Bill Text: IA SF513 | 2019-2020 | 88th General Assembly | Amended
Bill Title: A bill for an act relating to the prescribing and dispensing of self-administered hormonal contraceptives. (Formerly SF 348.)
Spectrum: Committee Bill
Status: (Engrossed - Dead) 2019-04-27 - Rereferred to Human Resources. H.J. 1077. [SF513 Detail]
Download: Iowa-2019-SF513-Amended.html
Senate
File
513
-
Reprinted
SENATE
FILE
513
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
SF
348)
(As
Amended
and
Passed
by
the
Senate
March
27,
2019
)
A
BILL
FOR
An
Act
relating
to
the
prescribing
and
dispensing
of
1
self-administered
hormonal
contraceptives.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
SF
513
(4)
88
pf/rh/mb
S.F.
513
Section
1.
Section
155A.3,
Code
2019,
is
amended
by
adding
1
the
following
new
subsections:
2
NEW
SUBSECTION
.
10A.
“Department”
means
the
department
of
3
public
health.
4
NEW
SUBSECTION
.
44A.
“Self-administered
hormonal
5
contraceptive”
means
a
self-administered
hormonal
contraceptive
6
that
is
approved
by
the
United
States
food
and
drug
7
administration
to
prevent
pregnancy.
“Self-administered
8
hormonal
contraceptive”
includes
an
oral
hormonal
contraceptive,
9
a
hormonal
vaginal
ring,
and
a
hormonal
contraceptive
patch,
10
but
does
not
include
any
drug
intended
to
induce
an
abortion
as
11
defined
in
section
146.1.
12
NEW
SUBSECTION
.
44B.
“Standing
order”
means
a
preauthorized
13
medication
order
with
specific
instructions
from
the
medical
14
director
of
the
department
to
dispense
a
medication
under
15
clearly
defined
circumstances.
16
Sec.
2.
NEW
SECTION
.
155A.47
Pharmacist
dispensing
of
17
self-administered
hormonal
contraceptives
——
standing
order
——
18
requirements
——
limitations
of
liability.
19
1.
a.
Notwithstanding
any
provision
of
law
to
the
contrary,
20
a
pharmacist
may
dispense
a
self-administered
hormonal
21
contraceptive
to
a
patient,
who
is
at
least
eighteen
years
of
22
age,
pursuant
to
a
standing
order
established
by
the
medical
23
director
of
the
department
in
accordance
with
this
section.
24
b.
In
dispensing
a
self-administered
hormonal
contraceptive
25
to
a
patient
under
this
section,
a
pharmacist
shall
comply
with
26
the
following:
27
(1)
For
an
initial
dispensing
of
a
self-administered
28
hormonal
contraceptive,
the
pharmacist
may
dispense
only
up
29
to
a
three-month
supply
at
one
time
of
the
self-administered
30
hormonal
contraceptive.
31
(2)
For
any
subsequent
dispensing
of
the
same
32
self-administered
hormonal
contraceptive,
the
pharmacist
33
may
dispense
up
to
a
twelve-month
supply
at
one
time
of
the
34
self-administered
hormonal
contraceptive.
35
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2.
A
pharmacist
who
dispenses
a
self-administered
hormonal
1
contraceptive
in
accordance
with
this
section
shall
not
2
require
any
other
prescription
drug
order
authorized
by
a
3
practitioner
prior
to
dispensing
the
self-administered
hormonal
4
contraceptive
to
a
patient.
5
3.
The
medical
director
of
the
department
may
establish
a
6
standing
order
authorizing
the
dispensing
of
self-administered
7
hormonal
contraceptives
by
a
pharmacist
who
does
all
of
the
8
following:
9
a.
Complies
with
the
standing
order
established
pursuant
to
10
this
section.
11
b.
Retains
a
record
of
each
patient
to
whom
a
12
self-administered
hormonal
contraceptive
is
dispensed
under
13
this
section
and
submits
the
record
to
the
department.
14
4.
The
standing
order
shall
require
a
pharmacist
who
15
dispenses
self-administered
hormonal
contraceptives
under
this
16
section
to
do
all
of
the
following:
17
a.
Complete
a
standardized
training
program
and
continuing
18
education
requirements
approved
by
the
board
in
consultation
19
with
the
department
that
are
related
to
prescribing
20
self-administered
hormonal
contraceptives
and
include
education
21
regarding
all
contraceptive
methods
approved
by
the
United
22
States
food
and
drug
administration.
23
b.
Obtain
a
completed
self-screening
risk
assessment,
24
approved
by
the
department
in
collaboration
with
the
board
and
25
the
board
of
medicine,
from
each
patient,
verify
the
identity
26
and
age
of
each
patient,
and
perform
a
blood
pressure
screening
27
on
each
patient,
prior
to
dispensing
the
self-administered
28
hormonal
contraceptive
to
the
patient.
