Introduced Version
SENATE BILL No. 189
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 25-26-25.
Synopsis: Pharmacist contraceptive prescriptions. Allows pharmacists
who meet certain requirements to prescribe and dispense hormonal
contraceptive patches and self-administered oral hormonal
contraceptives (contraceptives). Establishes requirements for
pharmacists who prescribe and dispense contraceptives. Requires the
Indiana board of pharmacy (board) to adopt rules. Requires health
plans to provide coverage for contraceptives and certain services.
Establishes an exception for nonprofit religious employers. Requires
the board to issue an annual report to the legislative council.
Effective: July 1, 2022.
Glick
January 6, 2022, read first time and referred to Committee on Health and Provider
Services.
2022 IN 189—LS 6623/DI 77 Introduced
Second Regular Session of the 122nd General Assembly (2022)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
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SENATE BILL No. 189
A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 25-26-25 IS ADDED TO THE INDIANA CODE
2 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2022]:
4 Chapter 25. Hormonal Contraceptives
5 Sec. 1. It is the policy of the state to promote and support
6 measures that will reduce the number of abortions in Indiana.
7 Sec. 2. The definitions in IC 25-26-13-2 apply to this chapter.
8 Sec. 3. As used in this chapter, "health plan" means:
9 (1) a policy of accident and sickness insurance (as defined in
10 IC 27-8-5-1); or
11 (2) an individual contract or a group contract with a health
12 maintenance organization under IC 27-13.
13 Sec. 4. As used in this chapter, "hormonal contraceptive patch"
14 means a transdermal patch applied to the skin of a patient, by the
15 patient or by a pharmacist, that releases a drug composed of a
16 combination of hormones that is approved by the federal Food and
17 Drug Administration to prevent pregnancy.
2022 IN 189—LS 6623/DI 77 2
1 Sec. 5. As used in this chapter, "self-administered oral hormonal
2 contraceptive" means a drug:
3 (1) composed of a hormone or a combination of hormones
4 that is approved by the federal Food and Drug Administration
5 to prevent pregnancy; and
6 (2) that the patient to whom the drug is prescribed may take
7 orally to administer to herself.
8 The term includes hormonal contraceptive pills.
9 Sec. 6. A pharmacist who meets the requirements under this
10 chapter may prescribe and dispense hormonal contraceptive
11 patches and self-administered oral hormonal contraceptives to a
12 patient who is at least eighteen (18) years of age, regardless of
13 whether the patient has evidence of a previous prescription from
14 a primary care practitioner or women's health care practitioner
15 for a hormonal contraceptive patch or self-administered oral
16 hormonal contraceptive.
17 Sec. 7. (a) Before January 1, 2023, the board shall adopt rules
18 under IC 4-22-2 to establish:
19 (1) in consultation with the state department of health;
20 (2) in consideration of guidelines established by federal
21 Centers for Disease Control and Prevention; and
22 (3) with the approval of the medical licensing board of
23 Indiana;
24 standard procedures for the prescribing of hormonal contraceptive
25 patches and self-administered oral hormonal contraceptives by
26 pharmacists.
27 (b) The rules adopted under this section must require a
28 pharmacist to do the following:
29 (1) Complete a training program approved by the board that
30 is related to prescribing hormonal contraceptive patches and
31 self-administered oral hormonal contraceptives. The board
32 may adopt a training program developed by another state.
33 (2) Provide a self-screening risk assessment tool that the
34 patient must use prior to the pharmacist's prescribing the
35 hormonal contraceptive patch or self-administered oral
36 hormonal contraceptive to assess for medical
37 contraindications, including high blood pressure.
38 (3) Require that the pharmacist take the patient's blood
39 pressure before prescribing the hormonal contraceptive patch
40 or self-administered oral hormonal contraceptive.
