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Senate Study Bill 3169 - IntroducedA Bill ForAn Act 1relating to the prescribing and dispensing of
2self-administered oral hormonal contraceptives including
3by pharmacists and providing insurance coverage for such
4contraceptives prescribed and dispensed.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 155A.3, Code 2018, is amended by adding
2the following new subsection:
3 NEW SUBSECTION. 42A. “Self-administered oral hormonal
4contraceptive” means a drug composed of a combination of
5hormones that is approved by the United States food and drug
6administration to prevent pregnancy and that the patient to
7whom the drug is prescribed may take orally.
8 Sec. 2. NEW SECTION. 155A.46 Prescribing and dispensing of
9self-administered oral hormonal contraceptives.
101. Notwithstanding any provision of law to the contrary,
11a pharmacist may prescribe and dispense self-administered
12oral hormonal contraceptives to a person regardless of
13whether the person has evidence of a previous prescription
14from a practitioner for a self-administered oral hormonal
15contraceptive.
162. a. The department of public health in consultation with
17the Iowa pharmacy association and the Iowa medical society, and
18in consideration of the guidelines established by the American
19college of obstetricians and gynecologists, shall adopt by rule
20a statewide protocol for the prescribing and dispensing of
21self-administered oral hormonal contraceptives by pharmacists.
22b. The rules adopted under this subsection shall require a
23pharmacist to do all of the following:
24(1) Complete a standardized training program approved by
25the department of public health that is related to prescribing
26self-administered oral hormonal contraceptives and includes
27education regarding all contraceptive methods approved by the
28United States food and drug administration.
29(2) Provide a standardized self-screening risk assessment
30tool to the patient for completion prior to the pharmacist’s
31prescribing of the self-administered oral hormonal
32contraceptive.
33(3) Prior to prescribing and dispensing the
34self-administered oral hormonal contraceptive, provide
35the patient with education regarding all contraceptive methods
-1-1approved by the United States food and drug administration.
2(4) Upon prescribing and dispensing the self-administered
3oral hormonal contraceptive, provide the patient with a written
4record of the prescribed and dispensed self-administered oral
5hormonal contraceptive, and refer the patient to the patient’s
6primary practitioner or women’s health care practitioner for
7preventive visits.
8(5) Dispense the self-administered oral hormonal
9contraceptive to the patient as soon as practicable after the
10pharmacist issues the prescription.
11c. The rules adopted under this subsection shall require
12a pharmacist to prescribe and dispense an initial three-month
13supply of the self-administered oral hormonal contraceptive,
14and shall authorize a pharmacist, upon verification of no
15adverse effects, to issue a prescription for and dispense
16up to a one-year supply of self-administered oral hormonal
17contraceptives to the patient at one time.
18d. The rules adopted under this subsection shall prohibit a
19pharmacist from requiring a patient to schedule an appointment
20with the pharmacist for the prescribing of a self-administered
21oral hormonal contraceptive.
223. All state and federal laws governing insurance coverage
23of contraceptive drugs, devices, products, and services shall
24apply to a self-administered oral hormonal contraceptive
25prescribed by a pharmacist under this section.
26 Sec. 3. Section 514C.19, subsection 1, paragraph a, Code
272018, is amended to read as follows:
28a. Exclude or restrict benefits for prescription
29contraceptive drugs or prescription contraceptive devices
30which prevent conception and which are approved by the United
31States food and drug administration, or generic equivalents
32approved as substitutable by the United States food and drug
33administration, if such policy or contract provides benefits
34for other outpatient prescription drugs or devices. Such
35policy or contract shall specifically provide for payment
-2-1of up to a one-year supply, dispensed at one time, of
2self-administered oral hormonal contraceptives as defined
3in section 155A.3, which are prescribed by a practitioner
4authorized to prescribe drugs in this state, including a
5pharmacist pursuant to section 155A.46.
6EXPLANATION
7The inclusion of this explanation does not constitute agreement with
8the explanation’s substance by the members of the general assembly.
9This bill authorizes a pharmacist to prescribe and dispense
10self-administered oral hormonal contraceptives. Under the
11bill, a pharmacist may prescribe and dispense these items to
12a person whether or not the person has evidence of a previous
13prescription from a practitioner for self-administered oral
14hormonal contraceptives.
15The department of public health in consultation with
16the Iowa pharmacy association and the Iowa medical society,
17and in consideration of the guidelines established by the
18American congress of obstetricians and gynecologists, is
19directed to adopt a statewide protocol for the prescribing and
20dispensing of self-administered oral hormonal contraceptives
21by pharmacists.
