State Reproductive Health Access Policies
State by State Policy Distribution
State By State Policies
Hover over a state to read highlights of the legislation. Click on the state to expand legislation details.
Alaska
Alaska: Pending: Pending
Print DataProtecting Contraceptive Coverage
Legislation introduced in Jan 2023 passed the legislature in May 2024 and was later vetoed by the Governor on September 3, 2024.
Legislation introduced in Jan 2023 passed the legislature in May 2024 and was later vetoed by the Governor on September 3, 2024.
Alaska: Pending: Pending
Arizona
Arizona
Print DataPharmacist Prescribing of Contraception
Pill, patch, ring
- Age restriction (18 years and older)
Pill, patch, ring
- Age restriction (18 years and older)
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Arizona
Arkansas
Arkansas
Print DataPharmacist Prescribing of Contraception
Limited grant funds are available to cover consultation costs, as it may take time for third party payers to adopt payment mechanisms.
Oral contraceptives
(-) Cannot prescribe more than a 6-month supply to those without evidence of a primary care visit within the previous 6 months
(-) Age restriction (18 and older)
Limited grant funds are available to cover consultation costs, as it may take time for third party payers to adopt payment mechanisms.
Oral contraceptives
(-) Cannot prescribe more than a 6-month supply to those without evidence of a primary care visit within the previous 6 months
(-) Age restriction (18 and older)
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Arkansas
California
California
Print DataExtended Supply of Contraceptives#
2016
January 1, 2017
n/a
Yes: MediCal Managed Care Plans
(+) Provides authority to providers and pharmacists.
(+) The state Medicaid Family Planning Expansion, Family PACT, has allowed an extended supply of oral contraceptives for over 25 years, when dispensed at a clinic.4
(+) The state began requiring Medi-Cal managed care plans to do the same on May 1, 2016 and has since updated the requirements.5
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.
(+) Part of a more expansive law on contraceptive access
2016
January 1, 2017
n/a
Yes: MediCal Managed Care Plans
(+) Provides authority to providers and pharmacists.
(+) The state Medicaid Family Planning Expansion, Family PACT, has allowed an extended supply of oral contraceptives for over 25 years, when dispensed at a clinic.4
(+) The state began requiring Medi-Cal managed care plans to do the same on May 1, 2016 and has since updated the requirements.5
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.
(+) Part of a more expansive law on contraceptive access
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2014
January 1, 2016
No
(+) Also applies to Medi-Cal managed care plans
(+) Coverage of all FDA-approved contraceptive drugs, devices, and products for women, as prescribed, with exceptions allowed for Rx methods that have therapeutic equivalents.
SB 523 (Extended protections passed in 2014 as part of SB 1053 to Medicaid Managed Care)
2022
January 1, 2024
Yes
(+) Covers OTC contraceptive drugs, devices, and products w/o a Rx; Point-of-sale coverage for OTC contraceptive drugs, devices, and products provided at in-network pharmacies without cost sharing or medical management restrictions.
2014
January 1, 2016
No
(+) Also applies to Medi-Cal managed care plans
(+) Coverage of all FDA-approved contraceptive drugs, devices, and products for women, as prescribed, with exceptions allowed for Rx methods that have therapeutic equivalents.
SB 523 (Extended protections passed in 2014 as part of SB 1053 to Medicaid Managed Care)
2022
January 1, 2024
Yes
(+) Covers OTC contraceptive drugs, devices, and products w/o a Rx; Point-of-sale coverage for OTC contraceptive drugs, devices, and products provided at in-network pharmacies without cost sharing or medical management restrictions.
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
2013, January 2014
Medicaid only
Statewide Protocol
pill, patch, ring, injection
(+) Self-screening tool available in multiple languages1
(+) Requires referral to a health care provider if these services are not available, if self-administered hormonal contraception is not recommended for patient, and after furnishing contraceptives to a patient
2013, January 2014
Medicaid only
Statewide Protocol
pill, patch, ring, injection
(+) Self-screening tool available in multiple languages1
(+) Requires referral to a health care provider if these services are not available, if self-administered hormonal contraception is not recommended for patient, and after furnishing contraceptives to a patient
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
California
Colorado
Colorado
Print DataExtended Supply of Contraceptives#
2019
July 1, 2019
3 months
Yes
(+) SB 19-113 provides $1.8 million in funds to cover dispensing of a 12- month supply of contraceptives at one time for Medicaid beneficiaries. Prior to this the state allowed a 6-month supply of oral contraceptives for Medicaid beneficiaries.7
2017
January 1, 2019
3 months
No
(+) HB 17-1186 Applies to CHIP
(-) The maximum amount of cycles that can be dispensed at once for the contraceptive ring is 3 months.
2019
July 1, 2019
3 months
Yes
(+) SB 19-113 provides $1.8 million in funds to cover dispensing of a 12- month supply of contraceptives at one time for Medicaid beneficiaries. Prior to this the state allowed a 6-month supply of oral contraceptives for Medicaid beneficiaries.7
2017
January 1, 2019
3 months
No
(+) HB 17-1186 Applies to CHIP
(-) The maximum amount of cycles that can be dispensed at once for the contraceptive ring is 3 months.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Pharmacist Prescribing of Contraception
2016
March 2017
Yes, some3
pill, patch, ring, shot
(-) Age restriction (18 and older)
(-) Cannot continue to prescribe to patient beyond three years from initial Rx, if no evidence of a clinical visit
2016
March 2017
Yes, some3
pill, patch, ring, shot
(-) Age restriction (18 and older)
(-) Cannot continue to prescribe to patient beyond three years from initial Rx, if no evidence of a clinical visit
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Colorado
Connecticut
Connecticut
Print DataExtended Supply of Contraceptives#
2018
January 1, 2019
N/A
No
N/A
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2018
January 1, 2019
No5
(+) Covers OTC contraceptive drugs 5
(+) Covers 12-month contraceptive supply 1
(+) Covers all FDA-approved drugs, devices, and products (excluding OTC drugs and devices) for women, but permits step therapy for Rx methods that have therapeutic equivalents.
