 Sec. 7. Section 155A.3, Code 2021, is amended by adding the 13 following new subsections: 14 NEW SUBSECTION . 10A. “Department” means the department of 15 public health. 16 NEW SUBSECTION . 44A. “Self-administered hormonal 17 contraceptive” means a self-administered hormonal contraceptive 18 that is approved by the United States food and drug 19 administration to prevent pregnancy. “Self-administered 20 hormonal contraceptive” includes an oral hormonal contraceptive, 21 a hormonal vaginal ring, and a hormonal contraceptive patch, 22 but does not include any drug intended to induce an abortion as 23 defined in section 146.1. 24 NEW SUBSECTION . 44B. “Standing order” means a preauthorized 25 medication order with specific instructions from the medical 26 director of the department to dispense a medication under 27 clearly defined circumstances. 28 Sec. 8. NEW SECTION . 155A.47 Pharmacist dispensing of 29 self-administered hormonal contraceptives —— standing order —— 30 requirements —— limitations of liability. 31 1. Notwithstanding any provision of law to the contrary, a 32 pharmacist may dispense, at one time, up to a one-year supply 33 of a self-administered hormonal contraceptive to a patient, 34 pursuant to a standing order established by the medical 35 -7- LSB 2399YH (6) 89 pf/rh 7/ 15

H.F. 570 director of the department in accordance with this section. 1 2. A pharmacist who dispenses a self-administered hormonal 2 contraceptive in accordance with this section shall not 3 require any other prescription drug order authorized by a 4 practitioner prior to dispensing the self-administered hormonal 5 contraceptive to a patient. 6 3. The medical director of the department may establish a 7 standing order authorizing the dispensing of self-administered 8 hormonal contraceptives by a pharmacist who does all of the 9 following: 10 a. Complies with the standing order established pursuant to 11 this section. 12 b. Retains a record of each patient to whom a 13 self-administered hormonal contraceptive is dispensed under 14 this section and submits the record to the department. 15 4. The standing order shall require a pharmacist who 16 dispenses self-administered hormonal contraceptives under this 17 section to do all of the following: 18 a. Complete a standardized training program and continuing 19 education requirements approved by the board in consultation 20 with the department that are related to prescribing 21 self-administered hormonal contraceptives and include education 22 regarding all contraceptive methods approved by the United 23 States food and drug administration. 24 b. Obtain a completed self-screening risk assessment, 25 approved by the department in collaboration with the board and 26 the board of medicine, from each patient prior to dispensing 27 the self-administered hormonal contraceptive to the patient. 28 c. Provide the patient with all of the following: 29 (1) Written information regarding all of the following: 30 (a) The importance of completing an appointment with the 31 patient’s primary care or women’s health care practitioner 32 to obtain preventative care, including but not limited to 33 recommended tests and screenings. 34 (b) The effectiveness and availability of long-acting 35 -8- LSB 2399YH (6) 89 pf/rh 8/ 15

H.F. 570 reversible contraceptives as an alternative to 1 self-administered hormonal contraceptives. 2 (2) A copy of the record of the pharmacist’s encounter with 3 the patient that includes all of the following: 4 (a) The patient’s completed self-screening risk assessment. 5 (b) A description of the contraceptive dispensed, or the 6 basis for not dispensing a contraceptive. 7 (3) Patient counseling regarding all of the following: 8 (a) The appropriate administration and storage of the 9 self-administered hormonal contraceptive. 10 (b) Potential side effects and risks of the 11 self-administered hormonal contraceptive. 12 (c) The need for backup contraception. 13 (d) When to seek emergency medical attention. 14 (e) The risk of contracting a sexually transmitted 15 infection or disease, and ways to reduce such a risk. 16 5. The standing order established pursuant to this section 17 shall prohibit a pharmacist who dispenses a self-administered 18 hormonal contraceptive under this section from doing any of the 19 following: 20 a. Requiring a patient to schedule an appointment with 21 the pharmacist for the prescribing or dispensing of a 22 self-administered hormonal contraceptive. 23 b. Dispensing self-administered hormonal contraceptives to 24 a patient for more than twenty-four months after the date a 25 self-administered hormonal contraceptive is initially dispensed 26 to the patient without the patient’s attestation that the 27 patient has consulted with a primary care or women’s health 28 care practitioner during the preceding twenty-four months. 29 c. Dispensing a self-administered hormonal contraceptive to 30 a patient if the results of the self-screening risk assessment 31 completed by a patient pursuant to subsection 4, paragraph 32 “b” , indicate it is unsafe for the pharmacist to dispense the 33 self-administered hormonal contraceptive to the patient, in 34 which case the pharmacist shall refer the patient to a primary 35 -9- LSB 2399YH (6) 89 pf/rh 9/ 15