22The bill prescribes what the rules are to require a
23pharmacist to do and what a pharmacist is prohibited from
24doing. The rules shall require a pharmacist to complete a
25standardized training program approved by the department of
26public health that is related to prescribing self-administered
27oral hormonal contraceptives and includes education regarding
28all contraceptive methods approved by the United States food
29and drug administration (FDA); to provide a standardized
30self-screening risk assessment tool to the patient for
31completion prior to the pharmacist’s prescribing of the
32self-administered oral hormonal contraceptive; prior to
33prescribing and dispensing the self-administered oral
34hormonal contraceptive, to provide the patient with education
35regarding all contraceptive methods approved by the FDA; upon
-3-1prescribing and dispensing the self-administered oral hormonal
2contraceptive, to provide the patient with a written record of
3the prescribed and dispensed self-administered oral hormonal
4contraceptive, and refer the patient to the patient’s primary
5practitioner or women’s health care practitioner for preventive
6visits; and to dispense the self-administered oral hormonal
7contraceptive to the patient as soon as practicable after the
8pharmacist issues the prescription. The bill provides that
9the rules adopted are to require a pharmacist to prescribe and
10dispense an initial three-month supply of the self-administered
11oral hormonal contraceptive and authorize a pharmacist, upon
12verification of no adverse effects, to issue a prescription
13for and dispense up to a one-year supply of self-administered
14oral hormonal contraceptives to the patient at one time. The
15rules shall prohibit a pharmacist from requiring a patient to
16schedule an appointment with the pharmacist for prescribing the
17self-administered oral hormonal contraceptive.
18All state and federal laws governing insurance coverage of
19contraceptive drugs, devices, products, and services apply to a
20self-administered oral hormonal contraceptive prescribed by a
21pharmacist under the bill.
22The bill amends prescription contraceptive coverage
23provisions to require that a group policy or contract providing
24for third-party payment or prepayment of health or medical
25expenses, and by reference individual policies as well,
26shall specifically provide for payment of up to a one-year
27supply, dispensed at one time, of self-administered oral
28hormonal contraceptives which are prescribed by a practitioner
29authorized to prescribe drugs in this state, including a
30pharmacist pursuant to Code section 155A.46.
-4-pf/rj
2self-administered oral hormonal contraceptives including
3by pharmacists and providing insurance coverage for such
4contraceptives prescribed and dispensed.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 155A.3, Code 2018, is amended by adding
2the following new subsection:
3 NEW SUBSECTION. 42A. “Self-administered oral hormonal
4contraceptive” means a drug composed of a combination of
5hormones that is approved by the United States food and drug
6administration to prevent pregnancy and that the patient to
7whom the drug is prescribed may take orally.
8 Sec. 2. NEW SECTION. 155A.46 Prescribing and dispensing of
9self-administered oral hormonal contraceptives.
101. Notwithstanding any provision of law to the contrary,
11a pharmacist may prescribe and dispense self-administered
12oral hormonal contraceptives to a person regardless of
13whether the person has evidence of a previous prescription
14from a practitioner for a self-administered oral hormonal
15contraceptive.
162. a. The department of public health in consultation with
17the Iowa pharmacy association and the Iowa medical society, and
18in consideration of the guidelines established by the American
19college of obstetricians and gynecologists, shall adopt by rule
20a statewide protocol for the prescribing and dispensing of
21self-administered oral hormonal contraceptives by pharmacists.
22b. The rules adopted under this subsection shall require a
23pharmacist to do all of the following:
24(1) Complete a standardized training program approved by
25the department of public health that is related to prescribing
26self-administered oral hormonal contraceptives and includes
27education regarding all contraceptive methods approved by the
28United States food and drug administration.
29(2) Provide a standardized self-screening risk assessment
30tool to the patient for completion prior to the pharmacist’s
31prescribing of the self-administered oral hormonal
32contraceptive.
33(3) Prior to prescribing and dispensing the
34self-administered oral hormonal contraceptive, provide
35the patient with education regarding all contraceptive methods
-1-1approved by the United States food and drug administration.
2(4) Upon prescribing and dispensing the self-administered
3oral hormonal contraceptive, provide the patient with a written
4record of the prescribed and dispensed self-administered oral
5hormonal contraceptive, and refer the patient to the patient’s
6primary practitioner or women’s health care practitioner for
7preventive visits.
8(5) Dispense the self-administered oral hormonal
9contraceptive to the patient as soon as practicable after the
10pharmacist issues the prescription.
