IN
Indiana House Bill HB1568

Indiana 2023 Regular Session

Indiana House Bill HB1568 Compare Versions

OldNewDifferences
1+*EH1568.2*
2+April 7, 2023
3+ENGROSSED
4+HOUSE BILL No. 1568
5+_____
6+DIGEST OF HB 1568 (Updated April 6, 2023 9:13 am - DI 140)
7+Citations Affected: IC 12-15; IC 16-19; IC 25-26; IC 34-30; IC 35-52.
8+Synopsis: Prescription for hormonal contraceptives. Allows
9+pharmacists who meet certain requirements to prescribe and dispense
10+hormonal contraceptive patches and self-administered hormonal
11+(Continued next page)
12+Effective: Upon passage; July 1, 2023.
13+Rowray, Negele, Vermilion, Fleming
14+(SENATE SPONSORS — GLICK, LEISING, BECKER, ALEXANDER,
15+BREAUX, BOHACEK, YODER)
16+January 19, 2023, read first time and referred to Committee on Public Health.
17+February 14, 2023, amended, reported — Do Pass.
18+February 16, 2023, read second time, amended, ordered engrossed.
19+February 17, 2023, engrossed.
20+February 20, 2023, read third time, passed. Yeas 86, nays 12.
21+SENATE ACTION
22+March 1, 2023, read first time and referred to Committee on Health and Provider Services.
23+March 30, 2023, reported favorably — Do Pass; reassigned to Committee on
24+Appropriations.
25+April 6, 2023, reported favorably — Do Pass.
26+EH 1568—LS 7414/DI 77 Digest Continued
27+contraceptives (contraceptives). Establishes requirements for
28+pharmacists who elect to prescribe and dispense contraceptives.
29+Provides that a pharmacist is not required to prescribe a contraceptive
30+to a woman if the pharmacist believes the contraceptive is
31+contraindicated or objects on ethical, moral, or religious grounds.
32+Provides that an individual who is a pharmacy technician, pharmacy
33+technician in training, pharmacist student, or pharmacist intern is not
34+required to dispense a contraceptive to a woman if the individual
35+objects on ethical, moral, or religious grounds. Requires the Indiana
36+board of pharmacy (board) to revoke the license of a pharmacist who
37+knowingly or intentionally prescribes a drug that is intended to cause
38+an abortion. Establishes penalties for a pharmacist who prescribes a
39+drug that is intended to cause an abortion. Requires the state health
40+commissioner or the commissioner's designated public health authority
41+to issue a standing order that allows a pharmacist to prescribe and
42+dispense contraceptives until the board adopts rules that adopt the
43+standing order. Establishes requirements for the standing order.
44+Requires the office of the secretary of family and social services to
45+reimburse a pharmacist for services and prescriptions for
46+contraceptives provided to an eligible Medicaid recipient.
47+EH 1568—LS 7414/DI 77EH 1568—LS 7414/DI 77 April 7, 2023
148 First Regular Session of the 123rd General Assembly (2023)
249 PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
350 Constitution) is being amended, the text of the existing provision will appear in this style type,
451 additions will appear in this style type, and deletions will appear in this style type.
552 Additions: Whenever a new statutory provision is being enacted (or a new constitutional
653 provision adopted), the text of the new provision will appear in this style type. Also, the
754 word NEW will appear in that style type in the introductory clause of each SECTION that adds
855 a new provision to the Indiana Code or the Indiana Constitution.
956 Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
1057 between statutes enacted by the 2022 Regular Session of the General Assembly.
11-HOUSE ENROLLED ACT No. 1568
12-AN ACT to amend the Indiana Code concerning health.
58+ENGROSSED
59+HOUSE BILL No. 1568
60+A BILL FOR AN ACT to amend the Indiana Code concerning
61+health.
1362 Be it enacted by the General Assembly of the State of Indiana:
14-SECTION 1. IC 12-15-1.3-6.5 IS ADDED TO THE INDIANA
63+1 SECTION 1. IC 12-15-1.3-6.5 IS ADDED TO THE INDIANA
64+2 CODE AS A NEW SECTION TO READ AS FOLLOWS
65+3 [EFFECTIVE UPON PASSAGE]: Sec. 6.5. Before July 1, 2023, the
66+4 office shall apply to the United States Department of Health and
67+5 Human Services to amend the state plan to reimburse a pharmacist
68+6 for services and prescriptions provided under IC 25-26-25 to an
69+7 eligible Medicaid recipient.
