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2023 - 2024 LEGISLATURE
2023 ASSEMBLY BILL 176
April 14, 2023 - Introduced by Representatives KITCHENS, MAGNAFICI, DUCHOW,
TUSLER, BINSFELD, SAPIK, RODRIGUEZ, AUGUST, BORN, CALLAHAN, DALLMAN,
DITTRICH, GREEN, HURD, S. JOHNSON, KNODL, KRUG, KURTZ, MACCO, MAXEY,
MICHALSKI, MURSAU, NEDWESKI, NOVAK, OLDENBURG, PLUMER, ROZAR, SNYDER,
SPIROS, STEFFEN, SUBECK, SUMMERFIELD, SWEARINGEN, VOS, WITTKE, SINICKI
and CLANCY, cosponsored by Senators FELZKOWSKI, CABRAL-GUEVARA, JAMES
and MARKLEIN. Referred to Committee on Health, Aging and Long-Term Care.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to amend 450.095 (title) and 450.095 (3); and to create 49.46 (2) (bg),
450.01 (16) (L), 450.095 (1) (ag) and (ar) and 450.095 (2m) of the statutes;
relating to: permitting pharmacists to prescribe certain contraceptives,
extending the time limit for emergency rule procedures, providing an
exemption from emergency rule procedures, granting rule-making authority,
and providing a penalty.
Analysis by the Legislative Reference Bureau
This bill permits a pharmacist to prescribe and dispense hormonal
contraceptive patches and self-administered oral hormonal contraceptives, subject
to limitations described as follows.
The bill requires the Pharmacy Examining Board, after consultation with the
Medical Examining Board, the Board of Nursing, and the Department of Health
Services, to promulgate rules to establish standard procedures for the prescribing of
contraceptives by pharmacists under the bill. The rules must require that
pharmacists use a self-assessment questionnaire, developed in consideration of
guidelines established by the American Congress of Obstetricians and
Gynecologists, when prescribing a contraceptive. The self-assessment
questionnaire must state and the patient must acknowledge on the self-assessment
questionnaire that a hormonal contraceptive patch or a self-administered oral
hormonal contraceptive is not protection against sexually transmitted diseases, and
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that it is strongly recommended that the patient annually meet with a physician or
other medical professional to discuss the patient's prescribed hormonal
contraceptive treatment and other routine preventive care.
Further, under the bill, the rules must include certain requirements for
pharmacists prescribing contraceptives, such as 1) requiring a report to the patient's
primary health care practitioner following a prescription; and 2) requiring the
contraceptive to be dispensed as soon as practicable after the pharmacist issues the
prescription order. In addition, the rules must prohibit a pharmacist from
prescribing or dispensing a contraceptive to a patient unless 1) the patient has
responded to the self-assessment questionnaire and undergone a blood pressure
screening; and 2) the use of the contraceptive is not contraindicated based upon the
results of the questionnaire and screening. A pharmacist who prescribes
contraceptives as permitted under the bill must comply with those rules, as well as
any other rules promulgated by the Pharmacy Examining Board. Finally, under the
bill, a pharmacist may prescribe a contraceptive only to a person who is at least 18
years of age.
The bill further requires that DHS must ensure any contraceptives or
contraceptive services covered under the Medical Assistance program are covered
and reimbursed when prescribed, if a prescription is required under federal law, or
provided by a pharmacist acting under the scope of his or her practice. The Medical
Assistance program is a joint federal and state program that provides health services
to individuals who have limited financial resources. The bill also requires DHS to
certify pharmacists as providers of Medical Assistance services for the purposes of
covering and reimbursing prescribed hormonal contraceptive patches and
self-administered oral hormonal contraceptives.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SECTION 1. 49.46 (2) (bg) of the statutes is created to read:
49.46 (2) (bg) The department shall ensure that any contraceptives, including
contraceptive drugs or drug products, or contraceptive services that are covered
under this subsection and for which reimbursement is made to any provider are
covered and reimbursed when prescribed, if a prescription is required under federal
law, or provided by a pharmacist acting under his or her scope of practice, including
under s. 450.095 (2m). The department shall certify pharmacists as providers of
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Medical Assistance services for the purposes of covering and reimbursing under this
paragraph services that are provided under s. 450.095 (2m).
SECTION 2. 450.01 (16) (L) of the statutes is created to read:
450.01 (16) (L) Prescribing and dispensing hormonal contraceptive patches
and self-administered oral hormonal contraceptives pursuant to s. 450.095 (2m).
