HB 274 — PHARMACY-BIRTH CONTROL

(1) A pharmacist may dispense a 12-month supply of hormonal contraceptives to a patient.

(2) A pharmacist shall have the patient complete the self-screening risk assessment tool.

The self-screening risk assessment tool is to be based on the most current version of the United States Medical Eligibility Criteria for Contraceptive Use published by the federal Centers for Disease Control and Prevention.

(3) Based upon the results of the self-screening risk assessment and the patient assessment, the pharmacist shall use his or her professional and clinical judgment as to when a patient should be referred to the patient's physician or another health care provider.

(4) The pharmacist shall provide, during the patient assessment and consultation, counseling and education about all methods of contraception, including methods not covered under the standing order, and their proper use and effectiveness.

(5) The patient consultation shall take place in a private manner consistent with rules adopted by the Department of Financial and Professional Regulation.

(6) The Department shall adopt rules under this Section that require a pharmacist to:

HB0274 Engrossed - 4 - LRB100 04385 SMS 14391 b (A) complete an educational training program accredited by the Accreditation Council for Pharmacy Education and approved by the Department that is related to the patient self-screening risk assessment, patient assessment, contraceptive counseling and education, and dispensation of hormonal contraceptives;

and (B) dispense the hormonal contraceptive to the patient as soon as practicable after meeting the requirements of paragraph (2).

(7) All State and federal laws governing insurance coverage of contraceptive drugs shall apply to hormonal contraceptives dispensed by a pharmacist under this Section.

Section 15.

The Counties Code is amended by changing Section 5-1069.3 as follows:

(55 ILCS 5/5-1069.3) Sec.

5-1069.3.

Required health benefits.

If a county, including a home rule county, is a self-insurer for purposes of providing health insurance coverage for its employees, the coverage shall include coverage for the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t and the coverage required under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x, HB0274 Engrossed - 5 - LRB100 04385 SMS 14391 b 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and 356z.29 of the Illinois Insurance Code.

The coverage shall comply with Sections 155.22a, 355b, 356z.19, and 370c of the Illinois Insurance Code.

The requirement that health benefits be covered as provided in this Section is an exclusive power and function of the State and is a denial and limitation under Article VII, Section 6, subsection (h) of the Illinois Constitution.

A home rule county to which this Section applies must comply with every provision of this Section.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules;

any purported rule not so adopted, for whatever reason, is unauthorized.

(Source:

P.A.

99-480, eff.

9-9-15;

100-24, eff.

7-18-17;

100-138, eff.

8-18-17;

revised 10-5-17.) Section 20.

The Illinois Municipal Code is amended by changing Section 10-4-2.3 as follows:

(65 ILCS 5/10-4-2.3) Sec.

10-4-2.3.

Required health benefits.

If a municipality, including a home rule municipality, is a self-insurer for purposes of providing health insurance HB0274 Engrossed - 6 - LRB100 04385 SMS 14391 b coverage for its employees, the coverage shall include coverage for the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t and the coverage required under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and 356z.29 of the Illinois Insurance Code.

The coverage shall comply with Sections 155.22a, 355b, 356z.19, and 370c of the Illinois Insurance Code.

The requirement that health benefits be covered as provided in this is an exclusive power and function of the State and is a denial and limitation under Article VII, Section 6, subsection (h) of the Illinois Constitution.

A home rule municipality to which this Section applies must comply with every provision of this Section.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules;

any purported rule not so adopted, for whatever reason, is unauthorized.

(Source:

P.A.

99-480, eff.

9-9-15;

100-24, eff.

7-18-17;

100-138, eff.

8-18-17;

revised 10-5-17.) Section 25.

The School Code is amended by changing Section 10-22.3f as follows:

HB0274 Engrossed - 7 - LRB100 04385 SMS 14391 b (105 ILCS 5/10-22.3f) Sec.

10-22.3f.

Required health benefits.

Insurance protection and benefits for employees shall provide the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t and the coverage required under Sections 356g, 356g.5, 356g.5-1, 356u, 356w, 356x, 356z.6, 356z.8, 356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, and 356z.25, 356z.26, and 356z.29 of the Illinois Insurance Code.

Insurance policies shall comply with Section 356z.19 of the Illinois Insurance Code.

The coverage shall comply with Sections 155.22a and 355b of the Illinois Insurance Code.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules;

any purported rule not so adopted, for whatever reason, is unauthorized.

(Source:

P.A.

100-24, eff.

7-18-17;

100-138, eff.

8-18-17;

revised 9-25-17.) Section 30.

The Illinois Insurance Code is amended by adding Section 356z.29 as follows:

(215 ILCS 5/356z.29 new) Sec.

356z.29.

