February 17, 2025 - Introduced by Representatives Kitchens, Rodriguez, Franklin, Duchow, Novak, Snyder, Zimmerman, August, Bare, Dittrich, Hong, Hysell, J. Jacobson, Krug, Miresse, Mursau, Nedweski, Neubauer, Phelps, Piwowarczyk, Sheehan, Spiros, Stroud, Subeck, Kirsch and Sinicki, cosponsored by Senators Cabral-Guevara, James and Marklein. Referred to Committee on Health, Aging and Long-Term Care.
AB43,1,6
1An Act to amend 450.095 (title) and 450.095 (3); to create 49.46 (2) (bg), 2450.01 (16) (L), 450.095 (1) (ag) and (ar) and 450.095 (2m) of the statutes; 3relating to: permitting pharmacists to prescribe certain contraceptives,
4extending the time limit for emergency rule procedures, providing an
5exemption from emergency rule procedures, granting rule-making authority,
6and 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 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.
Under the bill, the rules promulgated by the Pharmacy Examining Board establishing standard procedures for the prescribing of contraceptives by pharmacists must include certain requirements for pharmacists such as requiring that the pharmacist report to the patient’s primary health care practitioner following a prescription and requiring that the contraceptive be dispensed as soon as practicable after the pharmacist issues the prescription order. Further, the rules must prohibit a pharmacist from prescribing or dispensing a contraceptive to a patient unless the patient has responded to the self-assessment questionnaire and undergone a blood pressure screening and unless 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. A pharmacist may only prescribe a contraceptive to a person who is at least 18 years of age.
The bill requires any pharmacist who prescribes hormonal contraceptives as provided in the bill to have in effect malpractice liability insurance coverage in the amounts specified for other health care providers under current law.
Finally, the bill requires that DHS ensure any contraceptives or contraceptive services that are 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 within 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:
AB43,1
1Section 1. 49.46 (2) (bg) of the statutes is created to read: AB43,3,6249.46 (2) (bg) The department shall ensure that any contraceptives, including 3contraceptive drugs or drug products, or contraceptive services that are covered
1under this subsection and for which reimbursement is made to any provider are 2covered and reimbursed when prescribed, if a prescription is required under federal 3law, or provided by a pharmacist acting within his or her scope of practice, including 4under s. 450.095 (2m). The department shall certify pharmacists as providers of 5Medical Assistance services for the purposes of covering and reimbursing under 6this paragraph services that are provided under s. 450.095 (2m). AB43,27Section 2. 450.01 (16) (L) of the statutes is created to read: AB43,3,98450.01 (16) (L) Prescribing and dispensing hormonal contraceptive patches 9and self-administered oral hormonal contraceptives pursuant to s. 450.095 (2m). AB43,310Section 3. 450.095 (title) of the statutes is amended to read: AB43,3,1211450.095 (title) Duty to dispense Prescribing and dispensing of 12contraceptives. AB43,413Section 4. 450.095 (1) (ag) and (ar) of the statutes are created to read: AB43,3,1714450.095 (1) (ag) “Hormonal contraceptive patch” means a transdermal patch 15applied to the skin of a patient, by the patient or by a practitioner, that releases a 16drug composed of a combination of hormones that is approved by the federal food 17and drug administration to prevent pregnancy. AB43,3,2118(ar) “Self-administered oral hormonal contraceptive” means a drug composed 19of a combination of hormones that is approved by the federal food and drug 20administration to prevent pregnancy and that the patient to whom the drug is 21prescribed may take orally. AB43,522Section 5. 450.095 (2m) of the statutes is created to read: AB43,4,323450.095 (2m) (a) In accordance with rules promulgated by the board, a
