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House File 605 - IntroducedA Bill ForAn Act 1relating to the prescribing and dispensing of
2self-administered hormonal contraceptives.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 155A.3, Code 2025, is amended by adding
2the following new subsections:
3 NEW SUBSECTION. 10A. “Department” means the department of
4health and human services.
5 NEW SUBSECTION. 45A. “Self-administered hormonal
6contraceptive” means a self-administered hormonal contraceptive
7that is approved by the United States food and drug
8administration to prevent pregnancy. “Self-administered
9hormonal contraceptive” includes an oral hormonal contraceptive,
10a hormonal vaginal ring, and a hormonal contraceptive patch,
11but does not include any drug intended to induce an abortion as
12defined in section 146.1.
13 NEW SUBSECTION. 45B. “Standing order” means a preauthorized
14medication order with specific instructions from the medical
15director of the department to dispense a medication under
16clearly defined circumstances.
17 Sec. 2. NEW SECTION. 155A.49 Pharmacist dispensing of
18self-administered hormonal contraceptives — standing order —
19requirements — limitations of liability.
201. a. Notwithstanding any provision of law to the
21contrary, a pharmacist may dispense a self-administered
22hormonal contraceptive to a patient pursuant to a standing
23order established by the medical director of the department in
24accordance with this section.
25b. In dispensing a self-administered hormonal contraceptive
26to a patient under this section, a pharmacist shall comply with
27all of the following:
28(1) For an initial dispensing of a self-administered
29hormonal contraceptive, the pharmacist may dispense up to
30a twelve-month supply at one time of the self-administered
31hormonal contraceptive.
32(2) For any subsequent dispensing of the same
33self-administered hormonal contraceptive, the pharmacist
34may dispense up to a twelve-month supply at one time of the
35self-administered hormonal contraceptive.
-1- 12. A pharmacist who dispenses a self-administered hormonal
2contraceptive in accordance with this section shall not
3require any other prescription drug order authorized by a
4practitioner prior to dispensing the self-administered hormonal
5contraceptive to a patient.
63. The medical director of the department may establish a
7standing order authorizing the dispensing of self-administered
8hormonal contraceptives by a pharmacist who does all of the
9following:
10a. Complies with the standing order established pursuant to
11this section.
12b. Retains a record of each patient to whom a
13self-administered hormonal contraceptive is dispensed under
14this section and submits the record to the department.
154. The standing order shall require a pharmacist who
16dispenses self-administered hormonal contraceptives under this
17section to do all of the following:
18a. Complete a standardized training program and continuing
19education requirements approved by the board in consultation
20with the board of medicine and the department that are related
21to prescribing self-administered hormonal contraceptives and
22include education regarding all contraceptive methods approved
23by the United States food and drug administration.
24b. Obtain a completed self-screening risk assessment,
25approved by the department in collaboration with the board
26and the board of medicine, from each patient, and verify
27the identity of each patient prior to dispensing the
28self-administered hormonal contraceptive to the patient.
29c. Provide the patient with all of the following:
30(1) Written information regarding all of the following:
31(a) The importance of completing an appointment with the
32patient’s primary care or women’s health care practitioner
33to obtain preventative care, including but not limited to
34recommended tests and screenings.
35(b) The effectiveness and availability of long-acting
-2-1reversible contraceptives as an alternative to
2self-administered hormonal contraceptives.
3(2) A copy of the record of the pharmacist’s encounter with
4the patient that includes all of the following:
5(a) The patient’s completed self-screening risk assessment.
6(b) A description of the contraceptive dispensed, or the
7basis for not dispensing a contraceptive.
8(3) Patient counseling regarding all of the following:
9(a) The appropriate administration and storage of the
10self-administered hormonal contraceptive.
11(b) Potential side effects and risks of the
12self-administered hormonal contraceptive.
13(c) The need for backup contraception.
14(d) When to seek emergency medical attention.
15(e) The risk of contracting a sexually transmitted
16infection or disease, and ways to reduce such a risk.