SECTION 3. 450.095 (title) of the statutes is amended to read:
450.095 (title) Duty to dispense Prescribing and dispensing of
contraceptives.
SECTION 4. 450.095 (1) (ag) and (ar) of the statutes are created to read:
450.095 (1) (ag) “Hormonal contraceptive patch" means a transdermal patch
applied to the skin of a patient, by the patient or by a practitioner, that releases a
drug composed of a combination of hormones that is approved by the federal food and
drug administration to prevent pregnancy.
(ar) “Self-administered oral hormonal contraceptive" means a drug composed
of a combination of hormones that is approved by the federal food and drug
administration to prevent pregnancy and that the patient to whom the drug is
prescribed may take orally.
SECTION 5. 450.095 (2m) of the statutes is created to read:
450.095 (2m) (a) In accordance with rules promulgated by the board, a
pharmacist may prescribe and dispense hormonal contraceptive patches and
self-administered oral hormonal contraceptives to a person who is at least 18 years
of age.
(b) 1. The board shall, after consultation with the medical examining board, the
board of nursing, and the department of health services, promulgate rules to
establish standard procedures for the prescribing of hormonal contraceptive patches
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and self-administered oral hormonal contraceptives by pharmacists under this
subsection.
2. a. The rules promulgated under subd. 1. shall include a self-assessment
questionnaire, developed in consideration of guidelines established by the American
Congress of Obstetricians and Gynecologists, that must be used by a pharmacist as
described in subd. 3. a.
b. The self-assessment questionnaire shall state and the patient shall
acknowledge on the self-assessment questionnaire that a hormonal contraceptive
patch or a self-administered oral hormonal contraceptive is not protection against
sexually transmitted diseases, which may have a significant negative impact on
reproductive and general health.
c. The patient shall acknowledge on the self-assessment questionnaire that it
is strongly recommended that the patient annually meet with a physician or other
medical professional to discuss the patient's prescribed hormonal contraceptive
treatment and other routine preventive care.
3. The rules promulgated under subd. 1. shall require a pharmacist to do all
of the following:
a. Provide the self-assessment questionnaire described in subd. 2. to a patient
prior to the pharmacist's prescribing the hormonal contraceptive patch or
self-administered oral hormonal contraceptive to the patient.
b. Report to the patient's primary care practitioner upon prescribing and
dispensing the hormonal contraceptive patch or self-administered oral hormonal
contraceptive.
c. Provide the patient with a written record of the hormonal contraceptive
patch or self-administered oral hormonal contraceptive prescribed and dispensed.
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d. Dispense the hormonal contraceptive patch or self-administered oral
hormonal contraceptive to the patient as soon as practicable after the pharmacist
issues the prescription order.
4. The rules promulgated under subd. 1. shall prohibit a pharmacist from
prescribing and dispensing a hormonal contraceptive patch or self-administered
oral hormonal contraceptive to a patient unless all of the following apply:
a. The patient has responded to the self-assessment questionnaire provided
under subd. 3. a. and undergone a blood pressure screening.
b. The use of the hormonal contraceptive patch or self-administered oral
hormonal contraceptive by the patient is not contraindicated based upon the results
of the questionnaire and screening.
5. The rules promulgated under subd. 1. shall permit any qualified pharmacy
employee to provide a self-assessment questionnaire required under subd. 3. a. and
administer a blood pressure screening required under subd. 4. a. if a pharmacist
reviews the results of the self-assessment questionnaire and the blood pressure
screening before prescribing and dispensing any hormonal contraceptive path or
self-administered oral hormonal contraceptive to a patient.
SECTION 6. 450.095 (3) of the statutes is amended to read:
450.095 (3) Any person who violates this section or any rules promulgated
under this section may be required to forfeit not less than $250 nor more than $2,500
for each violation.
SECTION 7.0Nonstatutory provisions.
(1) The pharmacy examining board may promulgate emergency rules under s.
227.24 necessary to implement this act. Notwithstanding s. 227.24 (1) (c) and (2),
emergency rules promulgated under this subsection remain in effect until May 1,
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2025, or the date on which permanent rules take effect, whichever is sooner.
Notwithstanding s. 227.24 (1) (a) and (3), the examining board is not required to
provide evidence that promulgating a rule under this subsection as an emergency
rule is necessary for the preservation of the public peace, health, safety, or welfare
and is not required to provide a finding of emergency for a rule promulgated under
this subsection.
SECTION 8.0Effective dates. This act takes effect on January 1, 2024, except
as follows:
(1) SECTION 7 (1) of this act takes effect on the day after publication.
(END)
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