70+8 SECTION 2. IC 16-19-4-12 IS ADDED TO THE INDIANA CODE
71+9 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
72+10 1, 2023]: Sec. 12. (a) Subject to IC 25-26-25, before September 1,
73+11 2023, the state health commissioner or the commissioner's
74+12 designated public health authority who is a licensed prescriber
75+13 shall, as part of the individual's official capacity, issue a standing
76+14 order that allows a pharmacist to prescribe and dispense a
77+15 hormonal contraceptive patch (as defined in IC 25-26-25-2) and a
78+16 self-administered hormonal contraceptive (as defined in
79+17 IC 25-26-25-3).
80+EH 1568—LS 7414/DI 77 2
81+1 (b) A standing order described in subsection (a) must comply
82+2 with the requirements set forth under IC 25-26-25.
83+3 (c) The state health commissioner or designated public health
84+4 authority who issues a standing order under subsection (a) is
85+5 immune from civil liability related to the issuing of the standing
86+6 order.
87+7 SECTION 3. IC 25-26-25 IS ADDED TO THE INDIANA CODE
88+8 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
89+9 JULY 1, 2023]:
90+10 Chapter 25. Hormonal Contraceptives
91+11 Sec. 1. The definitions in IC 25-26-13-2 apply to this chapter.
92+12 Sec. 2. As used in this chapter, "hormonal contraceptive patch"
93+13 means a transdermal patch applied to the skin of a woman, by the
94+14 woman or by a pharmacist, that releases a drug composed of a
95+15 combination of hormones that is approved by the federal Food and
96+16 Drug Administration to prevent pregnancy. However, the term
97+17 does not include a drug, substance, or device that contains a
98+18 progesterone receptor antagonist.
99+19 Sec. 3. As used in this chapter, "self-administered hormonal
100+20 contraceptive" means a drug:
101+21 (1) composed of a hormone or a combination of hormones
102+22 that is approved by the federal Food and Drug Administration
103+23 to prevent pregnancy; and
104+24 (2) that the woman to whom the drug is prescribed may
105+25 administer to herself.
106+26 The term includes hormonal contraceptive pills. However, the term
107+27 does not include a drug or substance that contains a progesterone
108+28 receptor antagonist.
109+29 Sec. 4. A pharmacist may prescribe and dispense hormonal
110+30 contraceptive patches and self-administered hormonal
111+31 contraceptives to a woman who is at least eighteen (18) years of
112+32 age, regardless of whether the woman has evidence of a previous
113+33 prescription from a primary care practitioner or women's health
114+34 care practitioner for a hormonal contraceptive patch or
115+35 self-administered hormonal contraceptive.
116+36 Sec. 5. (a) The state health commissioner or designated public
117+37 health authority shall issue a standing order that concerns
118+38 standard procedures for the prescribing of hormonal contraceptive
119+39 patches and self-administered hormonal contraceptives by
120+40 pharmacists and that is effective until the board adopts rules under
121+41 this chapter.
122+42 (b) Before issuing a standing order under subsection (a), the
123+EH 1568—LS 7414/DI 77 3
124+1 state health commissioner or designated public health authority
125+2 shall:
126+3 (1) consult with appropriate medical experts; and
127+4 (2) receive approval of the medical licensing board of Indiana.
128+5 (c) The standing order issued under this section must require a
129+6 pharmacist who elects to prescribe hormonal contraceptive patches
130+7 and self-administered hormonal contraceptives to do the following:
131+8 (1) Complete a training program approved by the board that
132+9 is related to prescribing hormonal contraceptive patches and
133+10 self-administered hormonal contraceptives. The board may
134+11 adopt a training program developed by another state.
135+12 (2) Provide a self-screening risk assessment tool that the
136+13 woman must use before the pharmacist's prescribing of the
137+14 hormonal contraceptive patch or self-administered hormonal
138+15 contraceptive.