11c. The rules adopted under this subsection shall require
12a pharmacist to prescribe and dispense an initial three-month
13supply of the self-administered oral hormonal contraceptive,
14and shall authorize a pharmacist, upon verification of no
15adverse effects, to issue a prescription for and dispense
16up to a one-year supply of self-administered oral hormonal
17contraceptives to the patient at one time.
18d. The rules adopted under this subsection shall prohibit a
19pharmacist from requiring a patient to schedule an appointment
20with the pharmacist for the prescribing of a self-administered
21oral hormonal contraceptive.
223. All state and federal laws governing insurance coverage
23of contraceptive drugs, devices, products, and services shall
24apply to a self-administered oral hormonal contraceptive
25prescribed by a pharmacist under this section.
26 Sec. 3. Section 514C.19, subsection 1, paragraph a, Code
272018, is amended to read as follows:
28a. Exclude or restrict benefits for prescription
29contraceptive drugs or prescription contraceptive devices
30which prevent conception and which are approved by the United
31States food and drug administration, or generic equivalents
32approved as substitutable by the United States food and drug
33administration, if such policy or contract provides benefits
34for other outpatient prescription drugs or devices. Such
35policy or contract shall specifically provide for payment
-2-1of up to a one-year supply, dispensed at one time, of
2self-administered oral hormonal contraceptives as defined
3in section 155A.3, which are prescribed by a practitioner
4authorized to prescribe drugs in this state, including a
5pharmacist pursuant to section 155A.46.
6EXPLANATION
7The inclusion of this explanation does not constitute agreement with
8the explanation’s substance by the members of the general assembly.
9This bill authorizes a pharmacist to prescribe and dispense
10self-administered oral hormonal contraceptives. Under the
11bill, a pharmacist may prescribe and dispense these items to
12a person whether or not the person has evidence of a previous
13prescription from a practitioner for self-administered oral
14hormonal contraceptives.
15The department of public health in consultation with
16the Iowa pharmacy association and the Iowa medical society,
17and in consideration of the guidelines established by the
18American congress of obstetricians and gynecologists, is
19directed to adopt a statewide protocol for the prescribing and
20dispensing of self-administered oral hormonal contraceptives
21by pharmacists.
22The bill prescribes what the rules are to require a
23pharmacist to do and what a pharmacist is prohibited from
24doing. The rules shall require a pharmacist to complete a
25standardized training program approved by the department of
26public health that is related to prescribing self-administered
27oral hormonal contraceptives and includes education regarding
28all contraceptive methods approved by the United States food
29and drug administration (FDA); to provide a standardized
30self-screening risk assessment tool to the patient for
31completion prior to the pharmacist’s prescribing of the
32self-administered oral hormonal contraceptive; prior to
33prescribing and dispensing the self-administered oral
34hormonal contraceptive, to provide the patient with education
35regarding all contraceptive methods approved by the FDA; upon
-3-1prescribing and dispensing the self-administered oral hormonal
2contraceptive, to provide the patient with a written record of
3the prescribed and dispensed self-administered oral hormonal
4contraceptive, and refer the patient to the patient’s primary
5practitioner or women’s health care practitioner for preventive
6visits; and to dispense the self-administered oral hormonal
7contraceptive to the patient as soon as practicable after the
8pharmacist issues the prescription. The bill provides that
9the rules adopted are to require a pharmacist to prescribe and
10dispense an initial three-month supply of the self-administered
11oral hormonal contraceptive and authorize a pharmacist, upon
12verification of no adverse effects, to issue a prescription
13for and dispense up to a one-year supply of self-administered
14oral hormonal contraceptives to the patient at one time. The
15rules shall prohibit a pharmacist from requiring a patient to
16schedule an appointment with the pharmacist for prescribing the
17self-administered oral hormonal contraceptive.
18All state and federal laws governing insurance coverage of
19contraceptive drugs, devices, products, and services apply to a
20self-administered oral hormonal contraceptive prescribed by a
21pharmacist under the bill.
22The bill amends prescription contraceptive coverage
23provisions to require that a group policy or contract providing
24for third-party payment or prepayment of health or medical
25expenses, and by reference individual policies as well,
26shall specifically provide for payment of up to a one-year
27supply, dispensed at one time, of self-administered oral
28hormonal contraceptives which are prescribed by a practitioner
29authorized to prescribe drugs in this state, including a
30pharmacist pursuant to Code section 155A.46.
-4-pf/rj