29
c.
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
32
patient’s
primary
care
or
women’s
health
care
practitioner
33
to
obtain
preventative
care,
including
but
not
limited
to
34
recommended
tests
and
screenings.
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(b)
The
effectiveness
and
availability
of
long-acting
1
reversible
contraceptives
as
an
alternative
to
2
self-administered
hormonal
contraceptives.
3
(2)
A
copy
of
the
record
of
the
pharmacist’s
encounter
with
4
the
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
7
basis
for
not
dispensing
a
contraceptive.
8
(3)
Patient
counseling
regarding
all
of
the
following:
9
(a)
The
appropriate
administration
and
storage
of
the
10
self-administered
hormonal
contraceptive.
11
(b)
Potential
side
effects
and
risks
of
the
12
self-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
16
infection
or
disease,
and
ways
to
reduce
such
a
risk.
17
5.
The
standing
order
established
pursuant
to
this
section
18
shall
prohibit
a
pharmacist
who
dispenses
a
self-administered
19
hormonal
contraceptive
under
this
section
from
doing
any
of
the
20
following:
21
a.
Requiring
a
patient
to
schedule
an
appointment
with
22
the
pharmacist
for
the
prescribing
or
dispensing
of
a
23
self-administered
hormonal
contraceptive.
24
b.
Dispensing
self-administered
hormonal
contraceptives
to
25
a
patient
for
more
than
twenty-four
months
after
the
date
a
26
self-administered
hormonal
contraceptive
is
initially
dispensed
27
to
the
patient
without
the
patient’s
attestation
that
the
28
patient
has
consulted
with
a
primary
care
or
women’s
health
29
care
practitioner
during
the
preceding
twenty-four
months.
30
c.
Dispensing
a
self-administered
hormonal
contraceptive
to
31
a
patient
if
the
results
of
the
self-screening
risk
assessment
32
completed
by
a
patient
pursuant
to
subsection
4,
paragraph
33
“b”
,
indicate
it
is
unsafe
for
the
pharmacist
to
dispense
the
34
self-administered
hormonal
contraceptive
to
the
patient,
in
35
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which
case
the
pharmacist
shall
refer
the
patient
to
a
primary
1
care
or
women’s
health
care
practitioner.
2
6.
A
pharmacist
who
dispenses
a
self-administered
hormonal
3
contraceptive
and
the
medical
director
of
the
department
who
4
establishes
a
standing
order
in
compliance
with
this
section
5
shall
be
immune
from
criminal
and
civil
liability
arising
from
6
any
damages
caused
by
the
dispensing,
administering,
or
use
of
7
a
self-administered
hormonal
contraceptive
or
the
establishment
8
of
the
standing
order,
provided
that
the
pharmacist
acts
9
reasonably
and
in
good
faith.
The
medical
director
of
the
10
department
shall
be
considered
to
be
acting
within
the
scope
11
of
the
medical
director’s
office
and
employment
for
purposes
12
of
chapter
669
in
the
establishment
of
a
standing
order
in
13
compliance
with
this
section.
14
7.
The
department,
in
collaboration
with
the
board
and
15
the
board
of
medicine,
and
in
consideration
of
the
guidelines
16
established
by
the
American
congress
of
obstetricians
and
17
gynecologists,
shall
adopt
rules
pursuant
to
chapter
17A
to
18
administer
this
chapter.
19
Sec.
3.
Section
514C.19,
Code
2019,
is
amended
to
read
as
20
follows:
21
514C.19
Prescription
contraceptive
coverage.
22
1.
Notwithstanding
the
uniformity
of
treatment
requirements
23
of
section
514C.6
,
a
group
policy
,
or
contract
,
or
plan
24
providing
for
third-party
payment
or
prepayment
of
health
or
25
medical
expenses
shall
not
do
either
of
the
following
comply
26
as
follows
:
27
a.
Exclude
Such
policy,
contract,
or
plan
shall
not
28
exclude
or
restrict
benefits
for
prescription
contraceptive
29
drugs
or
prescription
contraceptive
devices
which
prevent
30
conception
and
which
are
approved
by
the
United
States
31
food
and
drug
administration,
or
generic
equivalents
32
approved
as
substitutable
by
the
United
States
food
and
drug
33
administration,
if
such
policy
,
or
contract
,
or
plan
provides
34
benefits
for
other
outpatient
prescription
drugs
or
devices.