139+16 (3) Refer the woman to a primary care practitioner or the
140+17 women's health care practitioner upon prescribing and
141+18 dispensing the hormonal contraceptive patch or
142+19 self-administered hormonal contraceptive.
143+20 (4) Provide the woman with a written record of the hormonal
144+21 contraceptive patch or the self-administered hormonal
145+22 contraceptive prescribed and dispensed and advise the woman
146+23 to consult with a primary care practitioner or women's health
147+24 care practitioner.
148+25 (5) If the pharmacist works at a site which, in the regular
149+26 course of business, has a provider who is a physician,
150+27 advanced practice registered nurse, or physician assistant
151+28 who is available to deliver patient care and who is capable of
152+29 prescribing the hormonal contraceptive patch or
153+30 self-administered hormonal contraceptive, suggest that the
154+31 woman see the provider.
155+32 (6) Administer the screening protocols before issuing each
156+33 prescription for a hormonal contraceptive patch or
157+34 self-administered hormonal contraceptive.
158+35 (7) Provide that a prescription for a contraceptive patch or
159+36 self-administered hormonal contraceptive may not be for
160+37 more than a six (6) month period and that the pharmacist may
161+38 not issue a prescription to the woman after twelve (12) months
162+39 unless the woman has been seen by a physician, advanced
163+40 practice registered nurse, or physician assistant in the
164+41 previous twelve (12) month period.
165+42 Sec. 6. The board shall adopt rules under IC 4-22-2 that adopt
166+EH 1568—LS 7414/DI 77 4
167+1 the state health commissioner's standing order under section 5 of
168+2 this chapter.
169+3 Sec. 7. A pharmacist may not require a woman to schedule an
170+4 appointment with the pharmacist for the prescribing or dispensing
171+5 of a hormonal contraceptive patch or self-administered hormonal
172+6 contraceptive.
173+7 Sec. 8. (a) A pharmacist is not required to prescribe or dispense
174+8 a hormonal contraceptive patch or self-administered hormonal
175+9 contraceptive to a woman if the pharmacist:
176+10 (1) believes that the hormonal contraceptive patch or
177+11 self-administered hormonal contraceptive is contraindicated;
178+12 or
179+13 (2) objects on ethical, moral, or religious grounds.
180+14 (b) An individual who is a pharmacy technician, pharmacy
181+15 technician in training, pharmacist student, or pharmacist intern is
182+16 not required to dispense a hormonal contraceptive patch or
183+17 self-administered hormonal contraceptive to a woman if the
184+18 individual objects on ethical, moral, or religious grounds.
185+19 Sec. 9. (a) Notwithstanding IC 25-1-9, the board shall revoke the
186+20 license of a pharmacist if, after appropriate notice and an
187+21 opportunity for a hearing, the attorney general proves by a
188+22 preponderance of the evidence that the pharmacist knowingly or
189+23 intentionally prescribed a drug under this chapter that is intended
190+24 to cause an abortion.
191+25 (b) A pharmacist who knowingly or intentionally prescribes a
192+26 drug under this chapter that is intended to cause an abortion
193+27 commits a level 5 felony.
194+28 SECTION 4. IC 34-30-2.1-197.2 IS ADDED TO THE INDIANA
195+29 CODE AS A NEW SECTION TO READ AS FOLLOWS
196+30 [EFFECTIVE JULY 1, 2023]: Sec. 197.2. IC 16-19-4-12 (Concerning
197+31 issuance of certain standing orders by the state health
198+32 commissioner and designated public health authorities).
199+33 SECTION 5. IC 35-52-25-46.8 IS ADDED TO THE INDIANA
200+34 CODE AS A NEW SECTION TO READ AS FOLLOWS
201+35 [EFFECTIVE JULY 1, 2023]: Sec. 46.8. IC 25-26-25-9 defines a
202+36 crime concerning pharmacists.
203+37 SECTION 6. An emergency is declared for this act.