41 (4) Refer the patient to the patient's primary care practitioner
42 or women's health care practitioner upon prescribing and
2022 IN 189—LS 6623/DI 77 3
1 dispensing the hormonal contraceptive patch or
2 self-administered oral hormonal contraceptive. However, if
3 the patient does not have a primary care practitioner or
4 women's health care practitioner, the pharmacist shall
5 provide the patient with local resources to find a practitioner.
6 (5) Provide the patient with a written record of the hormonal
7 contraceptive patch or the self-administered oral hormonal
8 contraceptive prescribed and dispensed and advise the patient
9 to consult with a primary care practitioner or women's health
10 care practitioner.
11 (6) Recommend that the patient have a clinical visit with a
12 primary care practitioner or women's health care practitioner
13 for a women's health examination at least every two (2) years.
14 (7) Require the dispensing pharmacist to dispense the
15 hormonal contraceptive patch or self-administered oral
16 hormonal contraceptive to the patient as soon as practicable
17 after the pharmacist issues the prescription.
18 (8) Inform the patient of the risks and benefits of the use of a
19 hormonal contraceptive patch or self-administered oral
20 hormonal contraceptive and that the contraceptive does not
21 protect the patient against a sexually transmitted disease.
22 (c) The rules adopted under this section must prohibit a
23 pharmacist from the following:
24 (1) Requiring a patient to schedule an appointment with the
25 pharmacist for the prescribing or dispensing of a hormonal
26 contraceptive patch or self-administered oral hormonal
27 contraceptive.
28 (2) Prescribing a drug that is considered to be an
29 abortifacient.
30 (d) All state and federal laws governing insurance coverage of
31 contraceptive drugs, devices, products, and services apply to
32 hormonal contraceptive patches and self-administered oral
33 hormonal contraceptives prescribed by a pharmacist under this
34 chapter.
35 (e) Notwithstanding subsection (a), if the board has not adopted
36 rules under this section before January 1, 2023, the board may
37 adopt emergency rules under IC 4-22-2-37.1. Notwithstanding
38 IC 4-22-2-37.1(g), an emergency rule adopted by the board under
39 this subsection and in the manner provided by IC 4-22-2-37.1
40 expires on the date on which a rule that supersedes the emergency
41 rule is adopted by the board under IC 4-22-2-24 through
42 IC 4-22-2-36. This subsection expires July 1, 2023.
2022 IN 189—LS 6623/DI 77 4
1 Sec. 8. (a) A health plan must provide payment, coverage, or
2 reimbursement for:
3 (1) prescription hormonal contraceptive patches and
4 self-administered oral hormonal contraceptives; and
5 (2) if covered for other drug benefits by the health plan,
6 outpatient consultations, including pharmacist consultations,
7 examinations, procedures, and medical services that are
8 necessary to prescribe, dispense, deliver, or distribute a
9 prescription contraceptive.
10 (b) The coverage required in subsection (a):
11 (1) may be subject to provisions of the health plan that apply
12 equally to other prescription drugs covered by the health
13 plan, including required copayments, deductibles, and
14 coinsurance; and
15 (2) must reimburse a health care provider or dispensing entity
16 for a dispensing of contraceptives intended to last for a twelve
17 (12) month period for dispensings of the same hormonal
18 contraceptive patch or self-administered oral hormonal
19 contraceptive to the patient regardless of whether the insured
20 was enrolled in the program, plan, or policy at the time the
21 contraceptive was first dispensed.
22 (c) A religious employer that is a nonprofit organization under
23 Section 6033(a)(3)(A)(i) or Section 6033(a)(3)(A)(iii) of the Internal
24 Revenue Code is exempt from the requirements of this section with
25 respect to a health plan it provides to its employees.
26 Sec. 9. (a) Beginning in 2024, the board shall submit an annual
27 report before February 15 to the legislative council that evaluates
28 the effectiveness and use of the laws under this chapter by
29 pharmacists and patients during the previous calendar year. The
30 report may include legislative recommendations.
31 (b) The report must be delivered in an electronic format under
32 IC 5-14-6.
2022 IN 189—LS 6623/DI 77