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However,
such
policy,
contract,
or
plan
shall
specifically
1
provide
for
payment,
including
reimbursement
for
pharmacist
2
consultations,
for
a
self-administered
hormonal
contraceptive,
3
as
prescribed
by
a
practitioner
as
defined
in
section
4
155A.3,
or
as
prescribed
by
standing
order
and
dispensed
by
a
5
pharmacist
pursuant
to
section
155A.47,
including
payment
for
6
up
to
an
initial
three-month
supply
of
the
self-administered
7
hormonal
contraceptive
dispensed
at
one
time
and
for
up
to
a
8
twelve-month
supply
of
the
same
self-administered
hormonal
9
contraceptive
subsequently
dispensed
at
one
time.
10
b.
Exclude
Such
policy,
contract,
or
plan
shall
not
exclude
11
or
restrict
benefits
for
outpatient
contraceptive
services
12
which
are
provided
for
the
purpose
of
preventing
conception
if
13
such
policy
,
or
contract
,
or
plan
provides
benefits
for
other
14
outpatient
services
provided
by
a
health
care
professional.
15
2.
A
person
who
provides
a
group
policy
,
or
contract
,
or
16
plan
providing
for
third-party
payment
or
prepayment
of
health
17
or
medical
expenses
which
is
subject
to
subsection
1
shall
not
18
do
any
of
the
following:
19
a.
Deny
to
an
individual
eligibility,
or
continued
20
eligibility,
to
enroll
in
or
to
renew
coverage
under
the
terms
21
of
the
policy
,
or
contract
,
or
plan
because
of
the
individual’s
22
use
or
potential
use
of
such
prescription
contraceptive
drugs
23
or
devices,
or
use
or
potential
use
of
outpatient
contraceptive
24
services.
25
b.
Provide
a
monetary
payment
or
rebate
to
a
covered
26
individual
to
encourage
such
individual
to
accept
less
than
the
27
minimum
benefits
provided
for
under
subsection
1
.
28
c.
Penalize
or
otherwise
reduce
or
limit
the
reimbursement
29
of
a
health
care
professional
because
such
professional
30
prescribes
contraceptive
drugs
or
devices,
or
provides
31
contraceptive
services.
32
d.
Provide
incentives,
monetary
or
otherwise,
to
a
health
33
care
professional
to
induce
such
professional
to
withhold
34
from
a
covered
individual
contraceptive
drugs
or
devices,
or
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contraceptive
services.
1
3.
This
section
shall
not
be
construed
to
prevent
a
2
third-party
payor
from
including
deductibles,
coinsurance,
or
3
copayments
under
the
policy
,
or
contract,
or
plan
as
follows:
4
a.
A
deductible,
coinsurance,
or
copayment
for
benefits
5
for
prescription
contraceptive
drugs
shall
not
be
greater
than
6
such
deductible,
coinsurance,
or
copayment
for
any
outpatient
7
prescription
drug
for
which
coverage
under
the
policy
,
or
8
contract
,
or
plan
is
provided.
9
b.
A
deductible,
coinsurance,
or
copayment
for
benefits
for
10
prescription
contraceptive
devices
shall
not
be
greater
than
11
such
deductible,
coinsurance,
or
copayment
for
any
outpatient
12
prescription
device
for
which
coverage
under
the
policy
,
or
13
contract
,
or
plan
is
provided.
14
c.
A
deductible,
coinsurance,
or
copayment
for
benefits
for
15
outpatient
contraceptive
services
shall
not
be
greater
than
16
such
deductible,
coinsurance,
or
copayment
for
any
outpatient
17
health
care
services
for
which
coverage
under
the
policy
,
or
18
contract
,
or
plan
is
provided.
19
4.
This
section
shall
not
be
construed
to
require
a
20
third-party
payor
under
a
policy
,
or
contract
,
or
plan
21
to
provide
benefits
for
experimental
or
investigational
22
contraceptive
drugs
or
devices,
or
experimental
or
23
investigational
contraceptive
services,
except
to
the
extent
24
that
such
policy
,
or
contract
,
or
plan
provides
coverage
for
25
other
experimental
or
investigational
outpatient
prescription
26
drugs
or
devices,
or
experimental
or
investigational
outpatient
27
health
care
services.
28
5.
This
section
shall
not
be
construed
to
limit
or
otherwise
29
discourage
the
use
of
generic
equivalent
drugs
approved
by
the
30
United
States
food
and
drug
administration,
whenever
available
31
and
appropriate.
This
section
,
when
a
brand
name
drug
is
32
requested
by
a
covered
individual
and
a
suitable
generic
33
equivalent
is
available
and
appropriate,
shall
not
be
construed
34
to
prohibit
a
third-party
payor
from
requiring
the
covered
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individual
to
pay
a
deductible,
coinsurance,
or
copayment
1
consistent
with
subsection
3
,
in
addition
to
the
difference
of
2
the
cost
of
the
brand
name
drug
less
the
maximum
covered
amount
3
for
a
generic
equivalent.
