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 pursuant to a standing order established by the medical director of the department of health and human services (medical director). For an initial dispensing, a pharmacist may dispense up to a 12-month supply at one time of the self-administered hormonal contraceptive, and for any subsequent dispensing of the same self-administered hormonal contraceptive, a 12-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 health and human services (HHS). 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 and verify the identity of 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; 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 provided the pharmacist acts reasonably and in good faith. 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 HHS, 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, 2026, 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 also requires HHS to provide prescription contraceptive coverage under the Medicaid program consistent with the coverage under private insurance as provided under the bill.