(-) Co-pays may apply for out-of-network providers
2018
January 1, 2019
No5
(+) Covers OTC contraceptive drugs 5
(+) Covers 12-month contraceptive supply 1
(+) Covers all FDA-approved drugs, devices, and products (excluding OTC drugs and devices) for women, but permits step therapy for Rx methods that have therapeutic equivalents.
(-) Co-pays may apply for out-of-network providers
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
2023 & TBD
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Connecticut
Delaware
Delaware
Print DataExtended Supply of Contraceptives#
2018
July 11, 2018
N/A
Yes
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.11
(+) Part of a more expansive law on contraceptive access
2018
July 11, 2018
N/A
Yes
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.11
(+) Part of a more expansive law on contraceptive access
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2018
July 11, 2018
Yes
(+) Covers 12-month contraceptive supply 1
(+) Applies to public and private plans
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions allowed for Rx methods that have therapeutic equivalents
(-) Coverage not required for male condoms
2018
July 11, 2018
Yes
(+) Covers 12-month contraceptive supply 1
(+) Applies to public and private plans
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions allowed for Rx methods that have therapeutic equivalents
(-) Coverage not required for male condoms
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
October 2021
Standing order
Contraceptives, defined as contraceptive medications approved by the FDA; injection
(+) No age restriction
October 2021
Standing order
Contraceptives, defined as contraceptive medications approved by the FDA; injection
(+) No age restriction
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Delaware
Hawaii
Hawaii
Print DataExtended Supply of Contraceptives#
2016
January 1, 2017 (private plans)
N/A
Yes: Medicaid Managed Care
N/A
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Pharmacist Prescribing of Contraception
2017, July 2017
No
Statewide Protocol
pill, patch, ring, injection
+ Requires referral to a health care provider after contraceptives are furnished
2017, July 2017
No
Statewide Protocol
pill, patch, ring, injection
+ Requires referral to a health care provider after contraceptives are furnished
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Hawaii
Idaho
Idaho
Print DataExtended Supply of Contraceptives#
S 1234 (would require coverage for a six-month supply of contraception)
March 2024
January 1, 2025
See other limits and features
Yes
(+) Applies to student health plans
(-) A six-month supply is not required if no prescription contraception has previously been prescribed to the enrollee
S 1234 (would require coverage for a six-month supply of contraception)
March 2024
January 1, 2025
See other limits and features
Yes
(+) Applies to student health plans
(-) A six-month supply is not required if no prescription contraception has previously been prescribed to the enrollee
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Pharmacist Prescribing of Contraception
HB 182
2019
Currently working on with private insurers
Other3
pill, patch, ring, injection
N/A
HB 182
2019
Currently working on with private insurers
Other3
pill, patch, ring, injection
N/A
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Idaho
Illinois
Illinois
Print DataExtended Supply of Contraceptives#
2016
January 1, 2017
N/A
No
(+) The state already allows a 3-month supply of oral contraceptives for Medicaid beneficiaries.7
(+) Part of a more expansive law on contraceptive access
2016
January 1, 2017
N/A
No
(+) The state already allows a 3-month supply of oral contraceptives for Medicaid beneficiaries.7
(+) Part of a more expansive law on contraceptive access
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2016
January 1, 2017
No5
(+) Covers all OTC methods, except male condoms 5
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions allowed for Rx methods that have therapeutic equivalents.
2016
January 1, 2017
No5
(+) Covers all OTC methods, except male condoms 5
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions allowed for Rx methods that have therapeutic equivalents.
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Illinois
Indiana
Indiana: Pending
Print DataProtecting Contraceptive Coverage
Sine Die
Pharmacist Prescribing of Contraception
May 2023
Standing Order (effective until the rules are adopted)
pill, patch, ring
(-) must be at least 18 years of age
May 2023
Standing Order (effective until the rules are adopted)
pill, patch, ring
(-) must be at least 18 years of age
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Indiana: Pending
Iowa
Iowa: Pending: Pending: Pending
Print DataExtended Supply of Contraceptives#
Legislation did not become law
Pharmacist Prescribing of Contraception
Legislation did not become law
Iowa: Pending: Pending: Pending
Louisiana
Louisiana
Print DataExtended Supply of Contraceptives#
June 2022
January 1, 2023
6 months
Yes
(-) Applies only to Medicaid health plans
(+) Contracts with managed care plans shall allow the insured to receive onsite dispensing of the prescribed contraceptive drugs at family practice clinics, if available.
June 2022
January 1, 2023
6 months
Yes
(-) Applies only to Medicaid health plans
(+) Contracts with managed care plans shall allow the insured to receive onsite dispensing of the prescribed contraceptive drugs at family practice clinics, if available.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Louisiana
Maine
Maine
Print DataExtended Supply of Contraceptives#
2017
January 1, 2019
N/A
No
(+) Part of a more expansive law on contraceptive access
*Indicates that the provision is part of a more expansive bill or regulation on contraceptive access.