204+EH 1568—LS 7414/DI 77 5
205+COMMITTEE REPORT
206+Mr. Speaker: Your Committee on Public Health, to which was
207+referred House Bill 1568, has had the same under consideration and
208+begs leave to report the same back to the House with the
209+recommendation that said bill be amended as follows:
210+Page 1, between the enacting clause and line 1, begin a new
211+paragraph and insert:
212+"SECTION 1. IC 12-15-1.3-6.5 IS ADDED TO THE INDIANA
15213 CODE AS A NEW SECTION TO READ AS FOLLOWS
16214 [EFFECTIVE UPON PASSAGE]: Sec. 6.5. Before July 1, 2023, the
17215 office shall apply to the United States Department of Health and
18216 Human Services to amend the state plan to reimburse a pharmacist
19217 for services and prescriptions provided under IC 25-26-25 to an
20218 eligible Medicaid recipient.
21219 SECTION 2. IC 16-19-4-12 IS ADDED TO THE INDIANA CODE
22220 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
23221 1, 2023]: Sec. 12. (a) Subject to IC 25-26-25, before September 1,
24222 2023, the state health commissioner or the commissioner's
25223 designated public health authority who is a licensed prescriber
26224 shall, as part of the individual's official capacity, issue a standing
27225 order that allows a pharmacist to prescribe and dispense a
28226 hormonal contraceptive patch (as defined in IC 25-26-25-2) and a
29-self-administered hormonal contraceptive (as defined in
227+self-administered oral hormonal contraceptive (as defined in
30228 IC 25-26-25-3).
31229 (b) A standing order described in subsection (a) must comply
32230 with the requirements set forth under IC 25-26-25.
33231 (c) The state health commissioner or designated public health
34232 authority who issues a standing order under subsection (a) is
35233 immune from civil liability related to the issuing of the standing
36-HEA 1568 2
37-order.
38-SECTION 3. IC 25-26-25 IS ADDED TO THE INDIANA CODE
39-AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
40-JULY 1, 2023]:
41-Chapter 25. Hormonal Contraceptives
42-Sec. 1. The definitions in IC 25-26-13-2 apply to this chapter.
43-Sec. 2. As used in this chapter, "hormonal contraceptive patch"
44-means a transdermal patch applied to the skin of a woman, by the
45-woman or by a pharmacist, that releases a drug composed of a
46-combination of hormones that is approved by the federal Food and
47-Drug Administration to prevent pregnancy. However, the term
48-does not include a drug, substance, or device that contains a
49-progesterone receptor antagonist.
50-Sec. 3. As used in this chapter, "self-administered hormonal
51-contraceptive" means a drug:
52-(1) composed of a hormone or a combination of hormones
53-that is approved by the federal Food and Drug Administration
54-to prevent pregnancy; and
55-(2) that the woman to whom the drug is prescribed may
56-administer to herself.
57-The term includes hormonal contraceptive pills. However, the term
58-does not include a drug or substance that contains a progesterone
59-receptor antagonist.
60-Sec. 4. A pharmacist may prescribe and dispense hormonal
61-contraceptive patches and self-administered hormonal
62-contraceptives to a woman who is at least eighteen (18) years of
63-age, regardless of whether the woman has evidence of a previous
64-prescription from a primary care practitioner or women's health
65-care practitioner for a hormonal contraceptive patch or
66-self-administered hormonal contraceptive.
67-Sec. 5. (a) The state health commissioner or designated public
234+order.".
235+Page 1, line 10, after "pregnancy." insert "However, the term does
236+not include a drug, substance, or device that contains a
237+progesterone receptor antagonist.".
238+Page 2, line 1, after "pills." insert "However, the term does not
239+include a drug or substance that contains a progesterone receptor
240+antagonist.".
241+Page 2, delete lines 9 through 14, begin a new paragraph and insert:
242+"Sec. 5. (a) The state health commissioner or designated public
68243 health authority shall issue a standing order that concerns
69244 standard procedures for the prescribing of hormonal contraceptive
70-patches and self-administered hormonal contraceptives by
245+patches and self-administered oral hormonal contraceptives by
71246 pharmacists and that is effective until the board adopts rules under
247+EH 1568—LS 7414/DI 77 6
72248 this chapter.