Coverage for patient care services for HB0274 Engrossed - 8 - LRB100 04385 SMS 14391 b hormonal contraceptives provided by a pharmacist.

A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 100th General Assembly shall provide coverage for patient care services provided by a pharmacist for hormonal contraceptives assessment and consultation.

Section 35.

The Pharmacy Practice Act is amended by changing Section 3 as follows:

(225 ILCS 85/3) (Section scheduled to be repealed on January 1, 2020) Sec.

or (2) where prescriptions of physicians, dentists, advanced practice registered nurses, physician assistants, veterinarians, podiatric physicians, or optometrists, within the limits of their licenses, are compounded, filled, or dispensed;

or (3) which has upon it or displayed within it, or affixed to or used in connection with it, a sign bearing the word or words HB0274 Engrossed - 9 - LRB100 04385 SMS 14391 b "Pharmacist", "Druggist", "Pharmacy", "Pharmaceutical Care", "Apothecary", "Drugstore", "Medicine Store", "Prescriptions", "Drugs", "Dispensary", "Medicines", or any word or words of HB0274 - 2 - LRB100 04385 SMS 14391 b similar or like import, either in the English language or any other language;

HB0274 Engrossed - 10 - LRB100 04385 SMS 14391 b (c) "Medicines" means and includes all drugs intended for human or veterinary use approved by the United States Food and Drug Administration.

HB0274 - 3 - LRB100 04385 SMS 14391 b (d) "Practice of pharmacy" meansmeans: (1) the interpretation and the provision of assistance in the monitoring, evaluation, and implementation of prescription drug orders;

(1) the interpretation and the provision of assistance in the monitoring, evaluation, and implementation of prescription drug orders;

(A) in the context of patient education on the proper use or delivery of medications;

(B) vaccination of patients 14 years of age and older pursuant to a valid prescription or standing order, by a physician licensed to practice medicine in all its branches, upon completion of appropriate training, including how to address contraindications and adverse reactions set forth by rule, with notification to the patient's physician and appropriate record retention, or pursuant to hospital pharmacy and therapeutics committee policies and procedures;

and (C) administration of injections of alpha-hydroxyprogesterone caproate, pursuant to a valid prescription, by a physician licensed to HB0274 Engrossed - 11 - LRB100 04385 SMS 14391 b practice medicine in all its branches, upon completion of appropriate training, including how to address contraindications and adverse reactions set forth by rule, with notification to the patient's physician and appropriate record retention, or pursuant to hospital pharmacy and therapeutics committee policies and procedures;

(7) HB0274 - 4 - LRB100 04385 SMS 14391 b drug or drug-related research;

and HB0274 Engrossed - 12 - LRB100 04385 SMS 14391 b (12) the responsibility for compounding and labeling of drugs and devices (except labeling by a manufacturer, repackager, or distributor of non-prescription drugs and commercially packaged legend drugs and devices), proper and safe storage of drugs and devices, and maintenance of required records;

andand. (13) the prescribing and dispensing of hormonal contraceptive patches and self-administered oral hormonal contraceptives.

(13) the assessment and consultation of patients and dispensing of hormonal contraceptives pursuant to the standing order under Section 2310-700 of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois.

(e) "Prescription" means and includes any written, oral, facsimile, or electronically transmitted order for drugs or medical devices, issued by a physician licensed to practice medicine in all its branches, dentist, veterinarian, podiatric physician, or optometrist, within the limits of his or her license their licenses, by a physician assistant in accordance with subsection (f) of Section 4, or by an advanced practice registered nurse in accordance with subsection (g) of Section 4, containing the following:

(6) prescriber's name, address, and HB0274 Engrossed - 13 - LRB100 04385 SMS 14391 b signature;

and (7) DEA numberregistration HB0274number - 5 - LRB100 04385 SMS 14391 b where required, for controlled substances.

DEA registration numbers shall not be required on inpatient drug orders.

(f) "Person" means and includes a natural person, copartnership,partnership, association, corporation, government entity, or any other legal entity.

(k) "Inpatient drug order" means an order issued by an authorized prescriber for a resident or patient of a facility licensed under the Nursing Home Care Act, the ID/DD Community Care Act, the MC/DD Act, the Specialized Mental Health Rehabilitation Act of 2013, or the Hospital Licensing Act, or the University of Illinois Hospital Act "An Act in relation to the founding and operation of the University of Illinois Hospital HB0274 Engrossed - 14 - LRB100 04385 SMS 14391 b and the conduct of University of Illinois health care programs", approved July 3, 1931, as HB0274 - 6 - LRB100 04385 SMS 14391 b amended, or a facility which is operated by the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities) or the Department of Corrections.

