Add 267-a, Pub Health L; amd 6527, 6802, 6801, 6902, 6909 & 6951, Ed L; amd 3216, 3221 & 4303, Ins L
Authorizes the dispensing of abortion medication under certain conditions; requires insurance policies providing coverage for contraception to provide coverage for abortion medication.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6835
SPONSOR: Paulin TITLE OF BILL:
An act to amend the public health law, the education law and the insur-
ance law, in relation to the dispensing of abortion medication
PURPOSE:
To improve the accessibility of abortion medication
SUMMARY OF PROVISIONS:
Section one of the bill adds a new section to public health law to
authorize the commissioner of health to establish a non-patient specific
order for dispensing abortion medication.
Section two of the bill amends section 6527 of the education law to
allow a licensed physician to prescribe and order a non-patient specific
order to a registered professional nurse or pharmacist licensed and
located in this state for dispensing abortion medication.
Section three of the bill amends the education law to define "abortion
medication."
Section four of the bill amends section 6801 of the education law to
allow a licensed pharmacist to execute a non-patient specific order
for the dispensing of abortion medication when prescribed or ordered by
the commissioner of health, a licensed midwife, a physician licensed in
this state, or a nurse practitioner certified in this state. It further
provides that prior to dispensing, the pharmacist must provide the
patient with a self-screening risk assessment questionnaire, developed
by the Commissioner of Health, in consultation with the Commissioner of
Education. The pharmacist must also provide the patient with a fact
sheet developed by the Commissioner of Health, in consultation with the
Commissioner of Education. Lastly, section also requires pharmacists to
receive training satisfactory to the Commissioner of Education; requires
pharmacists to notify a patient's primary care provider when abortion
medication is dispensed under this section unless the patient opts-out
and makes it clear that pharmacists retain the ability to refuse to
dispense a prescription if in their professional judgment, potential
adverse effects, interactions or other therapeutic complications could
endanger the health of the patient.
Section five amends section 6902 of the education law to allow a regis-
tered professional nurse to execute a non-patient specific order for the
dispensing of abortion medication when prescribed or ordered by the
commissioner of health, a licensed midwife, a physician licensed in this
state, or a nurse practitioner certified in this state. This section
mirrors the prior section in relation to the self-screening risk assess-
ment, fact sheet, reporting requirements, and the ability to refuse to
dispense abortion medication.
Section six amends section 6909 of the education law to allow a certi-
fied nurse practitioner to prescribe or order a non-patient specific
order to a registered professional nurse or pharmacist licensed and
located in the state for dispensing abortion medication.
Section seven amends section 6951 of the education law to allow licensed
midwives to prescribe a non-patient specific regimen of abortion medica-
tion to a registered professional nurse or pharmacist licensed and
located in the state.
Sections eight, nine, and 10 amend the insurance law to allow for cover-
age of abortion medication without cost-sharing.
Section eleven provides the effective date.
JUSTIFICATION:
In 2023, the Food and Drug Administration (FDA) made a regulatory change
that would allow medication commonly used for medication abortion to be
offered in retail pharmacies. This new rule would still require patients
to have a prescription from a certified healthcare provider, but it
greatly broadens the availability of abortion pills. While this is an
important step forward, those seeking the medication in New York will
still face access barriers when trying to obtain a prescription from a
licensed physician.
While current NYS law allows abortion medication to be prescribed by a
licensed physician, a certified nurse practitioner or properly licensed
midwife, this bill vastly expands access by allowing these healthcare
professionals to prescribe a non-patient specific order of abortion
medication to be dispensed by a local pharmacist or registered profes-
sional nurse. Allowing pharmacists to dispense this medication will help
address access. disparities for many New Yorkers, especially marginal-
ized populations, who are more likely to live closer to a pharmacy than
a physician's office. Similarly, allowing RNs to dispense this medica-
tion will expand access on health centers on college campuses in the
state.
In 2021, over half of abortions in the United States were medication
abortions. The FDA has found that medication abortion is safe and effec-
tive, with a 0.4% risk of major complications and an associated mortal-
ity rate of less than 0.001 percent. The medication comes with no risk
of overdose or addiction. Further, individuals have accessed these pills
without a prescription and safely induced abortion in countries like
India and Mexico for years.
Not only has abortion medication been proved safe and effective to
induce abortions up to 10 weeks into a pregnancy, but doctors also often
prescribe this same safe and effective regimen for early pregnancy loss,
as it helps expel a miscarriage. By limiting an individual's access to
this medication, we are preventing people from receiving the care they
need at the time they need it most.