175. The standing order established pursuant to this section
18shall prohibit a pharmacist who dispenses a self-administered
19hormonal contraceptive under this section from doing any of the
20following:
21a. Requiring a patient to schedule an appointment with
22the pharmacist for the prescribing or dispensing of a
23self-administered hormonal contraceptive.
24b. Dispensing a self-administered hormonal contraceptive to
25a patient if the results of the self-screening risk assessment
26completed by a patient pursuant to subsection 4, paragraph
27“b”, indicate it is unsafe for the pharmacist to dispense the
28self-administered hormonal contraceptive to the patient, in
29which case the pharmacist shall refer the patient to a primary
30care or women’s health care practitioner.
316. A pharmacist who dispenses a self-administered hormonal
32contraceptive and the medical director of the department who
33establishes a standing order in compliance with this section
34shall be immune from criminal and civil liability arising from
35any damages caused by the dispensing, administering, or use of
-3-1a self-administered hormonal contraceptive or the establishment
2of the standing order provided that the pharmacist acts
3reasonably and in good faith. The medical director of the
4department shall be considered to be acting within the scope
5of the medical director’s office and employment for purposes
6of chapter 669 in the establishment of a standing order in
7compliance with this section.
87. The department, in collaboration with the board and
9the board of medicine, and in consideration of the guidelines
10established by the American congress of obstetricians and
11gynecologists, shall adopt rules pursuant to chapter 17A to
12administer this chapter.
13 Sec. 3. Section 514C.19, Code 2025, is amended to read as
14follows:
15514C.19 Prescription contraceptive coverage.
161. Notwithstanding the uniformity of treatment requirements
17of section 514C.6, a group policy, or contract, or plan
18 providing for third-party payment or prepayment of health or
19medical expenses shall not do either of the following comply
20as follows:
21a. Exclude Such policy, contract, or plan shall not
22exclude or restrict benefits for prescription contraceptive
23drugs or prescription contraceptive devices which prevent
24conception and which are approved by the United States
25food and drug administration, or generic equivalents
26approved as substitutable by the United States food and drug
27administration, if such policy, or contract, or plan provides
28benefits for other outpatient prescription drugs or devices.
29However, such policy, contract, or plan shall specifically
30provide for payment including reimbursement for pharmacist
31consultations, for a self-administered hormonal contraceptive,
32as prescribed by a practitioner as defined in section
33155A.3, or as prescribed by standing order and dispensed by a
34pharmacist pursuant to section 155A.49, including payment for
35up to an initial twelve-month supply of a self-administered
-4-1hormonal contraceptive dispensed at one time and for up to a
2twelve-month supply of the same self-administered hormonal
3contraceptive subsequently dispensed at one time.
4b. Exclude Such policy, contract, or plan shall not exclude
5 or restrict benefits for outpatient contraceptive services
6which are provided for the purpose of preventing conception if
7such policy, or contract, or plan provides benefits for other
8outpatient services provided by a health care professional.
92. A person who provides a group policy, or contract, or
10plan providing for third-party payment or prepayment of health
11or medical expenses which is subject to subsection 1 shall not
12do any of the following:
13a. Deny to an individual eligibility, or continued
14eligibility, to enroll in or to renew coverage under the terms
15of the policy, or contract, or plan because of the individual’s
16use or potential use of such prescription contraceptive drugs
17or devices, or use or potential use of outpatient contraceptive
18services.
19b. Provide a monetary payment or rebate to a covered
20individual to encourage such individual to accept less than the
21minimum benefits provided for under subsection 1.
22c. Penalize or otherwise reduce or limit the reimbursement
23of a health care professional because such professional
24prescribes contraceptive drugs or devices, or provides
25contraceptive services.
26d. Provide incentives, monetary or otherwise, to a health
27care professional to induce such professional to withhold
28from a covered individual contraceptive drugs or devices, or
29contraceptive services.
303. This section shall not be construed to prevent a
31third-party payor from including deductibles, coinsurance, or
32copayments under the policy, or contract, or plan as follows:
33a. A deductible, coinsurance, or copayment for benefits
34for prescription contraceptive drugs shall not be greater than
35such deductible, coinsurance, or copayment for any outpatient
-5-1prescription drug for which coverage under the policy, or
2 contract, or plan is provided.