73249 (b) Before issuing a standing order under subsection (a), the
74250 state health commissioner or designated public health authority
75251 shall:
76252 (1) consult with appropriate medical experts; and
77-(2) receive approval of the medical licensing board of Indiana.
78-(c) The standing order issued under this section must require a
79-HEA 1568 3
80-pharmacist who elects to prescribe hormonal contraceptive patches
81-and self-administered hormonal contraceptives to do the following:
82-(1) Complete a training program approved by the board that
83-is related to prescribing hormonal contraceptive patches and
84-self-administered hormonal contraceptives. The board may
85-adopt a training program developed by another state.
86-(2) Provide a self-screening risk assessment tool that the
87-woman must use before the pharmacist's prescribing of the
88-hormonal contraceptive patch or self-administered hormonal
89-contraceptive.
90-(3) Refer the woman to a primary care practitioner or the
91-women's health care practitioner upon prescribing and
92-dispensing the hormonal contraceptive patch or
93-self-administered hormonal contraceptive.
94-(4) Provide the woman with a written record of the hormonal
95-contraceptive patch or the self-administered hormonal
96-contraceptive prescribed and dispensed and advise the woman
97-to consult with a primary care practitioner or women's health
98-care practitioner.
99-(5) If the pharmacist works at a site which, in the regular
253+(2) receive approval of the medical licensing board of
254+Indiana.".
255+Page 2, line 15, delete "(b) The rules adopted" and insert "(c) The
256+standing order issued".
257+Page 2, line 27, delete "the woman's" and insert "a".
258+Page 2, line 28, after "or" insert "the".
259+Page 2, between lines 35 and 36, begin a new line block indented
260+and insert:
261+"(5) If the pharmacist works at a site which, in the regular
100262 course of business, has a provider who is a physician,
101263 advanced practice registered nurse, or physician assistant
102264 who is available to deliver patient care and who is capable of
103265 prescribing the hormonal contraceptive patch or
104-self-administered hormonal contraceptive, suggest that the
105-woman see the provider.
266+self-administered oral hormonal contraceptive, suggest that
267+the woman see the provider.
106268 (6) Administer the screening protocols before issuing each
107269 prescription for a hormonal contraceptive patch or
108-self-administered hormonal contraceptive.
270+self-administered oral hormonal contraceptive.
109271 (7) Provide that a prescription for a contraceptive patch or
110-self-administered hormonal contraceptive may not be for
272+self-administered oral hormonal contraceptive may not be for
111273 more than a six (6) month period and that the pharmacist may
112274 not issue a prescription to the woman after twelve (12) months
113275 unless the woman has been seen by a physician, advanced
114276 practice registered nurse, or physician assistant in the
115277 previous twelve (12) month period.
116278 Sec. 6. The board shall adopt rules under IC 4-22-2 that adopt
117279 the state health commissioner's standing order under section 5 of
118-this chapter.
119-Sec. 7. A pharmacist may not require a woman to schedule an
120-appointment with the pharmacist for the prescribing or dispensing
121-of a hormonal contraceptive patch or self-administered hormonal
122-HEA 1568 4
123-contraceptive.
124-Sec. 8. (a) A pharmacist is not required to prescribe or dispense
125-a hormonal contraceptive patch or self-administered hormonal
126-contraceptive to a woman if the pharmacist:
127-(1) believes that the hormonal contraceptive patch or
128-self-administered hormonal contraceptive is contraindicated;
129-or
130-(2) objects on ethical, moral, or religious grounds.
131-(b) An individual who is a pharmacy technician, pharmacy
280+this chapter.".
281+Page 2, line 36, delete "(c) The rules adopted under this section
282+must prohibit a" and insert "Sec. 7. A".
283+Page 2, line 37, delete "from requiring" and insert "may not
284+require".
285+Page 2, line 41, delete "Sec. 6." and insert "Sec. 8. (a)".
286+Page 3, after line 5, begin a new paragraph and insert:
287+"(b) An individual who is a pharmacy technician, pharmacy
132288 technician in training, pharmacist student, or pharmacist intern is
133289 not required to dispense a hormonal contraceptive patch or
134-self-administered hormonal contraceptive to a woman if the
290+EH 1568—LS 7414/DI 77 7
291+self-administered oral hormonal contraceptive to a woman if the
135292 individual objects on ethical, moral, or religious grounds.
