2021 - 2022 LEGISLATURE
January 28, 2021 - Introduced by Senators Felzkowski, Bernier, Carpenter,
Darling, Feyen and Marklein, cosponsored by Representatives Kitchens,
Magnafici, Tusler, Armstrong, August, Born, Dittrich, Duchow, James,
Kerkman, Knodl, Krug, Kuglitsch, Kurtz, Loudenbeck, Moses, Mursau,
Neylon, Novak, Plumer, Skowronski, Snyder, Spiros, Steffen, Steineke,
Summerfield, Swearingen, Tauchen, Tranel, Vorpagel, Vos and Wittke.
Referred to Committee on Health.
1An Act to amend
450.095 (title) and 450.095 (3); and to create
49.46 (2) (bg), 2
450.01 (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 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
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:
49.46 (2) (bg) of the statutes is created to read:
(bg) The department shall ensure that any contraceptives, including 3
contraceptive drugs or drug products, or contraceptive services that are covered 4
under this subsection and for which reimbursement is made to any provider are 5
covered and reimbursed when prescribed, if a prescription is required under federal 6
law, or provided by a pharmacist acting under his or her scope of practice, including 7
under s. 450.095 (2m). The department shall certify pharmacists as providers of 8
Medical Assistance services for the purposes of covering and reimbursing under this 9
paragraph services that are provided under s. 450.095 (2m).
450.01 (16) (L) of the statutes is created to read:
(L) Prescribing and dispensing hormonal contraceptive patches 2
and self-administered oral hormonal contraceptives pursuant to s. 450.095 (2m).
450.095 (title) of the statutes is amended to read:
(title) Duty to dispense Prescribing and dispensing of
450.095 (1) (ag) and (ar) of the statutes are created to read:
(ag) “Hormonal contraceptive patch" means a transdermal patch 8
applied to the skin of a patient, by the patient or by a practitioner, that releases a 9
drug composed of a combination of hormones that is approved by the federal food and 10
drug administration to prevent pregnancy.
(ar) “Self-administered oral hormonal contraceptive" means a drug composed 12
of a combination of hormones that is approved by the federal food and drug 13
administration to prevent pregnancy and that the patient to whom the drug is 14
prescribed may take orally.
450.095 (2m) of the statutes is created to read:
(a) In accordance with rules promulgated by the board, a 17
pharmacist may prescribe and dispense hormonal contraceptive patches and 18
self-administered oral hormonal contraceptives to a person who is at least 18 years 19
(b) 1. The board shall, after consultation with the medical examining board, the 21
board of nursing, and the department of health services, promulgate rules to 22
establish standard procedures for the prescribing of hormonal contraceptive patches 23
and self-administered oral hormonal contraceptives by pharmacists under this 24
2. The rules promulgated under subd. 1. shall include a self-assessment 2
questionnaire, developed in consideration of guidelines established by the American 3
Congress of Obstetricians and Gynecologists, that must be used by a pharmacist as 4
described in subd. 3. a.
3. The rules promulgated under subd. 1. shall require a pharmacist to do all 6
of the following:
a. Provide the self-assessment questionnaire described in subd. 2. to a patient 8
prior to the pharmacist's prescribing the hormonal contraceptive patch or 9
self-administered oral hormonal contraceptive to the patient.
b. Report to the patient's primary care practitioner upon prescribing and 11
dispensing the hormonal contraceptive patch or self-administered oral hormonal 12
c. Provide the patient with a written record of the hormonal contraceptive 14
patch or self-administered oral hormonal contraceptive prescribed and dispensed.
d. Dispense the hormonal contraceptive patch or self-administered oral 16
hormonal contraceptive to the patient as soon as practicable after the pharmacist 17
issues the prescription order.
4. The rules promulgated under subd. 1. shall prohibit a pharmacist from 19
prescribing and dispensing a hormonal contraceptive patch or self-administered 20
oral hormonal contraceptive to a patient unless all of the following apply:
a. The patient has responded to the self-assessment questionnaire provided 22
under subd. 3. a. and undergone a blood pressure screening.
b. The use of the hormonal contraceptive patch or self-administered oral 24
hormonal contraceptive by the patient is not contraindicated based upon the results 25
of the questionnaire and screening.
450.095 (3) of the statutes is amended to read:
Any person who violates this section
or any rules promulgated
3under this section
may be required to forfeit not less than $250 nor more than $2,500 4
for each violation.
The pharmacy examining board may promulgate emergency rules under s. 7
227.24 necessary to implement this act. Notwithstanding s. 227.24 (1) (c) and (2), 8
emergency rules promulgated under this subsection remain in effect until May 1, 9
2023, or the date on which permanent rules take effect, whichever is sooner. 10
Notwithstanding s. 227.24 (1) (a) and (3), the examining board is not required to 11
provide evidence that promulgating a rule under this subsection as an emergency 12
rule is necessary for the preservation of the public peace, health, safety, or welfare 13
and is not required to provide a finding of emergency for a rule promulgated under 14
This act takes effect on the first day of the 10th 16
month beginning after publication, except as follows:
) of this act takes effect on the day after publication.