HB1138: HB1138 Increasing Access to Contraceptives Act; enact

26 HB 1138/AP House Bill 1138 (AS PASSED HOUSE AND SENATE) By: Representatives Camp of the 135 th, Jones of the 47 th, Ballard of the 147 th, Rice of the 139th, Reeves of the 99th, and others A BILL TO BE ENTITLED AN ACT To amend Titles 26, 33, and 49 of the Official Code of Georgia Annotated, relating to food,1 drugs, and cosmetics, insurance, and social services, respectiv ely, so as to authorize2 pharmacists in certain circumstances to dispense self-administered hormonal contraceptives3 or administer injectable hormonal contraceptives; to provide fo r a definition; to provide4 minimum amounts of certain contraceptives that shall be provided by insurers; to provide for5 certain minimums regarding Medicaid contraception coverage; to provide for compensation6 of pharmacists; to provide for a short title; to provide for an effective date and applicability;7 to provide for related matters; to repeal conflicting laws; and for other purposes.8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9 SECTION 1.10 This Act shall be known and may be cited as the "Increasing Access to Contraceptives Act."11 SECTION 2.12 Title 26 of the Official Code of Georgia Annotated, relating to food, drugs, and cosmetics,13 is amended in Chapter 4, relating to pharmacists and pharmacies , by adding a new Code14 section to read as follows:15 H. B. 1138 - 1 - 26 HB 1138/AP "26-4-53.16 (a) As used in this Code section, the term 'practitioner' mean s a physician duly licensed17 under Article 2 of Chapter 34 of Title 43, advanced practice re gistered nurse acting18 pursuant to the authority under Code Section 43-34-25, or physi cian assistant acting19 pursuant to the authority under Code Sections 43-34-23 and 43-34-105, who is a resident20 of and actively engaged in the practice of his or her profession in this state.21 (b) A person licensed under Chapter 4 of this title, the 'Georgia Pharmacy Practice Act,'22 who is acting in good faith and exercising reasonable care as a pharmacist and who is23 employed by a hospital or a pharmacy that is licensed by this s tate may dispense a24 self-administered contraceptive or administer an injectable con traceptive pursuant to a25 written joint protocol agreement issued in accordance with subs ection (d) of this Code26 section to a patient.27 (c) Nothing in this Code section shall be construed to require a pharmacist to dispense a28 self-administered contraceptive or administer an injectable contraceptive. Nothing in this29 article shall be construed to amend a pharmacist's duties to dispense or otherwise provide30 contraception prescribed by a practitioner.31 (d) The Department of Public Health and the Georgia State Board of Pharmacy shall issue32 a written joint protocol agreement to take effect on January 1, 2027, which shall authorize33 pharmacists to dispense self-administered contraceptives and ad minister injectable34 contraceptives without a patient-specific written order, and such agreement shall include35 the following:36 (1) Education or training that the Georgia State Board of Phar macy shall determine to37 be necessary for a pharmacist to dispense a self-administered contraceptive or administer38 an injectable contraceptive;39 (2) Information that a pharmacist shall provide to a patient p rior to dispensing a40 self-administered contraceptive or administering an injectable contraceptive and41 confirmation that the required information was provided to the patient;42 H. B. 1138 - 2 - 26 HB 1138/AP (3) Documentation regarding the dispensing of a self-administered contraceptive or the43 administering of an injectable contraceptive;44 (4) Evaluation and review of the dispensing and administration practices used by45 pharmacists authorized to dispense a self-administered contrace ptive or administer an46 injectable contraceptive; and47 (5) Any additional provisions that the Department of Public Health and the Georgia State48 Board of Pharmacy determine to be necessary or appropriate for inclusion in the protocol,49 including any reporting requirements.50 (e) For each new patient requesting a self-administered contra ceptive or injectable51 contraceptive and at least every 12 months for each returning p atient, the written joint52 protocol agreement provided in subsection (d) of this Code sect ion shall require a53 pharmacist dispensing or administering such contraceptives pursuant to this Code section54 to:55 (1) Obtain a completed self-screening risk assessment;56 (2) Utilize a standardized procedure as established by the Department of Public Health57 and the Georgia State Board of Pharmacy to perform a patient assessment;58 (3) Dispense, if clinically appropriate, a self-administered c ontraceptive or administer59 an injectable contraceptive, or refer the patient to a practitioner;60 (4) Provide the patient with a visit summary;61 (5) Advise the patient to consult with a practitioner;62 (6) Refer any patient who may be subject to abuse to the appro priate social services63 agency; and64 (7) Ensure that the pharmacy provides appropriate space to pre vent the spread of65 infection and ensure confidentiality.66 (f) The Department of Public Health and the Georgia State Boar d of Pharmacy may67 appoint an advisory committee of healthcare professionals licensed in this state to advise68 H. B. 1138 - 3 - 26 HB 1138/AP and assist in the development of the written joint protocol agr eement provided in69 subsection (d) of this Code section for its consideration.70 (g) Prior to dispensing self-administered contraceptives or ad ministering injectable71 contraceptives, a pharmacist shall have completed a certificate program that has been72 accredited by the American Council for Pharmacy Education or a similar health authority73 or professional body approved by the Georgia State Board of Pharmacy, as specified in the74 written joint protocol agreement provided in subsection (d) of this Code section, that is75 program-specific to self-administered contraceptives or injecta ble contraceptives, that76 includes the application of the United States Medical Eligibility Criteria for Contraceptive77 Use, and that includes federal Centers for Disease Control and Prevention guidance on78 contraception. The initial program required shall include 12 h ours of self-study, eight79 hours of live or recorded seminar, a written examination, and a hands-on assessment of80 intramuscular and subcutaneous injection technique. To