H.F. 570 care or women’s health care practitioner. 1 6. A pharmacist who dispenses a self-administered hormonal 2 contraceptive and the medical director of the department who 3 establishes a standing order in compliance with this section 4 shall be immune from criminal and civil liability arising 5 from any damages caused by the dispensing, administering, 6 or use of a self-administered hormonal contraceptive or the 7 establishment of the standing order. The medical director of 8 the department shall be considered to be acting within the 9 scope of the medical director’s office and employment for 10 purposes of chapter 669 in the establishment of a standing 11 order in compliance with this section. 12 7. The department, in collaboration with the board and 13 the board of medicine, and in consideration of the guidelines 14 established by the American congress of obstetricians and 15 gynecologists, shall adopt rules pursuant to chapter 17A to 16 administer this chapter. 17 Sec. 9. Section 514C.19, Code 2021, is amended to read as 18 follows: 19 514C.19 Prescription contraceptive coverage. 20 1. Notwithstanding the uniformity of treatment requirements 21 of section 514C.6 , a group policy , or contract , or plan 22 providing for third-party payment or prepayment of health or 23 medical expenses shall not do either of the following comply 24 as follows : 25 a. Exclude Such policy, contract, or plan shall not 26 exclude or restrict benefits for prescription contraceptive 27 drugs or prescription contraceptive devices which prevent 28 conception and which are approved by the United States 29 food and drug administration, or generic equivalents 30 approved as substitutable by the United States food and drug 31 administration, if such policy , or contract , or plan provides 32 benefits for other outpatient prescription drugs or devices. 33 However, such policy, contract, or plan shall specifically 34 provide for payment of a one-year supply of self-administered 35 -10- LSB 2399YH (6) 89 pf/rh 10/ 15

H.F. 570 hormonal contraceptives, as prescribed by a practitioner as 1 defined in section 155A.3, or as prescribed by standing order 2 and dispensed by a pharmacist pursuant to section 155A.47, 3 including self-administered hormonal contraceptives dispensed 4 at one time. 5 b. Exclude Such policy, contract, or plan shall not exclude 6 or restrict benefits for outpatient contraceptive services 7 which are provided for the purpose of preventing conception if 8 such policy , or contract , or plan provides benefits for other 9 outpatient services provided by a health care professional. 10 2. A person who provides a group policy , or contract , or 11 plan providing for third-party payment or prepayment of health 12 or medical expenses which is subject to subsection 1 shall not 13 do any of the following: 14 a. Deny to an individual eligibility, or continued 15 eligibility, to enroll in or to renew coverage under the terms 16 of the policy , or contract , or plan because of the individual’s 17 use or potential use of such prescription contraceptive drugs 18 or devices, or use or potential use of outpatient contraceptive 19 services. 20 b. Provide a monetary payment or rebate to a covered 21 individual to encourage such individual to accept less than the 22 minimum benefits provided for under subsection 1 . 23 c. Penalize or otherwise reduce or limit the reimbursement 24 of a health care professional because such professional 25 prescribes contraceptive drugs or devices, or provides 26 contraceptive services. 27 d. Provide incentives, monetary or otherwise, to a health 28 care professional to induce such professional to withhold 29 from a covered individual contraceptive drugs or devices, or 30 contraceptive services. 31 3. This section shall not be construed to prevent a 32 third-party payor from including deductibles, coinsurance, or 33 copayments under the policy , or contract, or plan as follows: 34 a. A deductible, coinsurance, or copayment for benefits 35 -11- LSB 2399YH (6) 89 pf/rh 11/ 15

H.F. 570 for prescription contraceptive drugs shall not be greater than 1 such deductible, coinsurance, or copayment for any outpatient 2 prescription drug for which coverage under the policy , or 3 contract , or plan is provided. 4 b. A deductible, coinsurance, or copayment for benefits for 5 prescription contraceptive devices shall not be greater than 6 such deductible, coinsurance, or copayment for any outpatient 7 prescription device for which coverage under the policy , or 8 contract , or plan is provided. 9 c. A deductible, coinsurance, or copayment for benefits for 10 outpatient contraceptive services shall not be greater than 11 such deductible, coinsurance, or copayment for any outpatient 12 health care services for which coverage under the policy , or 13 contract , or plan is provided. 14 4. This section shall not be construed to require a 15 third-party payor under a policy , or contract , or plan 16 to provide benefits for experimental or investigational 17 contraceptive drugs or devices, or experimental or 18 investigational contraceptive services, except to the extent 19 that such policy , or contract , or plan provides coverage for 20 other experimental or investigational outpatient prescription 21 drugs or devices, or experimental or investigational outpatient 22 health care services. 23 5. This section shall not be construed to limit or otherwise 24 discourage the use of generic equivalent drugs approved by the 25 United States food and drug administration, whenever available 26 and appropriate. This section , when a brand name drug is 27 requested by a covered individual and a suitable generic 28 equivalent is available and appropriate, shall not be construed 29 to prohibit a third-party payor from requiring the covered 30 individual to pay a deductible, coinsurance, or copayment 31 consistent with subsection 3 , in addition to the difference of 32 the cost of the brand name drug less the maximum covered amount 33 for a generic equivalent. 34 6. A person who provides an individual policy , or contract , 35 -12- LSB 2399YH (6) 89 pf/rh 12/ 15