3b. A deductible, coinsurance, or copayment for benefits for
4prescription contraceptive devices shall not be greater than
5such deductible, coinsurance, or copayment for any outpatient
6prescription device for which coverage under the policy, or
7 contract, or plan is provided.
8c. A deductible, coinsurance, or copayment for benefits for
9outpatient contraceptive services shall not be greater than
10such deductible, coinsurance, or copayment for any outpatient
11health care services for which coverage under the policy, or
12 contract, or plan is provided.
134. This section shall not be construed to require a
14third-party payor under a policy, or contract, or plan
15 to provide benefits for experimental or investigational
16contraceptive drugs or devices, or experimental or
17investigational contraceptive services, except to the extent
18that such policy, or contract, or plan provides coverage for
19other experimental or investigational outpatient prescription
20drugs or devices, or experimental or investigational outpatient
21health care services.
225. This section shall not be construed to limit or otherwise
23discourage the use of generic equivalent drugs approved by the
24United States food and drug administration, whenever available
25and appropriate. This section, when a brand name drug is
26requested by a covered individual and a suitable generic
27equivalent is available and appropriate, shall not be construed
28to prohibit a third-party payor from requiring the covered
29individual to pay a deductible, coinsurance, or copayment
30consistent with subsection 3, in addition to the difference of
31the cost of the brand name drug less the maximum covered amount
32for a generic equivalent.
336. A person who provides an individual policy, or contract,
34or plan providing for third-party payment or prepayment of
35health or medical expenses shall make available a coverage
-6-1provision that satisfies the requirements in subsections
21 through 5 in the same manner as such requirements are
3applicable to a group policy, or contract, or plan under those
4subsections. The policy, or contract, or plan shall provide
5that the individual policyholder may reject the coverage
6provision at the option of the policyholder.
77. For the purposes of this section:
8a. “Self-administered hormonal contraceptive” means a
9self-administered hormonal contraceptive that is approved
10by the United Sates food and drug administration to prevent
11pregnancy. “Self-administered hormonal contraceptive” includes
12an oral hormonal contraceptive, a hormonal vaginal ring, and
13a hormonal contraceptive patch, but does not include any drug
14intended to induce an abortion as defined in section 146.1.
15b. “Standing order” means a preauthorized medication
16order with specific instructions from the medical director
17of the department of health and human services to dispense a
18medication under clearly defined circumstances.
197. 8. a. This section applies to the following classes of
20third-party payment provider contracts, or policies, or plans
21 delivered, issued for delivery, continued, or renewed in this
22state on or after July 1, 2000 January 1, 2026:
23(1) Individual or group accident and sickness insurance
24providing coverage on an expense-incurred basis.
25(2) An individual or group hospital or medical service
26contract issued pursuant to chapter 509, 514, or 514A.
27(3) An individual or group health maintenance organization
28contract regulated under chapter 514B.
29(4) Any other entity engaged in the business of insurance,
30risk transfer, or risk retention, which is subject to the
31jurisdiction of the commissioner.
32(5) A plan established pursuant to chapter 509A for public
33employees.
34b. This section shall not apply to accident-only,
35specified disease, short-term hospital or medical, hospital
-7-1confinement indemnity, credit, dental, vision, Medicare
2supplement, long-term care, basic hospital and medical-surgical
3expense coverage as defined by the commissioner, disability
4income insurance coverage, coverage issued as a supplement
5to liability insurance, workers’ compensation or similar
6insurance, or automobile medical payment insurance.
7 Sec. 4. MEDICAID COVERAGE — SELF-ADMINISTERED HORMONAL
8CONTRACEPTIVES. Notwithstanding section 514B.32, subsection
95, section 505.34, and any other provision of law to the
10contrary, the department of health and human services shall,
11contractually and by administrative rules adopted pursuant
12to chapter 17A, require under Medicaid fee-for-service
13and Medicaid managed care administration, coverage for
14a self-administered hormonal contraceptive as prescribed
15by a practitioner as defined in section 155A.3, or as
16prescribed by standing order and dispensed by a pharmacist
17pursuant to section 155A.49, including payment for up to
18an initial twelve-month supply of the self-administered
19hormonal contraceptive dispensed at one time and for up to a
20twelve-month supply of the same self-administered hormonal
21contraceptive subsequently dispensed at one time.
