CHAPTER 205
HB 1822-FN - FINAL VERSION
22Mar2018... 1118h
10May2018... 1947-EBA
2018 SESSION
18-3030
01/04
HOUSE BILL 1822-FN
AN ACT making hormonal contraceptives available directly from pharmacists by means of a standing order.
SPONSORS: Rep. M. MacKay, Hills. 30; Rep. Knirk, Carr. 3; Rep. P. Schmidt, Straf. 19; Rep. J. MacKay, Merr. 14; Rep. Hinch, Hills. 21; Rep. LeBrun, Hills. 32; Rep. L. Ober, Hills. 37; Rep. W. Marsh, Carr. 8; Sen. Soucy, Dist 18; Sen. Reagan, Dist 17
COMMITTEE: Health, Human Services and Elderly Affairs
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ANALYSIS
This bill allows pharmacists to dispense hormonal contraceptives pursuant to a standing order entered into by health care providers.
This bill is the result of the commission established pursuant to 2017, 23.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
22Mar2018... 1118h
10May2018... 1947-EBA 18-3030
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eighteen
AN ACT making hormonal contraceptives available directly from pharmacists by means of a standing order.
Be it Enacted by the Senate and House of Representatives in General Court convened:
205:1 Pharmacies; Definitions. Amend RSA 318:1, VI-f to read as follows:
VI-f. "Hormonal contraceptives” means pills, patches, and rings which the United States Food and Drug Administration (FDA) classifies as available by prescription for the purpose of contraception or emergency contraception. It does not include similar items classified as “over the counter” by the FDA, intrauterine devices, shots, or intradermal implants.
VI-g. "Law enforcement officer'' means any officer of the state or political subdivision of the state who is empowered by law to conduct investigations of or to make arrests for offenses enumerated in this chapter.
205:2 New Section; Hormonal Contraceptives; Dispensing. Amend RSA 318 by inserting after section 47-k the following new section:
318:47-l Hormonal Contraceptives; Dispensing.
I. In this section, "standing order" means a written and signed protocol authored by one or more physicians licensed under RSA 329:12 or one or more advanced practice registered nurses licensed under RSA 326-B:18. Such agreement shall specify a protocol allowing the pharmacist licensed under RSA 318:18 to dispense hormonal contraceptives under the delegated prescriptive authority of the physician or APRN, specify a mechanism to document screening performed and the prescription in the patient's medical record, and include a plan for evaluating and treating adverse events. Any such prescription shall be regarded as being issued for a legitimate medical purpose in the usual course of professional practice.
II. Licensed pharmacists following standing orders may dispense hormonal contraceptives to persons in this state without a prior prescription.
III. A pharmacist, pharmacy, physician, or APRN issuing or following standing orders shall be prohibited from seeking personal financial benefit by participating in any incentive-based program or accepting any inducement that influences or encourages therapeutic or product changes or the ordering of tests or services.
IV. Prior to dispensing hormonal contraceptives under this section, a pharmacist shall complete an Accreditation Council for Pharmacy Education (ACPE) accredited educational training program related to hormonal contraceptives. In addition, pharmacists shall comply with the most current United States Medical Eligibility Criteria (USMEC) for Contraceptive Use as adopted by the Centers for Disease Control and Prevention.
V. The pharmacist shall provide each recipient of hormonal contraceptives pursuant to this section with a standardized information sheet written in plain language, which shall include, but is not limited to, the indication for the use of the hormonal contraceptive, the importance of follow-up care, and health care referral information.
VI. The board shall adopt rules, pursuant to RSA 541-A, relative to:
(a) Education and training required under paragraph IV.
(b) Content and format of the information sheet required under paragraph V, in consultation with the commissioner of the department of health and human services.
(c) A model statewide protocol, with the consent of the board of medicine, the board of nursing, and the department of health and human services to be used for the purposes of paragraph I.
(d) Other matters necessary to the proper administration of this section.