(n)HB0274 "NonresidentEngrossed pharmacy"- means15 a- pharmacyLRB100 that04385 isSMS located14391 HB0274b -(n) 7"Nonresident -pharmacy" LRB100means 04385a SMSpharmacy 14391that bis located in a state, commonwealth, or territory of the United States, other than Illinois, that delivers, dispenses, or distributes, through the United States Postal Service, commercially acceptable parcel delivery service, or other common carrier, to Illinois residents, any substance which requires a prescription.

(r) "Patient counseling" means the communication between a HB0274 Engrossed - 16 - LRB100 04385 SMS 14391 b pharmacist or a student pharmacist under the supervision of a HB0274 - 8 - LRB100 04385 SMS 14391 b pharmacist and a patient or the patient's representative about the patient's medication or device for the purpose of optimizing proper use of prescription medications or devices.

(u) "Medical device" or "device" means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component part or accessory, required under federal law to bear the label "Caution:

Federal law requires dispensing by or on HB0274 Engrossed - 17 - LRB100 04385 SMS 14391 b the order of a physician".

A seller of goods and services who, only for the HB0274 - 9 - LRB100 04385 SMS 14391 b purpose of retail sales, compounds, sells, rents, or leases medical devices shall not, by reasons thereof, be required to be a licensed pharmacy.

(11) proper utilization (including over or under utilization) HB0274 Engrossed - 1018 - LRB100 04385 SMS 14391 b (11) proper utilization (including over or under utilization) and optimum therapeutic outcomes;

(z) "Electronic"Electronically transmissiontransmitted prescription" means anya prescription orderthat foris whichcreated, arecorded, facsimile or electronicstored imageby ofelectronic themeans; order is electronically transmitted from a licensed prescriber to a pharmacy.

"Electronicissued transmissionand prescription"validated includeswith bothan dataelectronic andsignature; image prescriptions.

(aa)and "Medicationtransmitted therapyby managementelectronic services" means adirectly distinctfrom servicethe orprescriber group of services offered by licensed pharmacists, physicians licensed to practice medicine in all its branches, advanced practice nurses authorized in a writtenpharmacy. agreement with a physician licensed to practice medicine in all its branches, or physician assistants authorized in guidelines by a supervising physician that optimize therapeutic outcomes for individual patients through improved medication use.

An electronic prescription is not an image of a physical prescription that is transferred by electronic means from computer to computer, facsimile to facsimile, or facsimile to computer.

(aa) "Medication therapy management services" means a distinct service or group of services offered by licensed pharmacists, physicians licensed to practice medicine in all its branches, advanced practice registered nurses authorized in a written agreement with a physician licensed to practice medicine in all its branches, or physician assistants authorized in guidelines by a supervising physician that optimize therapeutic outcomes for individual patients through improved medication use.

(3) reasonable dose, duration of use, and route of administration, taking into consideration factors such as HB0274 Engrossed - 19 - LRB100 04385 SMS 14391 b age, gender, and contraindications;

HB0274 - 11 - LRB100 04385 SMS 14391 b (7) drug-food interactions;

"Medication therapy management services" may also include patient care functions authorized by a physician licensed to HB0274 Engrossed - 20 - LRB100 04385 SMS 14391 b practice medicine in all its branches for his or her identified patient or groups of patients under specified conditions or limitations in a standing order from the physician.

"Medication therapy management services" in a licensed HB0274 - 12 - LRB100 04385 SMS 14391 b hospital may also include the following:

HB0274 Engrossed - 21 - LRB100 04385 SMS 14391 b (1) education records covered by the federal Family Educational Right and Privacy Act;

HB0274 - 13 - LRB100 04385 SMS 14391 b (dd) "Standing order" means a specific order for a patient or group of patients issued by a physician licensed to practice medicine in all its branches in Illinois.

(ee) "Address of record" means the designated address recorded by the Department in the applicant's or licensee's application file or licensee's license file,file as maintained by the Department's licensure maintenance unit.

(gg) "Email address of record" means the designated email address recorded by the Department in the applicant's application file or the licensee's license file, as maintained by the Department's licensure maintenance unit.

98-104, eff.

7-22-13;

98-214, eff.

8-9-13;

98-756, eff.

7-16-14;

7-29-15.)7-29-15; (225 ILCS 85/19.7 new) Sec.

19.7.100-208, eff.

Contraceptive1-1-18; drugs and products.

(a)100-497, Aseff. used in this Section:

"Hormonal9-8-17; 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 United States Food and Drug Administration to prevent pregnancy.

"Self-administered100-513, oraleff. hormonal contraceptives" means a drug composed of a combination of hormones that is approved by the United States Food and Drug Administration to prevent pregnancy and that the patient to whom the drug is prescribed may take orally.