2017
January 1, 2019
N/A
No
(+) Part of a more expansive law on contraceptive access
*Indicates that the provision is part of a more expansive bill or regulation on contraceptive access.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2022
January 1, 2023
No
+ Covers 12-month contraceptive supply1
+ LD 1237 expands upon previous contraceptive coverage requirements. Private insurers must cover all FDA-approved contraceptive drugs, devices, and products, with an exception for therapeutically equivalent products (if at least one is covered w/out cost-sharing).
2017
January 1, 2019
No
+ Covers 12-month contraceptive supply1
- Only required coverage of at least one contraceptive in each of the FDA-approved contraceptive method categories.
2022
January 1, 2023
No
+ Covers 12-month contraceptive supply1
+ LD 1237 expands upon previous contraceptive coverage requirements. Private insurers must cover all FDA-approved contraceptive drugs, devices, and products, with an exception for therapeutically equivalent products (if at least one is covered w/out cost-sharing).
2017
January 1, 2019
No
+ Covers 12-month contraceptive supply1
- Only required coverage of at least one contraceptive in each of the FDA-approved contraceptive method categories.
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
2023
TBD
N/A
TBD
pill, patch, ring, shot
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Maine
Maryland
Maryland
Print DataExtended Supply of Contraceptives#
2016
January 1, 2018
2 months
Yes
(+) Also applies to CHIP
(+) Part of a more expansive law on contraceptive access
2016
January 1, 2018
2 months
Yes
(+) Also applies to CHIP
(+) Part of a more expansive law on contraceptive access
2018
January 1, 2020
July 1, 2018
N/A
No
Yes
HB 1283 applies specifically to private plans, HB 994 applies to Medicaid and CHIP
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2016
January 1, 2018
Yes
(+) Covers male sterilization
(+) Prohibits public and private plans from requiring prior authorization for long acting reversible contraceptives (LARC)
(+) Covers all FDA-approved contraceptive drugs and devices, with exceptions allowed for Rx methods with therapeutic equivalents.
(+) Covers 12-month contraceptive supply1
2016
January 1, 2018
Yes
(+) Covers male sterilization
(+) Prohibits public and private plans from requiring prior authorization for long acting reversible contraceptives (LARC)
(+) Covers all FDA-approved contraceptive drugs and devices, with exceptions allowed for Rx methods with therapeutic equivalents.
(+) Covers 12-month contraceptive supply1
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
2018
January 2019
Yes
Statewide Protocol
pill, patch, ring
+ Requires referral to a health care provider after contraceptives are furnished
2018
January 2019
Yes
Statewide Protocol
pill, patch, ring
+ Requires referral to a health care provider after contraceptives are furnished
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Maryland
Massachusetts
Massachusetts
Print DataExtended Supply of Contraceptives#
2017
August 2018
3 months
Yes: Medicaid Managed Care
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.11
(+) Part of a more expansive law on contraceptive access
2017
August 2018
3 months
Yes: Medicaid Managed Care
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.11
(+) Part of a more expansive law on contraceptive access
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2017
August 2018
Yes
(+) Covers 12-month contraceptive supply1
(+) Also applies to Medicaid and state employee health insurance
(-) Covers all FDA-approved contraceptive drugs, devices, and products, except male condoms and oral contraceptives without a therapeutic equivalent
2017
August 2018
Yes
(+) Covers 12-month contraceptive supply1
(+) Also applies to Medicaid and state employee health insurance
(-) Covers all FDA-approved contraceptive drugs, devices, and products, except male condoms and oral contraceptives without a therapeutic equivalent
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
FY 2024 Budget
Governor's approval message (see page 6)
Final Conference Report (see PDF page 375 amending SECTION 42. Chapter 94C of the General Laws)
TBD
TBD
Patch and pill
FY 2024 Budget
Governor's approval message (see page 6)
Final Conference Report (see PDF page 375 amending SECTION 42. Chapter 94C of the General Laws)
TBD
TBD
Patch and pill
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Massachusetts
Michigan
Michigan
Print DataExtended Supply of Contraceptives#
2022
May 1, 2022
N/A
Applies only to Medicaid, Healthy Michigan Plan, Children’s Special Health Care Services (CSHCS), and Maternity Outpatient Medical Services (MOMS)
(+) Policy applies at pharmacies and family planning clinics
(-) These medications will be subject to other existing Fee-for-Service (FFS) pharmacy policies and coverage limitations, including refill thresholds and prior authorization (PA)
requirements. See Michigan Medicaid Common Formulary.
2022
May 1, 2022
N/A
Applies only to Medicaid, Healthy Michigan Plan, Children’s Special Health Care Services (CSHCS), and Maternity Outpatient Medical Services (MOMS)
(+) Policy applies at pharmacies and family planning clinics
(-) These medications will be subject to other existing Fee-for-Service (FFS) pharmacy policies and coverage limitations, including refill thresholds and prior authorization (PA)
requirements. See Michigan Medicaid Common Formulary.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Pharmacist Prescribing of Contraception
N/A - the state allows collaborative practice agreements and CVS has leveraged this flexibility.
See pharmacies in Michigan prescribing birth control via birthcontrolpharmacies.com
No
Collaborative Practice Agreements (sample)
"Only self-administered, hormonal contraceptives"
N/A
N/A - the state allows collaborative practice agreements and CVS has leveraged this flexibility.
