H.F. 2033 Section 1. NEW SECTION . 155A.49 Accessible 1 prescription-related measures —— persons who are blind, 2 visually impaired, or have other print disabilities. 3 1. As used in this section, unless the context otherwise 4 requires, “health carrier” means an entity subject to the 5 insurance laws and regulations of this state, or subject to 6 the jurisdiction of the commissioner of insurance, including 7 an insurance company offering sickness and accident plans, a 8 health maintenance organization, a nonprofit health service 9 corporation, or a plan established pursuant to chapter 509A for 10 public employees. “Health carrier” does not include any of the 11 following: 12 a. The department of health and human services. 13 b. A policy or contract providing a prescription drug 14 benefit pursuant to 42 U.S.C. ch. 7, subch. XVIII, part D. 15 c. A plan offered or maintained by a multiple employer 16 welfare arrangement established under chapter 513D before 17 January 1, 2022. 18 2. The board shall adopt rules pursuant to chapter 17A 19 to ensure that on or before January 1, 2027, if a person who 20 is blind, has a visual impairment, or other print disability 21 requests access to prescription drug labels, bag tags, and 22 medical guides, a pharmacy provides access to prescription drug 23 labels, bag tags, and medical guides, or refers the person to 24 a pharmacy within a reasonable distance that provides access 25 to prescription drug labels, bag tags, and medical guides. 26 The accessibility measures shall meet all of the following 27 requirements: 28 a. Be provided at no additional cost to such persons. 29 b. After a reasonable development period for the pharmacy, 30 provide required information on prescription drug labels, bag 31 tags, and medical guides in a format that is fully accessible 32 to such persons within a time frame comparable to a person that 33 is not blind, does not have a visual impairment, or other print 34 disability. 35 -1- LSB 5784YH (6) 91 ak/ko 1/ 4

H.F. 2033 3. On or before April 1 of each year, the board shall 1 publish a list on the board’s internet site that contains the 2 pharmacies that provide accessibility measures. 3 4. A health carrier shall pay an enhanced dispensing fee to 4 reimburse the costs associated with the accessibility measures 5 under this section. 6 5. This section shall apply to any pharmacy that is 7 dispensing prescription drugs in the state except for the 8 following: 9 a. An institutional pharmacy. For the purpose of this 10 subsection, “institutional pharmacy” means a pharmacy located 11 within a hospital, nursing home, or long-term care facility. 12 b. A pharmacy participating in a prescription drug donation 13 repository program pursuant to chapter 135M, if the drug being 14 dispensed was donated under the program. 15 c. A pharmacy in a jail, a state correctional institution, a 16 federal correctional facility, or a juvenile detention home. 17 6. In adopting rules under this section, the board shall 18 solicit input from persons who are blind, have a visual 19 impairment, or other print disability. 20 7. The rules adopted under this section shall meet all of 21 the following requirements: 22 a. Comply with current guidelines and recommendations from 23 the United States government accountability office, and current 24 industry standards. 25 b. Include a method for providing notice to the public 26 that accessible prescription drug labels, bag tags, and 27 medical guides are available, including notice regarding the 28 availability of the prescription drug labels, bag tags, and 29 medical guides in audio format. 30 Sec. 2. ACCESSIBLE PRESCRIPTION-RELATED MEASURES —— 31 REPORT. The board of pharmacy shall submit a report to the 32 governor and the general assembly on or before January 1, 33 2028, that provides a summary of the progress on implementing 34 rules, and recommendations for additional measures to improve 35 -2- LSB 5784YH (6) 91 ak/ko 2/ 4

H.F. 2033 accessibility. 1 EXPLANATION 2 The inclusion of this explanation does not constitute agreement with 3 the explanation’s substance by the members of the general assembly. 4 This bill relates to the provision of accessible 5 prescription-related measures for persons who are blind, have a 6 visual impairment, or other print disability. 7 The bill requires the board of pharmacy (board) to adopt 8 administrative rules on or before January 1, 2027, to ensure 9 that if a person who is blind, has a visual impairment, or 10 other print disability requests access to prescription drug 11 labels, bag tags, and medical guides, a pharmacy provides 12 access to such, or refers the person to a pharmacy within a 13 reasonable distance that provides access to prescription drug 14 labels, bag tags, and medical guides. 15 The bill provides that accessibility measures shall be 16 provided by a pharmacy at no additional cost to such person; 17 and information required to be provided on prescription drug 18 labels, bag tags, and medical guides shall be provided in a 19 format that is fully accessible to such persons within a time 20 frame comparable to a person who is not blind, does not have a 21 visual impairment, or other print disability. 22 The bill requires the board to publish, on or before April 1 23 of each year, a list on the board’s internet site of pharmacies 24 that provide accessibility measures. 25 Under the bill, a health carrier shall pay an enhanced 26 dispensing fee to pharmacies to reimburse the costs associated 27 with the bill. “Health carrier” is defined in the bill. 28 The bill applies to any pharmacy dispensing prescription 29 drugs in the state except for an institutional pharmacy; a 30 pharmacy participating in a prescription drug repository 31 program under Code chapter 135M, if the drug being dispensed 32 was donated under the program; a pharmacy in a jail, a state 33 correctional institution, a federal correctional facility, or 34 a juvenile detention home. The bill defines “institutional 35 -3- LSB 5784YH (6) 91 ak/ko 3/ 4

H.F. 2033 pharmacy”. 1 Under the bill, the board is required to solicit input 2 in developing the rules from persons who are blind, have a 3 visual impairment, or other print disability. The rules shall 4 comply with guidelines and recommendations from the United 5 States government accountability office and current industry 6 standards, and shall include a method for providing notice to 7 the public that accessible prescription drug labels, bag tags, 8 and medical guides are available. 9 Under the bill, the board shall submit a report to the 10 governor and the general assembly on or before January 1, 11 2028, that provides a summary on the progress on implementing 12 rules, and recommendations and additional measures to improve 13 accessibility. 14 -4- LSB 5784YH (6) 91 ak/ko 4/ 4