1pharmacist may prescribe and dispense hormonal contraceptive patches and self-2administered oral hormonal contraceptives to a person who is at least 18 years of 3age. AB43,4,84(b) 1. The board shall, after consultation with the medical examining board, 5the board of nursing, and the department of health services, promulgate rules to 6establish standard procedures for the prescribing of hormonal contraceptive 7patches and self-administered oral hormonal contraceptives by pharmacists under 8this subsection. AB43,4,1292. a. The rules promulgated under subd. 1. shall include a self-assessment 10questionnaire, developed in consideration of guidelines established by the American 11Congress of Obstetricians and Gynecologists, that must be used by a pharmacist as 12described in subd. 3. a. AB43,4,1713b. The self-assessment questionnaire shall state and the patient shall 14acknowledge on the self-assessment questionnaire that a hormonal contraceptive 15patch or a self-administered oral hormonal contraceptive is not protection against 16sexually transmitted diseases, which may have a significant negative impact on 17reproductive and general health. AB43,4,2118c. The patient shall acknowledge on the self-assessment questionnaire that it 19is strongly recommended that the patient annually meet with a physician or other 20medical professional to discuss the patient’s prescribed hormonal contraceptive 21treatment and other routine preventive care. AB43,4,23223. The rules promulgated under subd. 1. shall require a pharmacist to do all of 23the following: AB43,5,3
1a. Provide the self-assessment questionnaire described in subd. 2. to a patient 2prior to the pharmacist’s prescribing the hormonal contraceptive patch or self-3administered oral hormonal contraceptive to the patient. AB43,5,64b. Report to the patient’s primary care practitioner upon prescribing and 5dispensing the hormonal contraceptive patch or self-administered oral hormonal 6contraceptive. AB43,5,87c. Provide the patient with a written record of the hormonal contraceptive 8patch or self-administered oral hormonal contraceptive prescribed and dispensed. AB43,5,119d. Dispense the hormonal contraceptive patch or self-administered oral 10hormonal contraceptive to the patient as soon as practicable after the pharmacist 11issues the prescription order. AB43,5,14124. The rules promulgated under subd. 1. shall prohibit a pharmacist from 13prescribing and dispensing a hormonal contraceptive patch or self-administered 14oral hormonal contraceptive to a patient unless all of the following apply: AB43,5,1615a. The patient has responded to the self-assessment questionnaire provided 16under subd. 3. a. and undergone a blood pressure screening. AB43,5,1917b. The use of the hormonal contraceptive patch or self-administered oral 18hormonal contraceptive by the patient is not contraindicated based upon the results 19of the questionnaire and screening. AB43,6,2205. The rules promulgated under subd. 1. shall permit any qualified pharmacy 21employee to provide a self-assessment questionnaire required under subd. 3. a. and 22administer a blood pressure screening required under subd. 4. a. if a pharmacist 23reviews the results of the self-assessment questionnaire and the blood pressure
1screening before prescribing and dispensing any hormonal contraceptive path or 2self-administered oral hormonal contraceptive to a patient. AB43,6,53(c) Any pharmacist who prescribes hormonal contraceptives under this 4subsection shall have in effect malpractice liability insurance coverage evidenced by 5one of the following: AB43,6,761. Personal liability coverage in the amounts specified for health care 7providers under s. 655.23 (4). AB43,6,982. Coverage under a group liability policy providing individual coverage for 9the pharmacist under s. 655.23 (4). AB43,610Section 6. 450.095 (3) of the statutes is amended to read: AB43,6,1311450.095 (3) Any person who violates this section or any rules promulgated 12under this section may be required to forfeit not less than $250 nor more than 13$2,500 for each violation. AB43,714Section 7. Nonstatutory provisions. AB43,6,2315(1) The pharmacy examining board may promulgate emergency rules under s. 16227.24 necessary to implement this act. Notwithstanding s. 227.24 (1) (c) and (2), 17emergency rules promulgated under this subsection remain in effect until May 1, 182027, or the date on which permanent rules take effect, whichever is sooner. 19Notwithstanding s. 227.24 (1) (a) and (3), the examining board is not required to 20provide evidence that promulgating a rule under this subsection as an emergency 21rule is necessary for the preservation of the public peace, health, safety, or welfare 22and is not required to provide a finding of emergency for a rule promulgated under 23this subsection. AB43,8
1Section 8. Effective dates. This act takes effect on January 1, 2026, except 2as follows: AB43,7,33(1) Section 7 (1) of this act takes effect on the day after publication.
