Revision 19-0; Effective July 1, 2019

 

 

To facilitate immediate client access to, and compliance with, contraceptive methods and related medications, contractors must be capable of providing limited pharmaceutical services (including contraceptive methods and related medications) to family planning clients at each clinic site that is funded by the HHSC FPP.

Contractors are required to have at least a Class D pharmacy on-site at each HHSC Title X clinic, have applied for a Class D pharmacy license through the Texas Pharmacy Licensing Board or have obtained approval for a Class D Pharmacy exemption from HHSC. HHSC staff will verify the license application date and status prior to reviewing a contractor’s exemption request.

It is the contractor’s responsibility to ensure that all contraceptive methods and related medications approved for reimbursement by the FPP are made available at no additional charge to the individual.

Pharmacies must be operated in accordance with federal and state laws relating to security and record keeping for drugs and devices. The inventory, supply and provision of pharmaceuticals must be conducted in accordance with state pharmacy laws and professional practice regulations. It is essential that each facility maintain an adequate supply and variety of drugs and devices on-site to effectively manage the contraceptive needs of its patients.

Class D Pharmacy Exemption

If extenuating circumstances prohibit a license from being granted, or if having an exemption would facilitate client access to contraceptive methods and related medications, a contractor may request an exemption to the requirement to have an on-site pharmacy.

A request for an exemption must be made in writing to the HHSC FPP and will be considered on a case-by-case basis. A request for an exemption is the first step in the process and must:

  • describe the process through which a person obtains medication from the referral pharmacy/pharmacies; and
  • include justification wherein referring individuals to an off-site pharmacy benefits the agency and/or individuals.

The following criteria must be met to potentially qualify for an exemption:

  • A signed and fully executed memorandum of understanding (MoU) with referral pharmacy/pharmacies, which includes the purpose of cooperation and details coordination between the contractors and the referral pharmacy/pharmacies to provide the following medications:
    • non-clinician administered hormonal contraceptive methods [oral contraceptives, transdermal hormonal contraceptives (patch) and vaginal hormonal contraceptives (ring)]; and
    • anti-infectives for the treatment of STIs and other infections.
  • The agreement made with referral pharmacy/pharmacies must not create barriers to the individual receiving the prescribed medication.
  • The referral pharmacy/pharmacies is/are located within a reasonable distance to participating clients.
  • Clients do not incur additional costs (such as a co-payment) to obtain medications.
  • The contractor has a written policy that ensures clients can obtain prescribed medication refills from the cooperating pharmacy/pharmacies without an additional clinic visit (unless medically indicated or necessary).

An exemption request will be reviewed by FPP staff and, depending on the justification and circumstances specific to each clinic site, may or may not be granted. The FPP reserves the right to approve or disapprove an exemption request based upon the merit of the justification.

The pharmacy exemption process is not complete until the contractor receives either an approval or a denial from the program.

A pharmacy exemption does not exclude a contractor from providing the following contraceptive methods on-site:

  • Injectable hormonal contraceptives;
  • Barrier methods and spermicides; and
  • Counseling and education on sexual abstinence.