- Training
- Mandated Fact Sheet
- Statewide Protocol and Collaborative Protocols
- EC Pharmacy Registration
- Record-keeping
- Assessment Fee
- Billing
- HMO Coverage & Reimbursement for EC Consultation Services
- FAQs
In California, a law effective January 1, 2002, allows pharmacists to provide Emergency Contraception (EC) to women directly, without them first having to get a prescription from a doctor or clinic. Following the FDA decision to make Plan B EC available without a prescription for consumers 18 and older, all women, including teens and women without proof of age, will still be able to obtain EC directly from specially trained pharmacists (in the states that allow pharmacy access to EC). Click here for more information on the FDA decision.
Pharmacists must complete a minimum of 1 hour of approved continuing education on emergency contraception drug therapy. Click here to find out about training opportunities.
Pharmacists must provide each recipient of EC with a standardized “Fact Sheet” that has been approved by the CA State Board of Pharmacy. Click here to view and print these fact sheets, available in 11 different languages.
Statewide Protocol and Collaborative Protocols
Pharmacists must obtain a protocol in California to initiate emergency contraception drug therapy. The CA State Pharmacy and Medical Boards have approved a statewide protocol. Pharmacists may download a copy of the protocol from www.pharmacy.ca.gov/licensing/ec_protocol.pdf and, provided they have had a minimum of 1-hour of continuing education in EC training, use this protocol to furnish EC directly to the public. Pharmacists may continue to develop or maintain individual physician signed protocols. Click here to view a sample collaborative protocol.
Pharmacists have the opportunity to list their EC Pharmacy Program on our consumer EC web site and hotline so women in the community know which pharmacies they can go to get EC directly. Download the registration form (PDF-168K) and fax to (510) 272-0285. Once signed on, you will also receive a FREE starter kit of promotional materials!
Under the California Pharmacy Practice Act (Section 1701.1, Pharmacy Profiles, a provision of the Act), pharmacists are required to keep information on allergies, other medications, indications for drug therapy and whatever other information is deemed necessary by the pharmacist. Pharmacy Access Partnership has developed several documents to help aid pharmacists with record keeping. Click here to view and download these documents.
By a law effective January 1, 2004, pharmacists were limited to a $10 fee that could be added to the cost of the EC drug dispensed. In addition, California law requires that upon patient request, the pharmacist or his/her employee must provide the total amount the patient would have to pay to get EC. This cost must be inclusive of the product price and any additional fee. Upon the August 24, 2006 FDA decision to make Plan B EC available OTC for consumers ages 18 and over, the $10 limit for the consultation fee for Plan B sold as a prescription product is no longer applicable.
- Pharmacists using a collaborative protocol with a physician can use the collaborating physician’s DEA number to bill insurance for EC (this includes private insurance, Family PACT, and Medi-Cal).
- The pharmacists name and collaborating physician’s name should both go on the prescription label.
- The statewide protocol currently does NOT have a Physician DEA number to bill insurance for EC.
- To initiate a collaborative protocol, to download the statewide protocol or to obtain a copy of an existing protocol, visit EC Protocols or call 510-272-0150.
Billing Family PACT & Medi-Cal
Health care coverage for qualifying low-income California residents.
Family PACT
Pharmacists participating in the Family PACT program can charge Family PACT for the cost of EC pills. Family PACT covers Plan B up to three times a year; not more than once per a month.
Medi-Cal
Effective August 1, 2005, Plan B is now on the Medi-Cal list of contract drugs (PDF-64K). Medi-Cal covers Plan B up to six times in a 12-month period.
HMO Coverage & Reimbursement for EC Consultation Services
Per Department of Managed Health Care in California, HMOs must cover emergency contraception when dispensed by a contracting pharmacist. In addition, HMOs are required to cover emergency contraception, even when obtained from a non-contracted provider, in the event of a medical emergency. Download the Department of Managed Health Care Letter (PDF-112K)
Both FamilyPACT and Medi-Cal cover the cost of the Plan B product (PDF-64K).
Both San Francisco Health Plan (SFHP) and Blue Cross of California (PDF-104K) network pharmacists can get reimbursed for EC consultation services
- For San Francisco Health Plan (SFHP) network pharmacists call SFHP at 415-547-7818 for the reimbursement form.
- For Blue Cross of California network pharmacists, obtain the reimbursement form here (PDF-92K).
To help answer any questions you might have as an EC Pharmacy Provider, please refer to Frequently Asked Questions (FAQs) and Answers. Click here to view. If you do not see your questions answered please contact us.