See pharmacies in Michigan prescribing birth control via birthcontrolpharmacies.com
No
Collaborative Practice Agreements (sample)
"Only self-administered, hormonal contraceptives"
N/A
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Michigan
Minnesota
Minnesota
Print DataExtended Supply of Contraceptives#
SF 2995 (Omnibus Health Appropriations)
2023
January 1, 2024
N/A
Yes
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2023
January 1, 2024
Yes
(+) For each health plan, the insurer must list the contraceptive methods and services that are covered without cost-sharing in a manner that is easily accessible to enrollees, health care providers, and representatives of health care providers. The list for each health plan must be promptly updated to reflect changes to the coverage
2023
January 1, 2024
Yes
(+) For each health plan, the insurer must list the contraceptive methods and services that are covered without cost-sharing in a manner that is easily accessible to enrollees, health care providers, and representatives of health care providers. The list for each health plan must be promptly updated to reflect changes to the coverage
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
May 2020
No
pill, patch, ring, and shot
(-) Age restriction (18 and older, unless minor has existing Rx from a licensed physician, physician assistant, or advanced practice registered nurse)
(-) Pharmacist who prescribes and dispenses an initial Rx cannot provide a refill if patient has no evidence of a clinical visit within preceding three years.
May 2020
No
pill, patch, ring, and shot
(-) Age restriction (18 and older, unless minor has existing Rx from a licensed physician, physician assistant, or advanced practice registered nurse)
(-) Pharmacist who prescribes and dispenses an initial Rx cannot provide a refill if patient has no evidence of a clinical visit within preceding three years.
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Minnesota
Mississippi
Mississippi: Pending: Pending: Pending
Print DataExtended Supply of Contraceptives#
HB 1026 would allow Medicaid to cover a 12-month supply of contraception.
Legislation introduced in February 2024, passed the House on 3/14, before dying in a Senate committee on 4/2.
Medicaid only
HB 1026 would allow Medicaid to cover a 12-month supply of contraception.
Legislation introduced in February 2024, passed the House on 3/14, before dying in a Senate committee on 4/2.
Medicaid only
Mississippi: Pending: Pending: Pending
Missouri
Missouri: Pending: Pending: Pending
Print DataExtended Supply of Contraceptives#
Passed the first chamber on April 22, 2024, but did not become law before the end of session.
Legislation did not become law
Passed the first chamber on April 22, 2024, but did not become law before the end of session.
Pharmacist Prescribing of Contraception
Legislation did not become law
Missouri: Pending: Pending: Pending
Montana
Montana
Print DataExtended Supply of Contraceptives#
2023
January 1, 2024
N/A
No
(+) Must allow the insured to renew and refill a 12-month prescription a minimum of 60 days before the prescription expires
2023
January 1, 2024
N/A
No
(+) Must allow the insured to renew and refill a 12-month prescription a minimum of 60 days before the prescription expires
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Pharmacist Prescribing of Contraception
See pharmacies in Montana prescribing birth control via birthcontrolpharmacies.com
unknown
Collaborative Practice Agreements
unknown
N/A
See pharmacies in Montana prescribing birth control via birthcontrolpharmacies.com
unknown
Collaborative Practice Agreements
unknown
N/A
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Montana
Nebraska
Nebraska
Print DataPharmacist Prescribing of Contraception
See pharmacies in Nebraska prescribing birth control via birthcontrolpharmacies.com
No
Collaborative Practice Agreements
Uknown
N/A
See pharmacies in Nebraska prescribing birth control via birthcontrolpharmacies.com
No
Collaborative Practice Agreements
Uknown
N/A
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Nebraska
Nevada
Nevada
Print DataExtended Supply of Contraceptives#
2017
January 1, 2018
3 months
Yes
(-) Requires a second dispensing of up to 9 months in the first year, then allows a refill of up to 12 months in subsequent year if insured by the same plan.
(+) Part of a more expansive law on contraceptive access
*Indicates that the provision is part of a more expansive bill or regulation on contraceptive access.
2017
January 1, 2018
3 months
Yes
(-) Requires a second dispensing of up to 9 months in the first year, then allows a refill of up to 12 months in subsequent year if insured by the same plan.
(+) Part of a more expansive law on contraceptive access
*Indicates that the provision is part of a more expansive bill or regulation on contraceptive access.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2017
January 1, 2018
No
+ Covers 12-month contraceptive supply1
+ Applies to Medicaid managed care plans and private plans
2017
January 1, 2018
No
+ Covers 12-month contraceptive supply1
+ Applies to Medicaid managed care plans and private plans
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
Statewide protocol
Pill, patch, ring, and any other self-administered hormonal method established by protocol
+ No age restriction
Statewide protocol
Pill, patch, ring, and any other self-administered hormonal method established by protocol
+ No age restriction
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Nevada
New Hampshire
New Hampshire
Print DataExtended Supply of Contraceptives#
2018
January 1, 2019
N/A
Yes
(+) Will also provide authority to pharmacists, due to HB 1822 becoming law in the same session.
2018
January 1, 2019
N/A
Yes
(+) Will also provide authority to pharmacists, due to HB 1822 becoming law in the same session.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2018
January 1, 2019
No
(+) Covers 12-month contraceptive supply1
(+) Applies to public and private plans
2018
January 1, 2019
No
(+) Covers 12-month contraceptive supply1
(+) Applies to public and private plans
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
2018
TBD
No
Standing order
pill, patch, ring
+ Insurers that cover outpatient contraceptive services must cover initial screening at pharmacy
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
New Hampshire
New Jersey
New Jersey
Print DataExtended Supply of Contraceptives#
2017
March 2018
3 months
No
May limit refills if there are less than six months left in the plan year.
2022
January 1, 2023
N/A
Yes
(+) Eliminates the initial dispensing requirement of the 2017 law
2017
March 2018
3 months
No
May limit refills if there are less than six months left in the plan year.