22EXPLANATION
23The inclusion of this explanation does not constitute agreement with
24the explanation’s substance by the members of the general assembly.
25This bill relates to the dispensing of self-administered
26hormonal contraceptives by a pharmacist. The bill
27defines “self-administered hormonal contraceptive” as a
28self-administered hormonal contraceptive that is approved by
29the United States food and drug administration to prevent
30pregnancy, including an oral hormonal contraceptive, a hormonal
31vaginal ring, and a hormonal contraceptive patch, but not
32including any drug intended to induce an abortion.
33The bill provides that notwithstanding any provision of law
34to the contrary, a pharmacist may dispense a self-administered
35hormonal contraceptive to a patient pursuant to a standing
-8-1order established by the medical director of the department of
2health and human services (medical director). For an initial
3dispensing, a pharmacist may dispense up to a 12-month supply
4at one time of the self-administered hormonal contraceptive,
5and for any subsequent dispensing of the same self-administered
6hormonal contraceptive, a 12-month supply at one time.
7Additionally, the bill prohibits a pharmacist who dispenses
8a self-administered hormonal contraceptive in accordance
9with the bill from requiring any other prescription drug
10order authorized by a practitioner prior to dispensing the
11self-administered hormonal contraceptive.
12The bill authorizes the medical director to establish a
13standing order authorizing the dispensing of self-administered
14hormonal contraceptives by any pharmacist who complies with the
15standing order and retains and submits the patient’s record to
16the department of health and human services (HHS).
17The standing order includes requiring a pharmacist who
18dispenses a self-administered hormonal contraceptive under
19the bill to: complete a standardized training program and
20continuing education requirements related to prescribing the
21hormonal contraceptives; obtain a completed self-screening risk
22assessment from each patient and verify the identity of each
23patient before dispensing the hormonal contraceptives; provide
24the patient with certain written information; provide the
25patient with a copy of the record of the pharmacist’s encounter
26with the patient; and provide patient counseling.
27The standing order would prohibit a pharmacist who dispenses
28hormonal contraceptives under the bill from requiring a
29patient to schedule an appointment with the pharmacist for
30the prescribing or dispensing of the hormonal contraceptive;
31and dispensing the hormonal contraceptives to a patient if
32the results of the patient’s self-screening risk assessment
33indicate it is unsafe for the pharmacist to dispense the
34hormonal contraceptives to the patient, in which case the
35pharmacist shall refer the patient to a practitioner.
-9- 1The bill provides immunity for a pharmacist who dispenses a
2self-administered hormonal contraceptive and for the medical
3director who establishes a standing order in compliance with
4the bill from criminal and civil liability arising from any
5damages caused by the dispensing, administering, or use of a
6self-administered hormonal contraceptive or the establishment
7of the standing order provided the pharmacist acts reasonably
8and in good faith. Additionally, the medical director shall
9be considered to be acting within the scope of the medical
10director’s office and employment for purposes of Code chapter
11669 (Iowa tort claims Act) in the establishment of a standing
12order in compliance with the bill.
13The bill requires HHS, in collaboration with the boards of
14pharmacy and medicine, and in consideration of the guidelines
15established by the American congress of obstetricians and
16gynecologists, to adopt administrative rules to administer the
17bill.
18The bill amends prescription contraceptive coverage
19provisions to require that a group policy, contract, or plan
20delivered, issued for delivery, continued, or renewed in the
21state on or after January 1, 2026, providing for third-party
22payment or prepayment of health or medical expenses, shall
23specifically provide for payment of self-administered hormonal
24contraceptives, prescribed and dispensed as specified in the
25bill, including those dispensed at one time.
26The bill also requires HHS to provide prescription
27contraceptive coverage under the Medicaid program consistent
28with the coverage under private insurance as provided under the
29bill.