LEGISLATIVE HISTORY:
New bill.
FISCAL:
None to the state.
EFFECTIVE DATE:
This act shall take effect eighteen months after it shall have become a
law; provided, however, that sections eight, nine and ten of this act
shall apply to policies and contracts issued, renewed, modified, altered
or amended on or after such effective date. Effective immediately, the
addition, amendment and/or repeal of any rule or regulation necessary
for the implementation of this act on its effective date are authorized
to be made and completed on or before such effective date.
STATE OF NEW YORK
________________________________________________________________________
6835
2023-2024 Regular Sessions
IN ASSEMBLY
May 8, 2023
___________
Introduced by M. of A. PAULIN, SEAWRIGHT, GLICK, GONZALEZ-ROJAS, SIMON,
THIELE, AUBRY, LEVENBERG, SHRESTHA, ARDILA -- read once and referred
to the Committee on Higher Education
AN ACT to amend the public health law, the education law and the insur-
ance law, in relation to the dispensing of abortion medication
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The public health law is amended by adding a new section
2 267-a to read as follows:
3 § 267-a. Abortion medication. The commissioner is authorized to estab-
4 lish a non-patient specific order, consistent with sections sixty-eight
5 hundred one and sixty-nine hundred two of the education law, for
6 dispensing abortion medication as defined in section sixty-eight hundred
7 two of the education law.
8 § 2. Section 6527 of the education law is amended by adding a new
9 subdivision 11 to read as follows:
10 11. A licensed physician may prescribe and order a non-patient specif-
11 ic order to a registered professional nurse or pharmacist licensed and
12 located in this state, pursuant to regulations promulgated by the
13 commissioner, and consistent with section sixty-eight hundred one of
14 this title, for dispensing abortion medication as defined in section
15 sixty-eight hundred two of this title.
16 § 3. Section 6802 of the education law is amended by adding a new
17 subdivision 29 to read as follows:
18 29. "Abortion medication" means any medication approved by the federal
19 Food and Drug Administration for the purposes of inducing abortion or
20 expelling a miscarriage.
21 § 4. Section 6801 of the education law is amended by adding a new
22 subdivision 9 to read as follows:
23 9. (a) A licensed pharmacist may execute a non-patient specific order
24 for the dispensing of abortion medication prescribed or ordered by the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06982-03-3
A. 6835 2
1 commissioner of health, a licensed midwife, a physician licensed in this
2 state, or a nurse practitioner certified in this state pursuant to rules
3 and regulations promulgated by the commissioner.
4 (b) Prior to dispensing abortion medication to a patient, the pharma-
5 cist shall:
6 (i) provide the patient with a self-screening risk assessment ques-
7 tionnaire, developed by the commissioner of health in consultation with
8 the commissioner, to be reviewed by the pharmacist to identify any known
9 risk factors; and
10 (ii) provide the patient with a fact sheet, developed by the commis-
11 sioner of health that includes but is not limited to, the clinical
12 considerations and recommendations for use of abortion medication, the
13 appropriate method for using abortion medication, information on the
14 importance of follow-up health care, health care referral information,
15 and the ability of the patient to opt out of practitioner reporting
16 requirements.
17 (c) No pharmacist shall dispense abortion medication under this subdi-
18 vision without receiving training satisfactory to the commissioner.
19 (d) A pharmacist shall notify the patient's primary health care prac-
20 titioner, unless the patient opts out of such notification, within
21 seventy-two hours of dispensing abortion medication, that such medica-
22 tion has been dispensed. If the patient does not have a primary health
23 care practitioner or is unable to provide contact information for their
24 primary health care practitioner, the pharmacist shall provide the
25 patient with a written record of the abortion medication dispensed, and
26 advise the patient to consult an appropriate health care practitioner.
27 (e) Nothing in this subdivision shall prevent a pharmacist from refus-
28 ing to dispense a non-patient specific order of abortion medication
29 pursuant to this subdivision if, in their professional judgment, poten-
30 tial adverse effects, interactions or other therapeutic complications
31 could endanger the health of the patient.
32 § 5. Section 6902 of the education law is amended by adding a new
33 subdivision 4 to read as follows:
34 4. (a) A registered professional nurse may execute a non-patient
35 specific order for the dispensing of abortion medication, as defined in
36 section sixty-eight hundred two of this title, prescribed or ordered by
37 the commissioner of health, a licensed midwife, a physician licensed in
38 this state, or a nurse practitioner certified in this state pursuant to
39 rules and regulations promulgated by the commissioner.