(b)1-1-18; A pharmacist may prescribe and dispense hormonal HB0274 - 14 - LRB100 04385 SMS 14391 b contraceptive patches and self-administered oral hormonal contraceptives to a person who is:

(1)revised at9-29-17.) leastSection 1840. years of age, regardless of whether the person has evidence of a previous prescription from a primary care practitioner or a women's health care practitioner for a hormonal contraceptive patch or self-administered oral hormonal contraceptive;

orThe (2)Illinois underPublic 18Aid yearsCode ofis ageamended onlyby ifadding theSection person5-5.12b hasas evidencefollows: of a previous prescription from a primary care practitioner or a women's health care practitioner for a hormonal contraceptive patch or self-administered oral hormonal contraceptive.

(c)(305 TheILCS Department5/5-5.12b shallnew) adoptSec. rules to establish, in consideration of guidelines established by the American Congress of Obstetricians and Gynecologists, standard procedures for the prescribing of hormonal contraceptive patches and self-administered oral hormonal contraceptives by pharmacists.

(d)5-5.12b. The rules adopted under this Section must require a pharmacist to:

(1)Coverage completefor apatient trainingcare programservices approvedfor by the Department that is related to prescribing hormonal contraceptivecontraceptives patchesprovided andby self-administereda oralpharmacist. hormonal contraceptives;

(2)HB0274 provideEngrossed a- self-screening22 risk- assessmentLRB100 tool04385 thatSMS the14391 patientb must(a) useSubject prior to approval by the pharmacist'sfederal prescribingCenters HB0274for -Medicare 15and -Medicaid LRB100Services, 04385the SMSmedical 14391assistance bprogram, including both the hormonalfee-for-service contraceptiveand patchmanaged orcare self-administeredmedical oralassistance programs established under this Article, shall cover patient care services provided by a pharmacist for hormonal contraceptive;contraceptives assessment and consultation.

(3)(b) referThe theDepartment patientshall toestablish thea patient'sfee primaryschedule carefor practitionerpatient or women's health care practitionerservices uponprovided prescribingby anda dispensingpharmacist thefor hormonal contraceptivecontraceptives patchassessment orand self-administeredconsultation. oral hormonal contraceptive;

(4)(c) provideThe therate patientof withreimbursement afor writtenpatient recordcare ofservices theprovided hormonalby contraceptivea patchpharmacist orfor self-administered oral hormonal contraceptivecontraceptives prescribedassessment and dispensedconsultation andshall advisebe theat patient85% toof consultthe withfee aschedule primaryfor carephysician practitionerservices orby women'sthe healthmedical careassistance practitioner;program.

and(d) (5)A dispensepharmacist must be enrolled in the hormonalmedical contraceptiveassistance patchprogram oras self-administeredan oralordering hormonaland contraceptivereferring provider prior to theproviding patienthormonal ascontraceptives soonassessment asand practicableconsultation afterthat theis submitted by a pharmacy or pharmacist issuesprovider thefor prescription.reimbursement pursuant to this Section.

(e) The rulesDirector adoptedshall underseek thisany Sectionnecessary mustfederal prohibitwaivers aor pharmacistapprovals from:to implement this Section.

(1)This requiringSection ashall patientnot tobe scheduleimplemented anuntil appointmentthe withreceipt theof pharmacistall fornecessary thefederal prescribingwaivers or dispensingapprovals ofor auntil hormonalJanuary contraceptive1, patch2021, orwhichever self-administeredcomes oralfirst. hormonal contraceptive;

andIf (2)federal prescribingapproval andis dispensing a hormonal contraceptive patch or self-administered oral hormonal contraceptive to a patient who does not haveobtained evidenceby ofJanuary a1, clinical2021, visit for women's health within the 3provisions years immediately following the initial prescription and HB0274 - 16 - LRB100 04385 SMS 14391 b dispensation of athis hormonalSection contraceptiveshall patchbe orimplemented self-administeredusing oralState hormonalfunds. contraceptive by a pharmacist to the patient.

(f) AllThis StateSection anddoes federalnot lawsrestrict governingor insuranceprohibit coverageany ofservices contraceptiveHB0274 drugs,Engrossed devices,- products,23 and- servicesLRB100 shall04385 applySMS to14391 hormonalb contraceptivecurrently patchesprovided andby self-administeredpharmacists oralas hormonalauthorized contraceptivesby prescribedlaw, byincluding, abut not limited to, pharmacist services provided under this Section.Code or authorized under the Illinois Title XIX State Plan.

(g) The Department shall adopt administrative rules for this Section as soon as practicable but no later than May 1, 2019.

Section 99.

Effective date.

This Act takes effect January 1, 2019.