-10-lh/ko
2self-administered hormonal contraceptives.
3BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 155A.3, Code 2025, is amended by adding
2the following new subsections:
3 NEW SUBSECTION. 10A. “Department” means the department of
4health and human services.
5 NEW SUBSECTION. 45A. “Self-administered hormonal
6contraceptive” means a self-administered hormonal contraceptive
7that is approved by the United States food and drug
8administration to prevent pregnancy. “Self-administered
9hormonal contraceptive” includes an oral hormonal contraceptive,
10a hormonal vaginal ring, and a hormonal contraceptive patch,
11but does not include any drug intended to induce an abortion as
12defined in section 146.1.
13 NEW SUBSECTION. 45B. “Standing order” means a preauthorized
14medication order with specific instructions from the medical
15director of the department to dispense a medication under
16clearly defined circumstances.
17 Sec. 2. NEW SECTION. 155A.49 Pharmacist dispensing of
18self-administered hormonal contraceptives — standing order —
19requirements — limitations of liability.
201. a. Notwithstanding any provision of law to the
21contrary, a pharmacist may dispense a self-administered
22hormonal contraceptive to a patient pursuant to a standing
23order established by the medical director of the department in
24accordance with this section.
25b. In dispensing a self-administered hormonal contraceptive
26to a patient under this section, a pharmacist shall comply with
27all of the following:
28(1) For an initial dispensing of a self-administered
29hormonal contraceptive, the pharmacist may dispense up to
30a twelve-month supply at one time of the self-administered
31hormonal contraceptive.
32(2) For any subsequent dispensing of the same
33self-administered hormonal contraceptive, the pharmacist
34may dispense up to a twelve-month supply at one time of the
35self-administered hormonal contraceptive.
-1- 12. A pharmacist who dispenses a self-administered hormonal
2contraceptive in accordance with this section shall not
3require any other prescription drug order authorized by a
4practitioner prior to dispensing the self-administered hormonal
5contraceptive to a patient.
63. The medical director of the department may establish a
7standing order authorizing the dispensing of self-administered
8hormonal contraceptives by a pharmacist who does all of the
9following:
10a. Complies with the standing order established pursuant to
11this section.
12b. Retains a record of each patient to whom a
13self-administered hormonal contraceptive is dispensed under
14this section and submits the record to the department.
154. The standing order shall require a pharmacist who
16dispenses self-administered hormonal contraceptives under this
17section to do all of the following:
18a. Complete a standardized training program and continuing
19education requirements approved by the board in consultation
20with the board of medicine and the department that are related
21to prescribing self-administered hormonal contraceptives and
22include education regarding all contraceptive methods approved
23by the United States food and drug administration.
24b. Obtain a completed self-screening risk assessment,
25approved by the department in collaboration with the board
26and the board of medicine, from each patient, and verify
27the identity of each patient prior to dispensing the
28self-administered hormonal contraceptive to the patient.
29c. Provide the patient with all of the following:
30(1) Written information regarding all of the following:
31(a) The importance of completing an appointment with the
32patient’s primary care or women’s health care practitioner
33to obtain preventative care, including but not limited to
34recommended tests and screenings.
35(b) The effectiveness and availability of long-acting
-2-1reversible contraceptives as an alternative to
2self-administered hormonal contraceptives.
3(2) A copy of the record of the pharmacist’s encounter with
4the patient that includes all of the following:
5(a) The patient’s completed self-screening risk assessment.
6(b) A description of the contraceptive dispensed, or the
7basis for not dispensing a contraceptive.
8(3) Patient counseling regarding all of the following:
9(a) The appropriate administration and storage of the
10self-administered hormonal contraceptive.
11(b) Potential side effects and risks of the
12self-administered hormonal contraceptive.
13(c) The need for backup contraception.
14(d) When to seek emergency medical attention.
15(e) The risk of contracting a sexually transmitted
16infection or disease, and ways to reduce such a risk.