40 (b) Prior to dispensing abortion medication to a patient, a registered
41 professional nurse shall:
42 (i) provide the patient with a self-screening risk assessment ques-
43 tionnaire, developed by the commissioner of health in consultation with
44 the commissioner, to be reviewed by the registered professional nurse to
45 identify any known risk factors; and
46 (ii) provide the patient with a fact sheet, developed by the commis-
47 sioner of health that includes but is not limited to, the clinical
48 considerations and recommendations for use of abortion medication, the
49 appropriate method for using abortion medication, information on the
50 importance of follow-up health care, health care referral information,
51 and the ability of the patient to opt out of practitioner reporting
52 requirements.
53 (c) No registered professional nurse shall dispense abortion medica-
54 tion under this subdivision without receiving training satisfactory to
55 the commissioner.
A. 6835 3
1 (d) A registered professional nurse shall notify the patient's primary
2 health care practitioner, unless the patient opts out of such notifica-
3 tion, within seventy-two hours of dispensing abortion medication, that
4 such medication has been dispensed. If the patient does not have a
5 primary health care practitioner or is unable to provide contact infor-
6 mation for their primary health care practitioner, the registered
7 professional nurse shall provide the patient with a written record of
8 the abortion medication dispensed, and advise the patient to consult an
9 appropriate health care practitioner.
10 (e) Nothing in this subdivision shall prevent a registered profes-
11 sional nurse from refusing to dispense a non-patient specific order of
12 abortion medication pursuant to this subdivision if, in their profes-
13 sional judgment, potential adverse effects, interactions or other thera-
14 peutic complications could endanger the health of the patient.
15 § 6. Section 6909 of the education law is amended by adding a new
16 subdivision 11 to read as follows:
17 11. A certified nurse practitioner may prescribe and order a non-pa-
18 tient specific order to a registered professional nurse or pharmacist
19 licensed and located in this state, pursuant to regulations promulgated
20 by the commissioner, and consistent with sections sixty-eight hundred
21 one and sixty-nine hundred two of this title, for dispensing abortion
22 medication as defined in section sixty-eight hundred two of this title.
23 § 7. Section 6951 of the education law is amended by adding a new
24 subdivision 4 to read as follows:
25 4. A licensed midwife may prescribe and order a non-patient specific
26 order to a registered professional nurse or pharmacist licensed and
27 located in this state, pursuant to regulations promulgated by the
28 commissioner and consistent with section sixty-eight hundred one and
29 section sixty-nine hundred two of this title, for dispensing abortion
30 medication as defined in section sixty-eight hundred two of this title.
31 § 8. Section 3216 of the insurance law is amended by adding a new
32 subsection (n) to read as follows:
33 (n) Any policy under this article that covers contraception when
34 provided pursuant to a prescription shall cover abortion medication as
35 defined in subdivision twenty-nine of section sixty-eight hundred two of
36 the education law, when provided pursuant to an ordinary prescription or
37 order under section sixty-eight hundred one or sixty-nine hundred two of
38 the education law and when lawfully provided other than through a
39 prescription or order.
40 § 9. Section 3221 of the insurance law is amended by adding a new
41 subsection (u) to read as follows:
42 (u) Any policy under this article that covers contraception when
43 provided pursuant to a prescription, shall cover abortion medication as
44 defined in subdivision twenty-nine of section sixty-eight hundred two of
45 the education law, when provided pursuant to an ordinary prescription or
46 order under section sixty-eight hundred one or sixty-nine hundred two of
47 the education law and when lawfully provided other than through a
48 prescription or order.
49 § 10. Section 4303 of the insurance law is amended by adding a new
50 subsection (vv) to read as follows:
51 (vv) Any policy under this article that covers contraception when
52 provided pursuant to a prescription, shall cover abortion medication as
53 defined in subdivision twenty-nine of section sixty-eight hundred two of
54 the education law, when provided pursuant to an ordinary prescription or
55 order under section sixty-eight hundred one or sixty-nine hundred two of
A. 6835 4
1 the education law and when lawfully provided other than through a
2 prescription or order.
3 § 11. This act shall take effect eighteen months after it shall have
4 become a law; provided, however, that sections eight, nine and ten of
5 this act shall apply to policies and contracts issued, renewed, modi-
6 fied, altered or amended on or after such effective date. Effective
7 immediately, the addition, amendment and/or repeal of any rule or regu-
8 lation necessary for the implementation of this act on its effective
9 date are authorized to be made and completed on or before such effective
10 date.