4
6.
A
person
who
provides
an
individual
policy
,
or
contract
,
5
or
plan
providing
for
third-party
payment
or
prepayment
of
6
health
or
medical
expenses
shall
make
available
a
coverage
7
provision
that
satisfies
the
requirements
in
subsections
8
1
through
5
in
the
same
manner
as
such
requirements
are
9
applicable
to
a
group
policy
,
or
contract
,
or
plan
under
those
10
subsections.
The
policy
,
or
contract
,
or
plan
shall
provide
11
that
the
individual
policyholder
may
reject
the
coverage
12
provision
at
the
option
of
the
policyholder.
13
7.
a.
This
section
applies
to
the
following
classes
of
14
third-party
payment
provider
contracts
,
or
policies
,
or
plan
15
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
16
state
on
or
after
July
1,
2000
January
1,
2020
:
17
(1)
Individual
or
group
accident
and
sickness
insurance
18
providing
coverage
on
an
expense-incurred
basis.
19
(2)
An
individual
or
group
hospital
or
medical
service
20
contract
issued
pursuant
to
chapter
509
,
514
,
or
514A
.
21
(3)
An
individual
or
group
health
maintenance
organization
22
contract
regulated
under
chapter
514B
.
23
(4)
Any
other
entity
engaged
in
the
business
of
insurance,
24
risk
transfer,
or
risk
retention,
which
is
subject
to
the
25
jurisdiction
of
the
commissioner.
26
(5)
A
plan
established
pursuant
to
chapter
509A
for
public
27
employees.
28
b.
This
section
shall
not
apply
to
accident-only,
29
specified
disease,
short-term
hospital
or
medical,
hospital
30
confinement
indemnity,
credit,
dental,
vision,
Medicare
31
supplement,
long-term
care,
basic
hospital
and
medical-surgical
32
expense
coverage
as
defined
by
the
commissioner,
disability
33
income
insurance
coverage,
coverage
issued
as
a
supplement
34
to
liability
insurance,
workers’
compensation
or
similar
35
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513
insurance,
or
automobile
medical
payment
insurance.
1
8.
This
section
shall
not
be
construed
to
require
a
2
third-party
payor
to
provide
payment
to
a
practitioner
for
the
3
dispensing
of
a
self-administered
hormonal
contraceptive
to
4
replace
a
self-administered
hormonal
contraceptive
that
has
5
been
dispensed
to
a
covered
person
and
that
has
been
misplaced,
6
stolen,
or
destroyed.
This
section
shall
not
be
construed
to
7
require
a
third-party
payor
to
replace
covered
prescriptions
8
that
are
misplaced,
stolen,
or
destroyed.
9
9.
For
the
purposes
of
this
section:
10
a.
“Self-administered
hormonal
contraceptive”
means
a
11
self-administered
hormonal
contraceptive
that
is
approved
12
by
the
United
Sates
food
and
drug
administration
to
prevent
13
pregnancy.
“Self-administered
hormonal
contraceptive”
includes
14
an
oral
hormonal
contraceptive,
a
hormonal
vaginal
ring,
and
15
a
hormonal
contraceptive
patch,
but
does
not
include
any
drug
16
intended
to
induce
an
abortion
as
defined
in
section
146.1.
17
b.
“Standing
order”
means
a
preauthorized
medication
order
18
with
specific
instructions
from
the
medical
director
of
the
19
department
of
public
health
to
dispense
a
medication
under
20
clearly
defined
circumstances.
21
Sec.
4.
MEDICAID
COVERAGE
——
SELF-ADMINISTERED
HORMONAL
22
CONTRACEPTIVES.
The
department
of
human
services
shall,
23
contractually
and
by
administrative
rules
adopted
pursuant
24
to
chapter
17A,
require
under
Medicaid
fee-for-service
25
and
Medicaid
managed
care
administration,
coverage
for
26
a
self-administered
hormonal
contraceptive
as
prescribed
27
by
a
practitioner
as
defined
in
section
155A.3,
or
as
28
prescribed
by
standing
order
and
dispensed
by
a
pharmacist
29
pursuant
to
section
155A.47,
including
payment
for
up
to
30
an
initial
three-month
supply
of
the
self-administered
31
hormonal
contraceptive
dispensed
at
one
time
and
for
up
to
a
32
twelve-month
supply
of
the
same
self-administered
hormonal
33
contraceptive
subsequently
dispensed
at
one
time.
34
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