175. The standing order established pursuant to this section
18shall prohibit a pharmacist who dispenses a self-administered
19hormonal contraceptive under this section from doing any of the
20following:
21a. Requiring a patient to schedule an appointment with
22the pharmacist for the prescribing or dispensing of a
23self-administered hormonal contraceptive.
24b. Dispensing a self-administered hormonal contraceptive to
25a patient if the results of the self-screening risk assessment
26completed by a patient pursuant to subsection 4, paragraph
27“b”, indicate it is unsafe for the pharmacist to dispense the
28self-administered hormonal contraceptive to the patient, in
29which case the pharmacist shall refer the patient to a primary
30care or women’s health care practitioner.
316. A pharmacist who dispenses a self-administered hormonal
32contraceptive and the medical director of the department who
33establishes a standing order in compliance with this section
34shall be immune from criminal and civil liability arising from
35any damages caused by the dispensing, administering, or use of
-3-1a self-administered hormonal contraceptive or the establishment
2of the standing order provided that the pharmacist acts
3reasonably and in good faith. The medical director of the
4department shall be considered to be acting within the scope
5of the medical director’s office and employment for purposes
6of chapter 669 in the establishment of a standing order in
7compliance with this section.
87. The department, in collaboration with the board and
9the board of medicine, and in consideration of the guidelines
10established by the American congress of obstetricians and
11gynecologists, shall adopt rules pursuant to chapter 17A to
12administer this chapter.
13 Sec. 3. Section 514C.19, Code 2025, is amended to read as
14follows:
15514C.19 Prescription contraceptive coverage.
161. Notwithstanding the uniformity of treatment requirements
17of section 514C.6, a group policy, or contract, or plan
18 providing for third-party payment or prepayment of health or
19medical expenses shall not do either of the following comply
20as follows:
21a. Exclude Such policy, contract, or plan shall not
22exclude or restrict benefits for prescription contraceptive
23drugs or prescription contraceptive devices which prevent
24conception and which are approved by the United States
25food and drug administration, or generic equivalents
26approved as substitutable by the United States food and drug
27administration, if such policy, or contract, or plan provides
28benefits for other outpatient prescription drugs or devices.
29However, such policy, contract, or plan shall specifically
30provide for payment including reimbursement for pharmacist
31consultations, for a self-administered hormonal contraceptive,
32as prescribed by a practitioner as defined in section
33155A.3, or as prescribed by standing order and dispensed by a
34pharmacist pursuant to section 155A.49, including payment for
35up to an initial twelve-month supply of a self-administered
-4-1hormonal contraceptive dispensed at one time and for up to a
2twelve-month supply of the same self-administered hormonal
3contraceptive subsequently dispensed at one time.
4b. Exclude Such policy, contract, or plan shall not exclude
5 or restrict benefits for outpatient contraceptive services
6which are provided for the purpose of preventing conception if
7such policy, or contract, or plan provides benefits for other
8outpatient services provided by a health care professional.
92. A person who provides a group policy, or contract, or
10plan providing for third-party payment or prepayment of health
11or medical expenses which is subject to subsection 1 shall not
12do any of the following:
13a. Deny to an individual eligibility, or continued
14eligibility, to enroll in or to renew coverage under the terms
15of the policy, or contract, or plan because of the individual’s
16use or potential use of such prescription contraceptive drugs
17or devices, or use or potential use of outpatient contraceptive
18services.
19b. Provide a monetary payment or rebate to a covered
20individual to encourage such individual to accept less than the
21minimum benefits provided for under subsection 1.
22c. Penalize or otherwise reduce or limit the reimbursement
23of a health care professional because such professional
24prescribes contraceptive drugs or devices, or provides
25contraceptive services.
26d. Provide incentives, monetary or otherwise, to a health
27care professional to induce such professional to withhold
28from a covered individual contraceptive drugs or devices, or
29contraceptive services.
303. This section shall not be construed to prevent a
31third-party payor from including deductibles, coinsurance, or
32copayments under the policy, or contract, or plan as follows:
33a. A deductible, coinsurance, or copayment for benefits
34for prescription contraceptive drugs shall not be greater than
35such deductible, coinsurance, or copayment for any outpatient
-5-1prescription drug for which coverage under the policy, or
2 contract, or plan is provided.
