Senate Study Bill 3082 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON COMMERCE BILL BY CHAIRPERSON PETERSEN) A BILL FOR An Act relating to the prescribing and dispensing of 1 self-administered oral hormonal contraceptives including 2 by pharmacists and providing insurance coverage for such 3 contraceptives prescribed and dispensed. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 5041XC (7) 86 pf/nh

S.F. _____ Section 1. Section 155A.3, Code 2016, is amended by adding 1 the following new subsection: 2 NEW SUBSECTION . 39A. “Self-administered oral hormonal 3 contraceptive” means a drug composed of a combination of 4 hormones that is approved by the United States food and drug 5 administration to prevent pregnancy and that the patient to 6 whom the drug is prescribed may take orally. 7 Sec. 2. NEW SECTION . 155A.45 Prescribing and dispensing of 8 self-administered oral hormonal contraceptives. 9 1. Notwithstanding any provision of law to the contrary, 10 a pharmacist may prescribe and dispense self-administered 11 oral hormonal contraceptives to a person regardless of 12 whether the person has evidence of a previous prescription 13 from a practitioner for a self-administered oral hormonal 14 contraceptive. 15 2. a. The department of public health in consultation with 16 the Iowa pharmacy association and the Iowa medical society, and 17 in consideration of the guidelines established by the American 18 congress of obstetricians and gynecologists, shall adopt by 19 rule a statewide protocol for the prescribing and dispensing of 20 self-administered oral hormonal contraceptives by pharmacists. 21 b. The rules adopted under this subsection shall require a 22 pharmacist to do all of the following: 23 (1) Complete a standardized training program approved by 24 the department of public health that is related to prescribing 25 self-administered oral hormonal contraceptives and includes 26 education regarding all contraceptive methods approved by the 27 federal food and drug administration. 28 (2) Provide a standardized self-screening risk assessment 29 tool to the patient for completion prior to the pharmacist’s 30 prescribing of the self-administered oral hormonal 31 contraceptive. 32 (3) Prior to prescribing and dispensing the 33 self-administered oral hormone contraceptive, provide 34 the patient with education regarding all contraceptive methods 35 -1- LSB 5041XC (7) 86 pf/nh 1/ 4

S.F. _____ approved by the federal food and drug administration. 1 (4) Upon prescribing and dispensing the self-administered 2 oral hormonal contraceptive, provide the patient with a written 3 record of the prescribed and dispensed self-administered oral 4 hormonal contraceptive, and refer the patient to the patient’s 5 primary practitioner or women’s health care practitioner for 6 preventive visits. 7 (5) Dispense the self-administered oral hormonal 8 contraceptive to the patient as soon as practicable after the 9 pharmacist issues the prescription. 10 (6) Prescribe and dispense an initial three-month supply of 11 the self-administered oral hormonal contraceptive, and, upon 12 verification of no adverse effects, issue a prescription for 13 and dispense at one time a one-year supply of self-administered 14 oral hormonal contraceptives to the patient. 15 c. The rules adopted under this subsection shall prohibit a 16 pharmacist from requiring a patient to schedule an appointment 17 with the pharmacist for the prescribing of a self-administered 18 oral hormonal contraceptive. 19 3. All state and federal laws governing insurance coverage 20 of contraceptive drugs, devices, products, and services shall 21 apply to a self-administered oral hormonal contraceptive 22 prescribed by a pharmacist under this section. 23 Sec. 3. Section 514C.19, subsection 1, paragraph a, Code 24 2016, is amended to read as follows: 25 a. Exclude or restrict benefits for prescription 26 contraceptive drugs or prescription contraceptive devices 27 which prevent conception and which are approved by the United 28 States food and drug administration, or generic equivalents 29 approved as substitutable by the United States food and drug 30 administration, if such policy or contract provides benefits 31 for other outpatient prescription drugs or devices. Such 32 policy or contract shall specifically provide for payment 33 of up to a one-year supply, dispensed at one time, of 34 self-administered oral hormonal contraceptives as defined 35 -2- LSB 5041XC (7) 86 pf/nh 2/ 4

S.F. _____ in section 155A.3, which are prescribed by a practitioner 1 authorized to prescribe drugs in this state, including a 2 pharmacist pursuant to section 155A.45. 3 EXPLANATION 4 The inclusion of this explanation does not constitute agreement with 5 the explanation’s substance by the members of the general assembly. 6 This bill authorizes a pharmacist to prescribe and dispense 7 self-administered oral hormonal contraceptives. Under the 8 bill, a pharmacist may prescribe and dispense these items to 9 a person whether or not the person has evidence of a previous 10 prescription from a practitioner for self-administered oral 11 hormonal contraceptives. 12 The department of public health in consultation with 13 the Iowa pharmacy association and the Iowa medical society, 14 and in consideration of the guidelines established by the 15 American congress of obstetricians and gynecologists, is 16 directed to adopt a statewide protocol for the prescribing and 17 dispensing of self-administered oral hormonal contraceptives 18 by pharmacists. 19 The bill prescribes what the rules are to require a 20 pharmacist to do and what a pharmacist is prohibited from 21 doing. The rules shall require a pharmacist to complete a 22 standardized training program approved by the department of 23 public health that is related to prescribing self-administered 24 oral hormonal contraceptives and includes education regarding 25 all contraceptive methods approved by the federal food and drug 26 administration (FDA); to provide a standardized self-screening 27 risk assessment tool to the patient for completion prior to 28 the pharmacist’s prescribing of the self-administered oral 29 hormonal contraceptive; prior to prescribing and dispensing 30 the self-administered oral hormonal contraceptive, to provide 31 the patient with education regarding all contraceptive methods 32 approved by the FDA; upon prescribing and dispensing the 33 self-administered oral hormonal contraceptive, to provide the 34 patient with a written record of the prescribed and dispensed 35 -3- LSB 5041XC (7) 86 pf/nh 3/ 4

S.F. _____ self-administered oral hormonal contraceptive, and refer the 1 patient to the patient’s primary practitioner or women’s 2 health care practitioner for preventive visits; to dispense 3 the self-administered oral hormonal contraceptive to the 4 patient as soon as practicable after the pharmacist issues 5 the prescription; and to prescribe and dispense an initial 6 three-month supply of the self-administered oral hormonal 7 contraceptive, and, upon verification of no adverse effects, 8 issue a prescription for and dispense at one time a one-year 9 supply of self-administered oral hormonal contraceptives to the 10 patient. The rules shall prohibit a pharmacist from requiring 11 a patient to schedule an appointment with the pharmacist for 12 prescribing the self-administered oral hormonal contraceptive. 13 All state and federal laws governing insurance coverage of 14 contraceptive drugs, devices, products, and services apply to a 15 self-administered oral hormonal contraceptive prescribed by a 16 pharmacist under the bill. 17 The bill amends prescription contraceptive coverage 18 provisions to require that a group policy or contract providing 19 for third-party payment or prepayment of health or medical 20 expenses, and by reference individual policies as well, 21 shall specifically provide for payment of up to a one-year 22 supply, dispensed at one time, of self-administered oral 23 hormonal contraceptives which are prescribed by a practitioner 24 authorized to prescribe drugs in this state, including a 25 pharmacist pursuant to Code section 155A.45. 26 -4- LSB 5041XC (7) 86 pf/nh 4/ 4