Reproductive health-care program - report - rules - definitions

(1) As used in this section, unless the context otherwise requires: (a) Repealed. (b) "Eligible individual" means an individual with reproductive capacity, regardless of gender, who would be eligible to enroll in the medical assistance program, as described in section 25.5-4-103 (13), but is not eligible due solely to the individual's immigration status, and who is not eligible for, or declines to enroll in, state medical assistance, as described in section 25.5-2-104. (c) "FDA" means the federal food and drug administration. (d) "Participant" means an eligible individual enrolled in the reproductive health-care program. (e) "Pharmacist" means a licensed pharmacist who has entered into a collaborative pharmacy practice agreement pursuant to section 12-280-602 to prescribe and dispense hormonal contraceptive patches and oral hormonal contraceptives. (f) "Provider" has the same meaning as set forth in section 25.5-4-103 (19)(a). (g) "Reproductive health-care services" means family planning services, as defined in section 25.5-4-412 (2)(b), and family-planning-related services, as defined in section 25.5-4-412 (2)(a). (2) On and after July 1, 2022, the state department shall administer a reproductive health-care program, referred to in this section as the "program", that provides reproductive health-care services to participants. (3) Upon the participant's initial and follow-up visits to the participant's provider, and unless the participant requests a shorter period of time, the program shall comply with the federal centers for disease control and prevention's selected practice recommendations for contraceptive use by ensuring the participant is offered at least a one-year supply of either: (a) The requested contraceptive drug, device, or product or one or more therapeutic equivalents of the requested drug, device, or product, if the therapeutic equivalent is available and approved by the FDA; or (b) An alternative contraceptive drug, device, or product, if a contraceptive drug, device, or product is deemed medically inadvisable by the participant's provider. (4) A participant's choice of a contraceptive drug, device, or product must not be infringed upon and must not require prior authorization, step therapy, or other utilization control techniques for medically appropriate contraceptive drugs, devices, or products approved by the FDA. (5) The state board shall adopt rules as necessary to implement this section, including rules specifying the manner in which eligible individuals will be notified about the program and the manner in which eligible individuals may enroll in the program. (5.5) To the extent practicable, the state department shall ensure that eligible individuals seeking to participate in the program are able to apply for and enroll in the program through their local county office, a state medical assistance program site, an online application, or any other mechanism that is available to applicants for the state medical assistance program. (6) The state department shall provide reproductive health-care services to participants without imposing any cost-sharing requirements. (7) Beginning in state fiscal year 2023-24, the state department shall analyze and report the cost-effectiveness of the program to the public through the annual hearing, pursuant to the "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act", part 2 of article 7 of title 2. At a minimum, the report must include: (a) The total number of eligible individuals; (b) The total number of participants enrolled in the program, disaggregated by race, ethnicity, gender identity, and income level; (c) The cost of providing reproductive health-care services to participants; (d) The participants' preferred method of contraceptive methods; and (e) The cost savings realized due to avoided unintended pregnancies, including avoided hospital costs.