3b. A deductible, coinsurance, or copayment for benefits for
4prescription contraceptive devices shall not be greater than
5such deductible, coinsurance, or copayment for any outpatient
6prescription device for which coverage under the policy, or
7 contract, or plan is provided.
8c. A deductible, coinsurance, or copayment for benefits for
9outpatient contraceptive services shall not be greater than
10such deductible, coinsurance, or copayment for any outpatient
11health care services for which coverage under the policy, or
12 contract, or plan is provided.
134. This section shall not be construed to require a
14third-party payor under a policy, or contract, or plan
15 to provide benefits for experimental or investigational
16contraceptive drugs or devices, or experimental or
17investigational contraceptive services, except to the extent
18that such policy, or contract, or plan provides coverage for
19other experimental or investigational outpatient prescription
20drugs or devices, or experimental or investigational outpatient
21health care services.
225. This section shall not be construed to limit or otherwise
23discourage the use of generic equivalent drugs approved by the
24United States food and drug administration, whenever available
25and appropriate. This section, when a brand name drug is
26requested by a covered individual and a suitable generic
27equivalent is available and appropriate, shall not be construed
28to prohibit a third-party payor from requiring the covered
29individual to pay a deductible, coinsurance, or copayment
30consistent with subsection 3, in addition to the difference of
31the cost of the brand name drug less the maximum covered amount
32for a generic equivalent.
336. A person who provides an individual policy, or contract,
34or plan providing for third-party payment or prepayment of
35health or medical expenses shall make available a coverage
-6-1provision that satisfies the requirements in subsections
21 through 5 in the same manner as such requirements are
3applicable to a group policy, or contract, or plan under those
4subsections. The policy, or contract, or plan shall provide
5that the individual policyholder may reject the coverage
6provision at the option of the policyholder.
77. For the purposes of this section:
8a. “Self-administered hormonal contraceptive” means a
9self-administered hormonal contraceptive that is approved
10by the United Sates food and drug administration to prevent
11pregnancy. “Self-administered hormonal contraceptive” includes
12an oral hormonal contraceptive, a hormonal vaginal ring, and
13a hormonal contraceptive patch, but does not include any drug
14intended to induce an abortion as defined in section 146.1.
15b. “Standing order” means a preauthorized medication
16order with specific instructions from the medical director
17of the department of health and human services to dispense a
18medication under clearly defined circumstances.
197. 8. a. This section applies to the following classes of
20third-party payment provider contracts, or policies, or plans
21 delivered, issued for delivery, continued, or renewed in this
22state on or after July 1, 2000 January 1, 2026:
23(1) Individual or group accident and sickness insurance
24providing coverage on an expense-incurred basis.
25(2) An individual or group hospital or medical service
26contract issued pursuant to chapter 509, 514, or 514A.
27(3) An individual or group health maintenance organization
28contract regulated under chapter 514B.
29(4) Any other entity engaged in the business of insurance,
30risk transfer, or risk retention, which is subject to the
31jurisdiction of the commissioner.
32(5) A plan established pursuant to chapter 509A for public
33employees.
34b. This section shall not apply to accident-only,
35specified disease, short-term hospital or medical, hospital
-7-1confinement indemnity, credit, dental, vision, Medicare
2supplement, long-term care, basic hospital and medical-surgical
3expense coverage as defined by the commissioner, disability
4income insurance coverage, coverage issued as a supplement
5to liability insurance, workers’ compensation or similar
6insurance, or automobile medical payment insurance.
7 Sec. 4. MEDICAID COVERAGE — SELF-ADMINISTERED HORMONAL
8CONTRACEPTIVES. Notwithstanding section 514B.32, subsection
95, section 505.34, and any other provision of law to the
10contrary, the department of health and human services shall,
11contractually and by administrative rules adopted pursuant
12to chapter 17A, require under Medicaid fee-for-service
13and Medicaid managed care administration, coverage for
14a self-administered hormonal contraceptive as prescribed
15by a practitioner as defined in section 155A.3, or as
16prescribed by standing order and dispensed by a pharmacist
17pursuant to section 155A.49, including payment for up to
18an initial twelve-month supply of the self-administered
19hormonal contraceptive dispensed at one time and for up to a
20twelve-month supply of the same self-administered hormonal
21contraceptive subsequently dispensed at one time.