136293 Sec. 9. (a) Notwithstanding IC 25-1-9, the board shall revoke the
137294 license of a pharmacist if, after appropriate notice and an
138295 opportunity for a hearing, the attorney general proves by a
139296 preponderance of the evidence that the pharmacist knowingly or
140297 intentionally prescribed a drug under this chapter that is intended
141298 to cause an abortion.
142299 (b) A pharmacist who knowingly or intentionally prescribes a
143300 drug under this chapter that is intended to cause an abortion
144301 commits a level 5 felony.
145302 SECTION 4. IC 34-30-2.1-197.2 IS ADDED TO THE INDIANA
146303 CODE AS A NEW SECTION TO READ AS FOLLOWS
147304 [EFFECTIVE JULY 1, 2023]: Sec. 197.2. IC 16-19-4-12 (Concerning
148305 issuance of certain standing orders by the state health
149306 commissioner and designated public health authorities).
150307 SECTION 5. IC 35-52-25-46.8 IS ADDED TO THE INDIANA
151308 CODE AS A NEW SECTION TO READ AS FOLLOWS
152309 [EFFECTIVE JULY 1, 2023]: Sec. 46.8. IC 25-26-25-9 defines a
153310 crime concerning pharmacists.
154-SECTION 6. An emergency is declared for this act.
155-HEA 1568 Speaker of the House of Representatives
156-President of the Senate
157-President Pro Tempore
158-Governor of the State of Indiana
159-Date: Time:
160-HEA 1568
311+SECTION 6. An emergency is declared for this act.".
312+Renumber all SECTIONS consecutively.
313+and when so amended that said bill do pass.
314+(Reference is to HB 1568 as introduced.)
315+BARRETT
316+Committee Vote: yeas 12, nays 0.
317+_____
318+HOUSE MOTION
319+Mr. Speaker: I move that House Bill 1568 be amended to read as
320+follows:
321+ Page 1, line 16, delete "oral".
322+Page 2, line 19, delete "oral".
323+Page 2, line 24, delete "take".
324+Page 2, line 25, delete "orally to".
325+Page 2, line 30, delete "oral".
326+Page 2, line 35, delete "oral".
327+EH 1568—LS 7414/DI 77 8
328+Page 2, line 39, delete "oral".
329+Page 3, line 7, delete "oral".
330+Page 3, line 11, delete "oral".
331+Page 3, line 15, delete "oral".
332+Page 3, line 20, delete "oral".
333+Page 3, line 22, delete "oral".
334+Page 3, line 31, delete "oral".
335+Page 3, line 35, delete "oral".
336+Page 3, line 37, delete "oral".
337+Page 4, line 6, delete "oral".
338+Page 4, line 9, delete "oral".
339+Page 4, line 12, delete "oral".
340+Page 4, line 18, delete "oral".
341+(Reference is to HB 1568 as printed February 14, 2023.)
342+NEGELE
343+_____
344+COMMITTEE REPORT
345+Madam President: The Senate Committee on Health and Provider
346+Services, to which was referred House Bill No. 1568, has had the same
347+under consideration and begs leave to report the same back to the
348+Senate with the recommendation that said bill DO PASS and be
349+reassigned to the Senate Committee on Appropriations.
350+ (Reference is to HB 1568 as reprinted February 17, 2023.)
351+CHARBONNEAU, Chairperson
352+Committee Vote: Yeas 8, Nays 2
353+_____
354+COMMITTEE REPORT
355+Madam President: The Senate Committee on Appropriations, to
356+which was referred Engrossed House Bill No. 1568, has had the same
357+under consideration and begs leave to report the same back to the
358+Senate with the recommendation that said bill DO PASS.
359+ (Reference is to EHB 1568 as printed March 31, 2023.)
360+EH 1568—LS 7414/DI 77 9
361+
362+BASSLER
363+Committee Vote: Yeas 7, Nays 2
364+EH 1568—LS 7414/DI 77