maintain eligibility, a pharmacist81 shall complete at least one hour of continuing education per year that is offered by an entity82 approved by the Georgia State Board of Pharmacy. An equivalent curriculum based83 training program completed on or after January 1, 2026, in an accredited Georgia pharmacy84 school shall satisfy the initial education requirement. Verification of compliance with the85 initial education requirement and continued eligibility shall be conducted by the Georgia86 State Board of Pharmacy.87 (h) A pharmacist who dispenses a self-administered contracepti ve or administers an88 injectable contraceptive pursuant to this chapter shall:89 (1) Obtain a completed self-screening risk assessment question naire that has been90 approved by the Department of Public Health, in collaboration w ith the Georgia State91 Board of Pharmacy, from the patient before dispensing the self- administered92 contraceptive or administering the injectable contraceptive. I f the results of the93 assessment indicate that it is unsafe to dispense a self-admini stered contraceptive or94 administer an injectable contraceptive to a patient, then the pharmacist may not dispense95 H. B. 1138 - 4 - 26 HB 1138/AP a self-administered contraceptive or administer an injectable contraceptive to the patient;96 and97 (2) Provide the patient with written materials regarding:98 (A) The importance of seeing the patient's practitioner annual ly to obtain99 recommended tests and screening;100 (B) The effectiveness and availability of long-acting reversib le contraceptives as an101 alternative to self-administered contraceptives or injectable contraceptives;102 (C) A copy of the record of the encounter with the patient tha t includes the patient's103 completed assessment questionnaire;104 (D) A description of the contraceptive dispensed or administered, or the basis for not105 dispensing or administering a contraceptive;106 (E) If applicable, the Medicaid program in this state and how to apply for Medicaid107 benefits; and108 (F) The effectiveness of abstinence in preventing pregnancy and contracting a sexually109 transmitted disease.110 (i) If a pharmacist dispenses a self-administered contraceptive or administers an injectable111 contraceptive to a patient, then the pharmacist shall, at a minimum, provide counseling to112 the patient regarding:113 (1) The appropriate administration and storage of a self-administered contraceptive, if114 appropriate;115 (2) Any potential side effects and risks of a self-administered contraceptive or injectable116 contraceptive;117 (3) The need for backup contraception;118 (4) When to seek emergency medical attention; and119 (5) The risk of contracting a sexually transmitted disease, along with ways to reduce the120 risk of contraction.121 H. B. 1138 - 5 - 26 HB 1138/AP (j) A pharmacist who dispenses a self-administered contracepti ve or administers an122 injectable contraceptive in accordance with the provisions of this Code section shall not be123 subject to criminal or civil liability."124 SECTION 3.125 Title 33 of the Official Code of Georgia Annotated, relating to insurance, is amended in126 Chapter 24, relating to insurance generally, by adding a new Code section to read as follows:127 "33-24-59.37.128 (a) Every health benefit policy that is delivered, issued, executed, or renewed in this state129 or approved for issuance or renewal in this state by the Commis sioner which provides130 coverage for prescription drugs on an outpatient basis shall pr ovide coverage for any131 prescribed drug or device approved by the United States Food and Drug Administration for132 use as a contraceptive to the extent required in subsection (b) of this Code section.133 (b) Every health benefit policy that provides benefits for a prescriptive contraceptive drug134 shall provide an insured or enrollee with coverage for no less than a three-month supply135 of the covered prescription at one time the first time that the insured or enrollee obtains the136 drug and a 12 month supply of the covered prescription at one time each subsequent time137 the insured or enrollee obtains the drug.138 (c) An insured or enrollee may obtain no more than a 12 month supply of a covered139 prescription contraceptive drug during each 12 month period.140 (d) Every insurer providing a policy described in subsection ( a) of this Code section is141 prohibited from denying reimbursement to a pharmacist or the employer of a pharmacist142 who dispenses a self-administered contraceptive or administers an injectable contraceptive143 in accordance with the provisions of Code Section 26-4-53. Such reimbursement shall be144 no less the rate than that provided to physician assistants and nurse practitioners providing145 the same or substantially the same service."146 H. B. 1138 - 6 - 26 HB 1138/AP SECTION 4.147 Title 49 of the Official Code of Georgia Annotated, relating to social services, is amended148 in Chapter 4, relating to public assistance, by adding a new Code section to read as follows:149 "49-4-159.5.150 (a) The department shall provide Medicaid recipients who are w omen with no less than151 a three-month supply of covered contraceptive drugs at one time the first time that the152 recipient obtains the drug and a 12 month supply of the covered prescription at one time153 each subsequent time such recipient obtains the drug.154 (b) The department shall provide Medicaid recipients who are women with no more than155 a 12 month supply of covered contraceptive drugs during each 12 month period.156 (c) The department shall reimburse a pharmacist or the employe r of a pharmacist who157 dispenses a self-administered contraceptive or administers an injectable contraceptive in158 accordance with the provisions of Code Section 26-4-53. Such reimbursement shall be no159 less the rate than that provided to physician assistants and nurse practitioners providing the160 same or substantially the same service.161 (d) To implement the provisions of this Code section, the depa rtment shall, when162 necessary, submit a Medicaid state plan amendment or waiver request to the United States163 Department of Health and Human Services."164 SECTION 5.165 This Act shall become effective on January 1, 2027, and shall a pply to all applicable166 insurance policies issued, delivered, issued for delivery, or renewed on or after that date.167 SECTION 6.168 All laws and parts of laws in conflict with this Act are repealed.169 H. B. 1138 - 7 -