Relating to the prescribing and dispensing of self-administered hormonal contraceptives

This bill relates to the dispensing of self-administered hormonal contraceptives by a pharmacist. The bill defines “self-administered hormonal contraceptive” as a self-administered hormonal contraceptive that is approved by the United States food and drug administration to prevent pregnancy, including an oral hormonal contraceptive, a hormonal vaginal ring, and a hormonal contraceptive patch, but not including any drug intended to induce an abortion. The bill provides that notwithstanding any provision of law to the contrary, a pharmacist may dispense a self-administered hormonal contraceptive to a patient who is at least years of age pursuant to a standing order established by the medical director of the department of public health (medical director). For an initial dispensing, a pharmacist may dispense only up to a three-month supply at one time of the self-administered hormonal contraceptive, and for any subsequent dispensing of the same self-administered hormonal contraceptive, a twelve-month supply at one time. Additionally, the bill prohibits a pharmacist who dispenses a self-administered hormonal contraceptive in accordance with the bill from requiring any other prescription drug order authorized by a practitioner prior to dispensing the self-administered hormonal contraceptive. The bill authorizes the medical director to establish a standing order authorizing the dispensing of self-administered hormonal contraceptives by any pharmacist who complies with the standing order and retains and submits the patient’s record to the department of public health (DPH). The standing order includes requiring a pharmacist who dispenses a self-administered hormonal contraceptive under the bill to: complete a standardized training program and continuing education requirements related to prescribing the hormonal contraceptives; obtain a completed self-screening risk assessment from each patient, verify the identity and age of each patient, and perform a blood pressure screening on each patient before dispensing the hormonal contraceptives; provide the patient with certain written information; provide the patient with a copy of the record of the pharmacist’s encounter with the patient; and provide patient counseling. The standing order would prohibit a pharmacist who dispenses hormonal contraceptives under the bill from requiring a patient to schedule an appointment with the pharmacist for the prescribing or dispensing of the hormonal contraceptive; dispensing the hormonal contraceptives to a patient for more than months after the date initially dispensed without the patient’s attestation that the patient has consulted with a practitioner during the preceding months; and dispensing the hormonal contraceptives to a patient if the results of the patient’s self-screening risk assessment indicate it is unsafe for the pharmacist to dispense the hormonal contraceptives to the patient, in which case the pharmacist shall refer the patient to a practitioner. The bill provides immunity for a pharmacist who dispenses a self-administered hormonal contraceptive and for the medical director who establishes a standing order in compliance with the bill from criminal and civil liability arising from any damages caused by the dispensing, administering, or use of a self-administered hormonal contraceptive or the establishment of the standing order. Additionally, the medical director shall be considered to be acting within the scope of the medical director’s office and employment for purposes of Code chapter 669 (Iowa tort claims Act) in the establishment of a standing order in compliance with the bill. The bill requires DPH, in collaboration with the boards of pharmacy and medicine, and in consideration of the guidelines established by the American congress of obstetricians and gynecologists, to adopt administrative rules to administer the bill. The bill amends prescription contraceptive coverage provisions to require that a group policy, contract, or plan delivered, issued for delivery, continued, or renewed in the state on or after January 1, 2022, providing for third-party payment or prepayment of health or medical expenses, shall specifically provide for payment of self-administered hormonal contraceptives, prescribed and dispensed as specified in the bill, including those dispensed at one time. The bill provides, however, that the provisions of the bill relating to coverage are not to be construed to require a third-party payor to provide payment to a practitioner for dispensing a self-administered hormonal contraceptive to replace a self-administered hormonal contraceptive that has been dispensed to a covered person and that has been misplaced, stolen, or destroyed. These provisions are also not to be construed to require a third-party payor to replace covered prescriptions that are misplaced, stolen, or destroyed. The bill also requires the board of pharmacy in collaboration with the board of medicine and DPH to expand the information program for drug prescribing to collect from pharmacists information relating to the dispensing of self-administered hormonal contraceptives as provided in the bill.