AB 36 — 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. (FE)

- 2022 LEGISLATURE LRBa0948/1LRB-0840/1 JPC:cjs&amnJPC:kjf ASSEMBLY AMENDMENT 2, TO ASSEMBLY BILL 36 OctoberFebruary 27,10, 2021 - OfferedIntroduced by RepresentativeITCHENS.RepresentativesITCHENS, MAGNAFICI, USLER , A RMSTRONG, A UGUST, BORN, D ITTRIC, D UCHOW, JAMES , KERKMAN , KNODL , K RUG, KUGLITSCH, K URTZ, LOUDENBECK , MOSES, M URSAU, N EYLON, NOVAK , PLUMER , SKOWRONSKI , SNYDER , SPIRO, STEFFEN , STEINEKE, SUMMERFIELD , SWEARINGEN , TAUCHEN , RANEL , ORPAGEL , OS and W ITTKE, cosponsored by Senators FELZKOWSKI , ERNIER , ARPENTER , DARLING, EYEN and M ARKLEIN .

AtReferred theto locationsCommittee indicated,on amendHealth. the bill as follows:

A N A CT 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 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 when prescribing a contraceptive.

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 - 2022 Legislature - 2 - LRB-0840/1 JPC:kjf ASSEMBLY BILL 36 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 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:

LRB-0840/1 - 2022 Legislature - 3 - JPC:kjf SECTION 2 ASSEMBLY BILL 36 450.01 (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.