2022
January 1, 2023
N/A
Yes
(+) Eliminates the initial dispensing requirement of the 2017 law
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2020
April 16, 2020
Yes
+ Covers male sterilization and male condoms (except cost-sharing is permitted in high-deductible plans)
+ Covers OTC contraceptive drugs w/out a Rx
+ Covers all FDA-approved contraceptive drugs, devices, and products with exceptions allowed for Rx methods with therapeutic equivalents.
S 1492 would extend current requirement to male sterilization, with exceptions for high-deductible plans
Pending legislation introduced in 2024
2020
April 16, 2020
Yes
+ Covers male sterilization and male condoms (except cost-sharing is permitted in high-deductible plans)
+ Covers OTC contraceptive drugs w/out a Rx
+ Covers all FDA-approved contraceptive drugs, devices, and products with exceptions allowed for Rx methods with therapeutic equivalents.
S 1492 would extend current requirement to male sterilization, with exceptions for high-deductible plans
Pending legislation introduced in 2024
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
S 275 (Public Law 2023, c.2.)
1/13/2023
Standing Order
TBD by the Board of Pharmacy and State Board of Medical Examiners
+ The bill includes a provision allowing the Commissioner of Health to establish a public awareness campaign about the availability of the service.
S 275 (Public Law 2023, c.2.)
1/13/2023
Standing Order
TBD by the Board of Pharmacy and State Board of Medical Examiners
+ The bill includes a provision allowing the Commissioner of Health to establish a public awareness campaign about the availability of the service.
PENDING AS OF 1/4/2023
PENDING AS OF 1/4/2023
PENDING AS OF 1/4/2023
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
New Jersey
New Mexico
New Mexico
Print DataExtended Supply of Contraceptives#
2019
January 1, 2020
N/A
Yes
(+) Medicaid beneficiaries can receive up to 12-month supply
(+) Part of a more expansive law on contraceptive access
*Indicates that the provision is part of a more expansive bill or regulation on contraceptive access.
2019
January 1, 2020
N/A
Yes
(+) Medicaid beneficiaries can receive up to 12-month supply
(+) Part of a more expansive law on contraceptive access
*Indicates that the provision is part of a more expansive bill or regulation on contraceptive access.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2019
January 1, 2020
Yes
+ Covers male sterilization and male condoms (except cost-sharing is permitted in high-deductible plans)
+ Covers OTC contraceptive drugs w/out a Rx
2019
January 1, 2020
Yes
+ Covers male sterilization and male condoms (except cost-sharing is permitted in high-deductible plans)
+ Covers OTC contraceptive drugs w/out a Rx
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
2017
June 2017
Yes, with HB 42 passed in 2020
Statewide Protocol
pill, patch, ring, injection
+ Requires referral to a health care provider if hormonal contraception is not recommended, desired method is not available, or if patient experiences side effects
2017
June 2017
Yes, with HB 42 passed in 2020
Statewide Protocol
pill, patch, ring, injection
+ Requires referral to a health care provider if hormonal contraception is not recommended, desired method is not available, or if patient experiences side effects
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
New Mexico
New York
New York
Print DataExtended Supply of Contraceptives#
2017
August 27, 2017
3 months
No
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.
S659A*~
2019
January 1, 2020
N/A
Yes
N/A
2017
August 27, 2017
3 months
No
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2019
January 1, 2020
Yes
(+) Covers 12-month contraceptive supply1
(+) Covers all FDA-approved contraceptive drugs, devices, and products when prescribed, with exceptions allowed for Rx methods with therapeutic equivalents.
2019
January 1, 2020
Yes
(+) Covers 12-month contraceptive supply1
(+) Covers all FDA-approved contraceptive drugs, devices, and products when prescribed, with exceptions allowed for Rx methods with therapeutic equivalents.
2017
August 27, 2017
No3
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
Became law 5/2/23
Statewide
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
New York
North Carolina
North Carolina
Print DataPharmacist Prescribing of Contraception
August 2021
February 2022 (expected)
Pill, patch
- Age restriction (18 years and older)
August 2021
February 2022 (expected)
Pill, patch
- Age restriction (18 years and older)
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
North Carolina
Oklahoma
Oklahoma: Pending: Pending: Pending
Print DataExtended Supply of Contraceptives#
Passed both chambers; conference committee requested.
Pending as of May 29, 2024
Pharmacist Prescribing of Contraception
Passed both chambers; conference granted, naming Conference Committee on Business and Commerce.
Pending as of May 28, 2024
Passed both chambers; conference granted, naming Conference Committee on Business and Commerce.
Pending as of May 28, 2024
Oklahoma: Pending: Pending: Pending
Oregon
Oregon
Print DataExtended Supply of Contraceptives#
2016
January 1, 2016
3 months
No
(+) Also applies to student health insurance policies.
(+) The state Medicaid Family Planning Expansion, CCare Program, already requires this.8
2016
January 1, 2016
3 months
No
(+) Also applies to student health insurance policies.
