Legislative Analysis
Phone: (517) 373-8080
PHARMACIST PRESCRIPTION OF CONTRACEPTIVES
http://www.house.mi.gov/hfa
House Bill 5435 (H-1) as passed by the House
Analysis available at
Sponsor: Rep. Stephanie A. Young http://www.legislature.mi.gov
House Bill 5436 (H-3) as passed by the House
Sponsor: Rep. Kara Hope
Committee: Health Policy
Complete to 11-14-24
SUMMARY:
House Bills 5435 and 5436 would amend the Insurance Code and the Public Health Code,
respectively, to add provisions related to the prescription of certain contraceptives by a
pharmacist. House Bill 5436 would authorize pharmacists to prescribe and dispense certain
hormonal and emergency contraceptives, and House Bill 5435 would require health insurance
policies to cover prescriptions for those hormonal (but not emergency) contraceptives at in-
network pharmacies. House Bill 5435 would take effect December 31, 2025. Neither bill could
take effect unless both were enacted.
House Bill 5436 would authorize a pharmacist to issue a prescription for a hormonal
contraceptive patch, self-administered hormonal contraceptive, emergency contraceptive, or
vaginal ring hormonal contraceptive to an individual. This authorization would be subject to
the rules developed and issued by the Department of Licensing and Regulation (LARA) as
described below. The pharmacist could prescribe the contraceptive regardless of the
individual’s age and regardless of whether they have evidence of a previous prescription from
a prescriber for a contraceptive described above.
Hormonal contraceptive patch would mean a transdermal patch applied to the skin of
an individual that releases a drug composed of a combination of hormones that is
approved by the Food and Drug Administration (FDA) to prevent pregnancy.
Self-administered hormonal contraceptive would mean a drug composed of a single
hormone or combination of hormones that is approved by the FDA to prevent
pregnancy and that the individual the drug is prescribed to may take orally, inject, or
otherwise self-administer.
Emergency contraceptive would mean a drug approved by the FDA to prevent
pregnancy as soon as possible following unprotected sexual intercourse or a known or
suspected contraceptive failure.
A pharmacist also could dispense a contraceptive pursuant to a prescription issued under the
above provisions.
Rules and self-screening risk assessment
The bill would require LARA, in consultation with the Michigan Board of Pharmacy, to
develop and issue rules to implement the bill. The rules would have to be issued by 18 months
after the bill’s effective date. The rules would have to establish a standard procedure for issuing
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 a prescription for a contraceptive as described above, including prohibiting a pharmacist from
issuing a prescription for a contraceptive as described above to an individual who has not
completed the self-screening risk assessment tool described below. The rules also would have
to require that a pharmacist comply with all of the following:
• Complete a training program approved by the board for issuing a prescription as
described above.
• Before issuing a prescription as described above, provide the self-screening risk
assessment tool described below to the individual and obtain a completed risk
assessment from them.
• Upon issuing a prescription and dispensing the contraceptive, refer the individual to
their primary care physician or, if they do not have a primary care physician, to another
licensed health professional that the pharmacist considers appropriate.
• Provide the individual with a written record of the prescribed contraceptive and advise
them to consult with a physician or other licensed health professional.
• After issuing a prescription, refer the individual to their primary care provider for a
physical examination if they have not had a physical exam in the previous 12 months.
• Dispense the contraceptive as soon as practicable after issuing the prescription, or
transmit the prescription to another pharmacy of the individual’s choice if authorized
by these rules.
LARA, by rule and in consultation with the Michigan Board of Pharmacy, would have to
develop a self-screening risk assessment tool to be used by an individual who is seeking a
prescription under these provisions.
Other amendments
The bill would amend the code’s definition of the practice of pharmacy to include issuing
prescriptions for hormonal contraceptive patches, self-administered hormonal contraceptives,
emergency contraceptives, and vaginal ring hormonal contraceptives under the bill. The bill
also would define an order issued by a pharmacist to dispense any of those contraceptives as a
prescription for purposes of Part 177 (Pharmacy Practice and Drug Control) of the code.
The code now prohibits a pharmacist from knowingly dispensing a drug or device under a
prescription if either the prescriber or the patient has died. The bill would remove the
prohibition against dispensing under a prescription when the prescriber has died.
Finally, the code requires a receipt to be provided for the purchase of a prescription drug that,
in addition to other required information, includes the name of the prescriber. The bill would
require the receipt to include the name of the pharmacist issuing the prescription in the case of
prescriptions issued under the bill.
MCL 333.17703 et seq. and proposed MCL 333.17744g
House Bill 5435 would require an insurer that delivers, issues for delivery, or renews in
Michigan a health insurance policy that provides coverage for prescription drugs to provide
coverage for a hormonal contraception patch, self-administered hormonal contraception, or
vaginal ring hormonal contraceptive that is covered under an insured’s health insurance policy
and is prescribed and dispensed by a pharmacist as provided in House Bill 5436, at a pharmacy
in the insurer’s network. (This would be in addition to any other coverage requirements under
House Fiscal Agency HBs 5435 (H-1) and 5436 (H-3) as passed by the House Page 2 of 3
 state or federal law.) In addition, an insurer described above would have to provide coverage
for consultation.
Coverage required under the bill would have to be consistent with coverage of other
prescription drugs under the insured’s health insurance policy.
Proposed MCL 500.3406tt
FISCAL IMPACT:
House Bill 5435 would not have a fiscal impact on the state or on local units of government.
House Bill 5436 would have a minimal fiscal impact on the Department of Licensing and
Regulatory Affairs. LARA would be required to promulgate rules and may incur administrative
costs under the bill, but these costs would likely be nominal.
POSITIONS:
Representatives of the following entities testified in support of the bills (3-5-24):
• Michigan Pharmacists Association
• Planned Parenthood of Michigan
• East Lansing Free Emergency Contraceptives
The following entities indicated support for the bills:
• ACLU of Michigan (3-5-24)
• American Association of University Women of Michigan (4-18-24)
• American College of Obstetricians and Gynecologists (4-18-24)
• Authority Health (4-18-24)
• Michigan Academy of Family Physicians (3-5-24)
• Michigan Affiliate of the American Collee of Nurse-Midwives (3-5-24)
• Michigan Council for Maternal and Child Health (3-5-24)
• Michigan Nurses Association (4-18-24)
• Michigan Retailers Association (3-5-24)
• Michigan State Medical Society (4-18-24)
• Michigan Unitarian Universalist Social Justice Network (4-18-24)
• Planned Parenthood Advocates of Michigan (3-5-24)
• YWCA Kalamazoo (4-18-24)
The Pharmaceutical Care management Association indicated support for HB 5435. (3-5-24)
The Michigan Association of Health Plans indicated opposition to HB 5435. (3-5-24)
Legislative Analyst: Rick Yuille
Fiscal Analyst: Marcus Coffin
■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their
deliberations and does not constitute an official statement of legislative intent.
House Fiscal Agency HBs 5435 (H-1) and 5436 (H-3) as passed by the House Page 3 of 3


Statutes affected:
Substitute (H-1): 500.100, 500.8302
House Introduced Bill: 500.100, 500.8302
As Passed by the House: 500.100, 500.8302
As Passed by the Senate: 500.100, 500.8302
House Concurred Bill: 500.100, 500.8302