22EXPLANATION
23The inclusion of this explanation does not constitute agreement with
24the explanation’s substance by the members of the general assembly.
25This bill relates to the dispensing of self-administered
26hormonal contraceptives by a pharmacist. The bill
27defines “self-administered hormonal contraceptive” as a
28self-administered hormonal contraceptive that is approved by
29the United States food and drug administration to prevent
30pregnancy, including an oral hormonal contraceptive, a hormonal
31vaginal ring, and a hormonal contraceptive patch, but not
32including any drug intended to induce an abortion.
33The bill provides that notwithstanding any provision of law
34to the contrary, a pharmacist may dispense a self-administered
35hormonal contraceptive to a patient pursuant to a standing
-8-1order established by the medical director of the department of
2health and human services (medical director). For an initial
3dispensing, a pharmacist may dispense up to a 12-month supply
4at one time of the self-administered hormonal contraceptive,
5and for any subsequent dispensing of the same self-administered
6hormonal contraceptive, a 12-month supply at one time.
7Additionally, the bill prohibits a pharmacist who dispenses
8a self-administered hormonal contraceptive in accordance
9with the bill from requiring any other prescription drug
10order authorized by a practitioner prior to dispensing the
11self-administered hormonal contraceptive.
12The bill authorizes the medical director to establish a
13standing order authorizing the dispensing of self-administered
14hormonal contraceptives by any pharmacist who complies with the
15standing order and retains and submits the patient’s record to
16the department of health and human services (HHS).
17The standing order includes requiring a pharmacist who
18dispenses a self-administered hormonal contraceptive under
19the bill to: complete a standardized training program and
20continuing education requirements related to prescribing the
21hormonal contraceptives; obtain a completed self-screening risk
22assessment from each patient and verify the identity of each
23patient before dispensing the hormonal contraceptives; provide
24the patient with certain written information; provide the
25patient with a copy of the record of the pharmacist’s encounter
26with the patient; and provide patient counseling.
27The standing order would prohibit a pharmacist who dispenses
28hormonal contraceptives under the bill from requiring a
29patient to schedule an appointment with the pharmacist for
30the prescribing or dispensing of the hormonal contraceptive;
31and dispensing the hormonal contraceptives to a patient if
32the results of the patient’s self-screening risk assessment
33indicate it is unsafe for the pharmacist to dispense the
34hormonal contraceptives to the patient, in which case the
35pharmacist shall refer the patient to a practitioner.
-9- 1The bill provides immunity for a pharmacist who dispenses a
2self-administered hormonal contraceptive and for the medical
3director who establishes a standing order in compliance with
4the bill from criminal and civil liability arising from any
5damages caused by the dispensing, administering, or use of a
6self-administered hormonal contraceptive or the establishment
7of the standing order provided the pharmacist acts reasonably
8and in good faith. Additionally, the medical director shall
9be considered to be acting within the scope of the medical
10director’s office and employment for purposes of Code chapter
11669 (Iowa tort claims Act) in the establishment of a standing
12order in compliance with the bill.
13The bill requires HHS, in collaboration with the boards of
14pharmacy and medicine, and in consideration of the guidelines
15established by the American congress of obstetricians and
16gynecologists, to adopt administrative rules to administer the
17bill.
18The bill amends prescription contraceptive coverage
19provisions to require that a group policy, contract, or plan
20delivered, issued for delivery, continued, or renewed in the
21state on or after January 1, 2026, providing for third-party
22payment or prepayment of health or medical expenses, shall
23specifically provide for payment of self-administered hormonal
24contraceptives, prescribed and dispensed as specified in the
25bill, including those dispensed at one time.
26The bill also requires HHS to provide prescription
27contraceptive coverage under the Medicaid program consistent
28with the coverage under private insurance as provided under the
29bill.
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