(+) The state Medicaid Family Planning Expansion, CCare Program, already requires this.8
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2017
January 1, 2019
No5
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions for Rx methods that have therapeutic equivalents
(+) Private insurers must cover all Women’s Preventive Services required by federal guidelines as of 1/1/17
(+) Directs the state to appropriate funds to provide coverage for the aforementioned to women who are of reproductive age but are temporarily ineligible for Medicaid due to their immigration status
(+) Requires a report on insurer compliance
2017
January 1, 2019
No5
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions for Rx methods that have therapeutic equivalents
(+) Private insurers must cover all Women’s Preventive Services required by federal guidelines as of 1/1/17
(+) Directs the state to appropriate funds to provide coverage for the aforementioned to women who are of reproductive age but are temporarily ineligible for Medicaid due to their immigration status
(+) Requires a report on insurer compliance
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
2017
2015
January 2016
Yes
Statewide Protocol
pill, patch, ring, injection
(+) Self-screening tool also available in Spanish1
(+) Referral to a health care provider required if hormonal contraception is not recommended
(+) Age restriction (18 and older) removed as of January 2020
(-) Cannot continue to prescribe to patient beyond three years from initial Rx, without evidence of a clinical visit
2017
2015
January 2016
Yes
Statewide Protocol
pill, patch, ring, injection
(+) Self-screening tool also available in Spanish1
(+) Referral to a health care provider required if hormonal contraception is not recommended
(+) Age restriction (18 and older) removed as of January 2020
(-) Cannot continue to prescribe to patient beyond three years from initial Rx, without evidence of a clinical visit
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Oregon
Pennsylvania
Pennsylvania: Pending: Pending
Print DataProtecting Contraceptive Coverage
PENDING AS OF 6/12/2024
Pennsylvania: Pending: Pending
Rhode Island
Rhode Island
Print DataExtended Supply of Contraceptives#
2018
July 1, 2019 (Medicaid)
April 1, 2019 (private plans)
N/A
Yes, and any other public insurance plans
N/A
2018
July 1, 2019 (Medicaid)
April 1, 2019 (private plans)
N/A
Yes, and any other public insurance plans
N/A
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
HB 7255/ SB 2088
PENDING LEGISLATION INTRODUCED IN JANUARY 2024
Pharmacist Prescribing of Contraception
TBD
TBD
"all short-term, FDA-approved hormonal contraceptives"
(+) Legislation directs the Rhode Island state pharmacy board to track and report on accessibility and use, including the number and geographic locations of participating pharmacy stores; and number of
pharmacists that are eligible to prescribe.
(+) Legislation directs pharmacies to display signs in stores and on websites indicating the availability of the service.
(-) Limits an initial prescription issued by a pharmacist to a three month supply.
TBD
TBD
"all short-term, FDA-approved hormonal contraceptives"
(+) Legislation directs the Rhode Island state pharmacy board to track and report on accessibility and use, including the number and geographic locations of participating pharmacy stores; and number of
pharmacists that are eligible to prescribe.
(+) Legislation directs pharmacies to display signs in stores and on websites indicating the availability of the service.
(-) Limits an initial prescription issued by a pharmacist to a three month supply.
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Rhode Island
South Carolina
South Carolina
Print DataExtended Supply of Contraceptives#
Part of SCDHHS' July 2020 pharmacy benefit changes
2020
July 1, 2020
N/A
Medicaid only
+ This applies to contraceptive pills, patches, and rings
Part of SCDHHS' July 2020 pharmacy benefit changes
2020
July 1, 2020
N/A
Medicaid only
+ This applies to contraceptive pills, patches, and rings
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Pharmacist Prescribing of Contraception
In Medicaid, pending federal approval
standing order (Per the Board of Pharmacy, each pharmacy is responsible for obtaining its own provider partner in order to issue
a standing order. There is not a blanket provider for all participating pharmacies to use.)
pill, patch, ring, and shot
- Cannot prescribe to someone under eighteen years of age, unless evidence of a previous prescription from a practitioner for a self-administered hormonal contraceptive or an injectable hormonal contraceptive.
In Medicaid, pending federal approval
standing order (Per the Board of Pharmacy, each pharmacy is responsible for obtaining its own provider partner in order to issue
a standing order. There is not a blanket provider for all participating pharmacies to use.)
pill, patch, ring, and shot
- Cannot prescribe to someone under eighteen years of age, unless evidence of a previous prescription from a practitioner for a self-administered hormonal contraceptive or an injectable hormonal contraceptive.
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
South Carolina
South Dakota
South Dakota
Print DataPharmacist Prescribing of Contraception
See pharmacies in South Dakota prescribing birth control via birthcontrolpharmacies.com
No
Collaborative Practice Agreements
unknown
N/A
See pharmacies in South Dakota prescribing birth control via birthcontrolpharmacies.com
No
Collaborative Practice Agreements
unknown
N/A
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
South Dakota
Tennessee
Tennessee: Pending: Pending
Print DataExtended Supply of Contraceptives#
April 2024
Jan 1, 2025
N/A
Medicaid/CHIP only
Pharmacist Prescribing of Contraception
2016
Late 2019
No
Collaborative Practice Agreements (Template)
pill, patch, ring, injection
(-) Age restriction (18 and older unless an emancipated minor)
(-) Pharmacists may charge an annual administrative fee, except insured patients are not required to pay it
2016
Late 2019
No
Collaborative Practice Agreements (Template)
pill, patch, ring, injection
(-) Age restriction (18 and older unless an emancipated minor)
(-) Pharmacists may charge an annual administrative fee, except insured patients are not required to pay it
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Tennessee: Pending: Pending
Texas
Texas
Print DataExtended Supply of Contraceptives#
2023
1/1/2024
3 months
Yes: Fee for Service and Medicaid Managed Care
(+) Specifies that an enrollee is entitled to a 12-month supply of the covered prescription contraceptive drug at one time each subsequent time the enrollee obtains the same drug, regardless of whether the enrollee was enrolled in the health benefit plan the first time the enrollee obtained the drug.