H.F. 570 or plan providing for third-party payment or prepayment of 1 health or medical expenses shall make available a coverage 2 provision that satisfies the requirements in subsections 3 1 through 5 in the same manner as such requirements are 4 applicable to a group policy , or contract , or plan under those 5 subsections. The policy , or contract , or plan shall provide 6 that the individual policyholder may reject the coverage 7 provision at the option of the policyholder. 8 7. a. This section applies to the following classes of 9 third-party payment provider contracts , or policies , or plans 10 delivered, issued for delivery, continued, or renewed in this 11 state on or after July 1, 2000 January 1, 2022 : 12 (1) Individual or group accident and sickness insurance 13 providing coverage on an expense-incurred basis. 14 (2) An individual or group hospital or medical service 15 contract issued pursuant to chapter 509 , 514 , or 514A . 16 (3) An individual or group health maintenance organization 17 contract regulated under chapter 514B . 18 (4) Any other entity engaged in the business of insurance, 19 risk transfer, or risk retention, which is subject to the 20 jurisdiction of the commissioner. 21 (5) A plan established pursuant to chapter 509A for public 22 employees. 23 b. This section shall not apply to accident-only, 24 specified disease, short-term hospital or medical, hospital 25 confinement indemnity, credit, dental, vision, Medicare 26 supplement, long-term care, basic hospital and medical-surgical 27 expense coverage as defined by the commissioner, disability 28 income insurance coverage, coverage issued as a supplement 29 to liability insurance, workers’ compensation or similar 30 insurance, or automobile medical payment insurance. 31 8. This section shall not be construed to require a 32 third-party payor to provide payment to a practitioner for the 33 dispensing of a self-administered hormonal contraceptive to 34 replace a self-administered hormonal contraceptive that has 35 -13- LSB 2399YH (6) 89 pf/rh 13/ 15

H.F. 570 been dispensed to a covered person and that has been misplaced, 1 stolen, or destroyed. This section shall not be construed to 2 require a third-party payor to replace covered prescriptions 3 that are misplaced, stolen, or destroyed. 4 9. For the purposes of this section: 5 a. “Self-administered hormonal contraceptive” means a 6 self-administered hormonal contraceptive that is approved 7 by the United Sates food and drug administration to prevent 8 pregnancy. “Self-administered hormonal contraceptive” includes 9 an oral hormonal contraceptive, a hormonal vaginal ring, and 10 a hormonal contraceptive patch, but does not include any drug 11 intended to induce an abortion as defined in section 146.1. 12 b. “Standing order” means a preauthorized medication order 13 with specific instructions from the medical director of the 14 department of public health to dispense a medication under 15 clearly defined circumstances. 16 EXPLANATION 17 The inclusion of this explanation does not constitute agreement with 18 the explanation’s substance by the members of the general assembly. 19 This bill relates to state family planning services. 20 Division I of the bill provides a basis for a family planning 21 and abortion reduction policy. 22 Division II of the bill requires the department of human 23 services (DHS) to submit a Medicaid state plan amendment to 24 the centers for Medicare and Medicaid services of the United 25 States department of health and human services (CMS) for 26 approval to establish the Iowa family planning network with the 27 same benefits, eligibility requirements, and other provisions 28 included in the Medicaid Iowa family planning network waiver 29 as approved by CMS in effect on June 30, 2017. The section of 30 division II of the bill requiring submission of the state plan 31 amendment takes effect upon enactment. 32 Division III of the bill repeals the state family planning 33 services program. The repeal of the program takes effect upon 34 receipt of approval by DHS from CMS of the Medicaid state plan 35 -14- LSB 2399YH (6) 89 pf/rh 14/ 15

H.F. 570 amendment establishing the Iowa family planning network. 1 Division IV of the bill relates to the dispensing of 2 self-administered hormonal contraceptives by a pharmacist. 3 The division provides that notwithstanding any provision 4 of law to the contrary, a pharmacist may dispense at one 5 time, up to a one-year supply of a self-administered hormonal 6 contraceptive to a patient pursuant to a standing order 7 established by the medical director of the department of public 8 health (medical director). 9 The division authorizes the medical director to establish a 10 standing order authorizing the dispensing of self-administered 11 hormonal contraceptives by any pharmacist who complies with the 12 standing order and retains and submits the patient’s record to 13 the department of public health (DPH). 14 The division requires DPH, in collaboration with the 15 boards of pharmacy and medicine, and in consideration of 16 the guidelines established by the American congress of 17 obstetricians and gynecologists, to adopt administrative rules 18 to administer the division. 19 The division amends prescription contraceptive coverage 20 provisions to require that a group policy, contract, or plan 21 delivered, issued for delivery, continued, or renewed in the 22 state on or after January 1, 2022, providing for third-party 23 payment or prepayment of health or medical expenses, shall 24 specifically provide for payment of a one-year supply of 25 self-administered hormonal contraceptives, as prescribed 26 and dispensed as specified in the division, including those 27 dispensed at one time. 28 -15- LSB 2399YH (6) 89 pf/rh 15/ 15