VII. The board of medicine shall not deny, revoke, suspend, or otherwise take disciplinary action against a physician based on a pharmacist's failure to follow standing orders provided the provisions of this section and the rules adopted under this section are satisfied. The board of nursing shall not deny, revoke, suspend, or otherwise take disciplinary action against an APRN based on a pharmacist's failure to follow standing orders provided the provisions of this section and the rules adopted under this section are satisfied. The board of pharmacy shall not deny, revoke, suspend, or otherwise take disciplinary action against a pharmacist who follows standing orders based on a defect in those standing orders provided the provisions of this section and the rules adopted under this section are satisfied.
205:3 New Paragraph; Pharmacists; Rulemaking. Amend RSA 318:5-a by inserting after paragraph XVIII the following new paragraph:
XIX. Dispensing hormonal contraceptives in accordance with RSA 318:47-l.
205:4 Insurance; Group; Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. Amend RSA 415:18-i to read as follows:
415:18-i Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. Each insurer that issues or renews any group policy of accident or health insurance providing benefits for medical or hospital expenses, which provides coverage for outpatient services shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "Outpatient contraceptive services'' means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which has been approved by the U.S. Food and Drug Administration. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover all prescription contraceptive drugs and prescription contraceptive devices approved by the U.S. Food and Drug Administration under the same terms and conditions as other prescription drugs. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services.
205:5 Insurance; Health Service Corporations; Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. Amend RSA 420-A:17-c to read as follows:
420-A:17-c Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, which provides coverage for outpatient services shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "Outpatient contraceptive services'' means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which has been approved by the U.S. Food and Drug Administration. Each health service corporation and every other similar corporation licensed under the laws of a different state that issues or renews any group policy of accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover all prescription contraceptive drugs and prescription contraceptive devices approved by the U.S. Food and Drug Administration under the same terms and conditions as other prescription drugs. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services.
205:6 Insurance; Health Maintenance Organizations; Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. Amend RSA 420-B:8-gg to read as follows:
420-B:8-gg Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. Every health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any policy of group health insurance providing benefits for medical or hospital expenses, which provides coverage for outpatient services shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "Outpatient contraceptive services'' means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which has been approved by the U.S. Food and Drug Administration. Each health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any group health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover all prescription contraceptive drugs and prescription contraceptive devices approved by the U.S. Food and Drug Administration under the same terms and conditions as other prescription drugs. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services.
205:7 New Section; Insurance; Individual; Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. Amend RSA 415 by inserting after section 6-v the following new section:
415:6-w Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, which provides coverage for outpatient services shall provide to persons covered by such insurance who are residents of this state coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "Outpatient contraceptive services'' means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which has been approved by the U.S. Food and Drug Administration. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover all prescription contraceptive drugs and prescription contraceptive devices approved by the U.S. Food and Drug Administration under the same terms and conditions as other prescription drugs. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services.
I. Sections 4-7 of this act shall take effect January 1, 2019.
II. The remainder of this act shall take effect 60 days after its passage.
Approved: June 08, 2018
Effective Date:
I. Sections 4-7 shall take effect January 1, 2019.
II. Remainder shall take effect August 7, 2018.
| Date | Body | Type |
|---|---|---|
| Jan. 11, 2018 | House | Hearing |
| Jan. 25, 2018 | House | Exec Session |
| House | Floor Vote | |
| Feb. 7, 2018 | House | Floor Vote |
| March 6, 2018 | House | Hearing |
| March 13, 2018 | House | Hearing |
| March 14, 2018 | House | Hearing |
| March 15, 2018 | House | Exec Session |
| March 21, 2018 | House | Floor Vote |
| April 4, 2018 | Senate | Hearing |
| April 3, 2018 | Senate | Hearing |
| April 12, 2018 | Senate | Floor Vote |
| April 12, 2018 | Senate | Floor Vote |
| April 19, 2018 | Senate | Floor Vote |
| April 19, 2018 | Senate | Floor Vote |
| May 3, 2018 | Senate | Floor Vote |
| April 26, 2018 | Senate | Floor Vote |
| May 2, 2018 | Senate | Floor Vote |
| May 2, 2018 | Senate | Floor Vote |
| May 3, 2018 | Senate | Floor Vote |
June 8, 2018: Signed by Governor Sununu 06/08/2018; Chapter 205; I. Sections 4-7 eff. 1/1/2019; II. Rem. eff. 8/7/2018
May 10, 2018: Enrolled 05/10/2018
May 10, 2018: Enrolled (In recess 05/10/2018); SJ 18
May 10, 2018: Enrolled Bill Amendment # 2018-1947e: AA VV 05/10/2018
May 10, 2018: Enrolled Bill Amendment # 2018-1947e Adopted, VV, (In recess of 05/10/2018); SJ 18
May 3, 2018: Ought to Pass: MA, VV; OT3rdg; 05/03/2018; SJ 16
May 3, 2018: Committee Report: Ought to Pass, 05/03/2018;
May 3, 2018: Special Order to 05/03/2018, Without Objection, MA; 05/02/2018 SJ 15
May 2, 2018: Committee Report: Ought to Pass, 05/02/2018; SC 19
May 2, 2018: Special Order to 05/02/2018, Without Objection, MA; 04/26/2018 SJ 14
May 3, 2018: Committee Report: Ought to Pass, 05/03/2018; SC 19
May 3, 2018: Special Order to 05/03/2018, Without Objection, MA; 04/19/2018 SJ 13
April 19, 2018: Committee Report: Ought to Pass, 04/19/2018; SC 17
April 12, 2018: Special Order to the next session, Without Objection, MA; 04/12/2018; SJ 12
April 12, 2018: Committee Report: Ought to Pass, 04/12/2018; SC 16
April 4, 2018: Hearing: 04/04/2018, Room 101, LOB, 02:00 pm; SC 15
April 3, 2018: Hearing: 04/03/2018, Room 101, LOB, 02:00 pm; SC 15
March 22, 2018: Introduced 03/22/2018 and Referred to Health and Human Services; SJ 11
March 22, 2018: Ought to Pass with Amendment 1118h: MA VV 03/22/2018 HJ 10 P. 21
March 22, 2018: Amendment # 2018-1118h: AA VV 03/22/2018 HJ 10 P. 21
: Minority Committee Report: Inexpedient to Legislate
March 21, 2018: Majority Committee Report: Ought to Pass with Amendment # 2018-1118h for 03/21/2018 (Vote 10-6; RC) HC 11 P. 18
: Majority Committee Report: Ought to Pass with Amendment # 2018-1118h (Vote 10-6; RC)
March 15, 2018: Executive Session: 03/15/2018 12:00 PM LOB 302
March 14, 2018: Subcommittee Work Session: 03/14/2018 01:30 PM LOB 302
March 14, 2018: Public Hearing: 03/14/2018 11:00 AM LOB 302
March 13, 2018: ==CANCELLED== Subcommittee Work Session: 03/13/2018 01:30 PM LOB 302
March 13, 2018: ==CANCELLED== Public Hearing: 03/13/2018 11:00 AM LOB 302
March 6, 2018: ==CANCELLED== Subcommittee Work Session: 03/06/2018 01:30 PM LOB 302
March 6, 2018: ==CANCELLED== Public Hearing: 03/06/2018 11:00 AM LOB 302
Feb. 8, 2018: Referred to Commerce and Consumer Affairs 02/08/2018 HJ 3 P. 50
Feb. 8, 2018: Ought to Pass: MA VV 02/08/2018 HJ 3 P. 50
Feb. 8, 2018: Inexpedient to Legislate: MF RC 76-265 02/08/2018 HJ 3 P. 48
: Minority Committee Report: Ought to Pass
: Majority Committee Report: Inexpedient to Legislate (Vote 13-8; RC)
Feb. 7, 2018: Majority Committee Report: Inexpedient to Legislate for 02/07/2018 (Vote 13-8; RC) HC 5 P. 24
Jan. 25, 2018: Executive Session: 01/25/2018 LOB 205
Jan. 25, 2018: Full Committee Work Session: 01/25/2018 09:00 AM LOB 205
Jan. 11, 2018: Public Hearing: 01/11/2018 11:00 AM LOB 205
Jan. 3, 2018: Introduced 01/03/2018 and referred to Health, Human Services and Elderly Affairs HJ 1 P. 25