2023
1/1/2024
3 months
Yes: Fee for Service and Medicaid Managed Care
(+) Specifies that an enrollee is entitled to a 12-month supply of the covered prescription contraceptive drug at one time each subsequent time the enrollee obtains the same drug, regardless of whether the enrollee was enrolled in the health benefit plan the first time the enrollee obtained the drug.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Texas
Utah
Utah
Print DataPharmacist Prescribing of Contraception
2018
April 2019
No
pill, patch, ring
(+)Self-screening tool also available in Spanish 1
(-) Age restriction (18 and older), regardless of whether patient has an existing Rx
(+) Referral to a health care provider is required if hormonal contraception is not recommended
(-) Cannot continue to prescribe to a patient more than 2 years after initial Rx, without evidence of consultation with a primary care provider
2018
April 2019
No
pill, patch, ring
(+)Self-screening tool also available in Spanish 1
(-) Age restriction (18 and older), regardless of whether patient has an existing Rx
(+) Referral to a health care provider is required if hormonal contraception is not recommended
(-) Cannot continue to prescribe to a patient more than 2 years after initial Rx, without evidence of consultation with a primary care provider
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Utah
Vermont
Vermont
Print DataExtended Supply of Contraceptives#
2016
October 1, 2016 (Medicaid)
October 1, 2017 (private plans)
N/A
Yes, and any other public insurance plans
N/A
2016
October 1, 2016 (Medicaid)
October 1, 2017 (private plans)
N/A
Yes, and any other public insurance plans
N/A
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2016
October 1, 2016 (Medicaid)
October 1, 2017 (private plans)
No
+ Applies to public and private plans
+ Plans must cover sterilizations for men and women, with some limits
+ Directs the state’s Department of Health Access to establish and implement value-based payments for LARC insertion and removal2
H 663 (Act 157)
2020
N/A
This law includes a request that the Vermont Department of Financial Regulation investigate compliance with existing State and federal laws regarding access to contraceptives and take appropriate enforcement action as needed.
2016
October 1, 2016 (Medicaid)
October 1, 2017 (private plans)
No
+ Applies to public and private plans
+ Plans must cover sterilizations for men and women, with some limits
+ Directs the state’s Department of Health Access to establish and implement value-based payments for LARC insertion and removal2
H 663 (Act 157)
2020
N/A
This law includes a request that the Vermont Department of Financial Regulation investigate compliance with existing State and federal laws regarding access to contraceptives and take appropriate enforcement action as needed.
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
October 2020
July 1, 2021
TBD
Statewide
pill, patch, ring
+ H 663, ensures that existing health insurance coverage requirements for contraceptives will also apply to self-administered hormonal contraceptives prescribed by a pharmacist
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Vermont
Virginia
Virginia
Print DataExtended Supply of Contraceptives#
2017
January 1, 2018
N/A
No
(+) The state already allows 12-months dispensing of oral contraceptives for Medicaid beneficiaries at clinics.9
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.11
March 2021
Medicaid only
(+) The Department of Medical Assistance Services cannot impose controls over dispensing unless there are contraindications.
2017
January 1, 2018
N/A
No
(+) The state already allows 12-months dispensing of oral contraceptives for Medicaid beneficiaries at clinics.9
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.11
March 2021
Medicaid only
(+) The Department of Medical Assistance Services cannot impose controls over dispensing unless there are contraindications.
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
HB 819 passed the legislature in March 2024. The Governor vetoed the bill.
Pharmacist Prescribing of Contraception
April 2020
January 11, 2021
Yes, in private plans
pills, patch, ring, and shot
(-) age restriction (18 and older)
April 2020
January 11, 2021
Yes, in private plans
pills, patch, ring, and shot
(-) age restriction (18 and older)
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Virginia
Washington
Washington
Print DataExtended Supply of Contraceptives#
2017
January 1, 2018
N/A
No
(-) The plan may limit refills obtained in the last quarter of the plan year if a 12-month supply of the contraceptive has already been dispensed during the plan year.
(+) The state already allows 12-months dispensing of oral contraceptives for Medicaid beneficiaries.10
2017
January 1, 2018
N/A
No
(-) The plan may limit refills obtained in the last quarter of the plan year if a 12-month supply of the contraceptive has already been dispensed during the plan year.
(+) The state already allows 12-months dispensing of oral contraceptives for Medicaid beneficiaries.10
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2017
January 1, 2019
Yes
(+) Plans must cover male sterilization
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions for Rx methods that have therapeutic equivalents.
(+) Covers all OTC methods without a Rx
2017
January 1, 2019
Yes
(+) Plans must cover male sterilization
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions for Rx methods that have therapeutic equivalents.
(+) Covers all OTC methods without a Rx
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
1979
1998
Yes, if enrolled as a provider (except Medicaid Fee-for- Service)
Collaborative Practice Agreements
(-) age restriction (18 and older)
1979
1998
Yes, if enrolled as a provider (except Medicaid Fee-for- Service)
Collaborative Practice Agreements
(-) age restriction (18 and older)
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Washington
Washington, DC
Washington, DC
Print DataExtended Supply of Contraceptives#
2015
Jan 1, 2017
Yes
N/A
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
-------------
1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
2018
January 1, 2019
No5
(+) Public and private plans must cover a wide range of women’s preventive services
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions for Rx methods that have therapeutic equivalents
(+) Covers OTC contraceptives5
(+) Covers 12-month contraceptive supply1
2018
January 1, 2019
No5
(+) Public and private plans must cover a wide range of women’s preventive services
(+) Covers all FDA-approved contraceptive drugs, devices, and products, with exceptions for Rx methods that have therapeutic equivalents
(+) Covers OTC contraceptives5
(+) Covers 12-month contraceptive supply1
References
-------------
1 These laws/regulations include coverage for an extended supply of prescription contraceptives. For more details: https://powertodecide.org/what-we-do/information/resource-library/extended-supply-contraception.
2 Value-based payments reward providers for the value of the care they deliver, thus value-based payments for LARC should take into account the value of preventing unintended pregnancy.
3 This is required for Medicaid beneficiaries pursuant to regulation HLT-39-16-00031.
4 This applies to plans issued or renewed after the effective date. As explained earlier, these policies generally do not apply to self-funded plans. Also, most states have exemptions for religiously affiliated employers.
5 Connecticut and Oregon require health insurers to cover OTC contraceptive drugs, D.C. requires coverage for OTC contraceptives, and Illinois requires coverage for all OTC contraceptive drugs, devices, and products—none of these state laws specify that such coverage is required for OTC contraception without a prescription.
Pharmacist Prescribing of Contraception
2018, TBD
Yes
Collaborative Practice Agreements
pill, patch, ring
+ Requires referral to a health care provider after contraceptives are furnished or if self-administered hormonal contraception is not recommended
2018, TBD
Yes
Collaborative Practice Agreements
pill, patch, ring
+ Requires referral to a health care provider after contraceptives are furnished or if self-administered hormonal contraception is not recommended
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
-------------
1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
Washington, DC
West Virginia
West Virginia
Print DataExtended Supply of Contraceptives#
2020
January 1, 2021
Unclear
(The law requires coverage for a 12-month refill after the insured has completed the initial supply, but it does not specify the length of the initial supply.)
No
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.11
(+) The West Virginia law requires coverage for a 12-month refill after the insured has completed the initial supply, but it does not specify the length of the initial supply
2020
January 1, 2021
Unclear
(The law requires coverage for a 12-month refill after the insured has completed the initial supply, but it does not specify the length of the initial supply.)
No
(+) State law specifies that coverage is not excluded for contraception prescribed for reasons other than contraception.11
(+) The West Virginia law requires coverage for a 12-month refill after the insured has completed the initial supply, but it does not specify the length of the initial supply
^ Some states require the patient to first have an “initial dispensing” of a few months’ worth of a given contraceptive, before receiving a subsequent larger quantity of the same method or therapeutic equivalent. Laws in Colorado, Massachusetts, New Jersey, and Oregon specify that the covered person can receive the larger quantity, whether or not they were enrolled in the same plan when they received the initial dispensing. While an initial dispensing is not a required practice from the medical community, it is a balance some states have struck in order to assuage insurer concerns.
# States requiring a twelve-month supply of contraception at one-time, except for New Jersey and New Mexico, which require a six-month supply at one time.
References
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1 Foster, D.G., Hulett, D., Bradsberry, M., Darney, P., and Policar, M. (2011). Number of Oral Contraceptive Pill Packages Dispensed and Subsequent Unintended Pregnancies. Obstetrics & Gynecology, 117(3):566-572. doi:10.1097/AOG.0b013e3182056309
2 The Centers for Disease Control and Prevention. US Selected Practice Recommendations for Contraceptive Use, 2016. Retrieved from www.cdc.gov/reproductivehealth/contraception/mmwr/spr/combined.html.
3 Judge-Golden, C.P., Smith K.J., Mor M.K., Borrero S. (2019).Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. Published online July 08, 2019. doi:10.1001/jamainternmed.2019.1678
4 Effective January 1, 2017, Family PACT policy covers an extended supply of the contraceptive ring and patch at clinics. Family PACT Update. (2017). Retrieved from http://files.medi-cal.ca.gov/pubsdoco/bulletins/artfull/fpact201704.asp#a4.
5 State of California-Health and Human Services Agency, Department of Health Care Services. All Plan Letter 16-003 Revised. (2016). Retrieved from www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2016/APL16-003R.pdf.
6 KFF Medicaid Coverage of Family Planning Benefits: Results from a State Survey. Retrieved from kff.org/attachment/Report-Medicaid-Coverage-of-Family-Planning-Benefits-Results-from-a-State-Survey.
7 Ibid.
8 Ibid.
9 Ibid.
10 Ibid.
11 This does not necessarily mean the coverage would be excluded in states where it is not specified in legislation.
Protecting Contraceptive Coverage
SINE DIE
Pharmacist Prescribing of Contraception
No2
Standing order
N/A
N/A
* Several studies have shown that while these services may theoretically be available, consumers in some states can find it hard to access these services.
References
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1. All states require self-screening tools, but they may not be available in languages other than English.
2. While HB 2583 does not provide for reimbursement, SB 787, passed in the 2020 legislative session gives pharmacists provider status under WV law, requiring private plans to reimburse in-network pharmacists for services that would be reimbursed if performed by another health care provider.
3. HB 18-1112, passed in 2018, requires health benefit plans to cover services provided by a pharmacist if the services are provided within a health professional shortage area, and the plan would cover the services if provided by a licensed physician or APN. They are still pursuing coverage through Medicaid.
4. HB 182 expands the scope of practice for pharmacists to prescribe drugs in accordance with the US FDA-approved labeling and that are generally limited to minor conditions that do require a diagnosis.
5. While Washington has allowed pharmacists to prescribe contraception for several decades, up-take has been slow.
Print Data
West Virginia
Wisconsin
Wisconsin: Pending
Print DataPharmacist Prescribing of Contraception
THE ASSEMBLY BILL PASSED THE HOUSE IN 2023, BUT DID NOT ADVANCE TO BECOME LAW BEFORE THE END OF SESSION
THE ASSEMBLY BILL PASSED THE HOUSE IN 2023, BUT DID NOT ADVANCE TO BECOME LAW BEFORE THE END OF SESSION
