,,ii #aafth ,,congress #ast ,session ,s4 #ajhf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,april #i1 #bjai,mr4 ,booker 7for himself1 ,ms4 ,baldwin1 ,mr4 ,murphy1 ,mr4 ,blumenthal1 ,ms4 ,warren1 ,ms4 ,rosen1 ,mr4 ,whitehouse1 ,ms4 ,smith1 ,mrs4 ,shaheen1 ,mr4 ,sanders1 ,mr4 ,kaine1 ,ms4 ,harris1 ,mr4 ,wyden1 ,mr4 ,merkley1 ,mrs4 ,murray1 ,mr4 ,van ,hollen1 ,mrs4 ,gillibrand1 ,mr4 ,markey1 ,mr4 ,brown1 and ,ms4 ,hirono7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to establish certain duties for pharmacies to ensure provision of ,food and ,drug ,administration-approved contraception1 medication related to contraception1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,access to ,birth ,control ,act4 #b4 ,findings ,congress finds as follows3 7#a7 ,family planning is basic health care4 ,access to contraception helps prevent unintended pregnancy and control the timing and spacing of planned births4 7#b7 ,as a result of the enactment of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh71 #fb1hjj1jjj women now have coverage of the full range of ,food and ,drug ,administration-approved contraceptive methods without cost sharing4 7#c7 ,the ,patient ,protection and ,affordable ,care ,act saved women #a1djj1jjj1jjj on birth control pills alone in #bjac4 7#d7 ,nearly #b_/c of women of reproductive age are currently using a contraceptive method4 7#e7 ,although the ,centers for ,disease ,control and ,prevention included family planning in its published list of the ,ten ,great ,public ,health ,achievements in the #bjth ,century1 the ,united ,states still has one of the highest rates of unintended pregnancies among industrialized nations4 7#f7 ,each year1 #b1hjj1jjj pregnancies1 nearly half of all pregnancies1 in the ,united ,states are unintended1 and nearly half of unintended pregnancies end in abortion4 7#g7 ,access to contraceptives at no cost has been found to contribute to significantly lower rates of unintended pregnancy and abortion4 7#h7 ,women who do not use contraception1 women who have gaps in contraception1 and women who use contraception inconsistently or incorrectly account for #ie percent of unintended pregnancies in the ,united ,states4 7#i7 ,prescription contraceptives are used for a range of medical purposes in addition to birth control1 such as regulation of cycles and endometriosis4 7#aj7 ,the ,food and ,drug ,administration has approved emergency contraception as safe and effective in preventing unintended pregnancy and has approved over-the-counter access to some forms of emergency contraception for all individuals1 regardless of age4 ,if taken soon after unprotected sex or primary contraceptive failure1 emergency contraception can significantly reduce a woman's chance of unintended pregnancy4 7#aa7 ,legal contraception is a protected fundamental right in the ,united ,states and should not be impeded by one individual's personal beliefs4 7#ab7 ,reports of pharmacists refusing to fill prescriptions for contraceptives or provide emergency contraception over-the-counter1 including emergency contraceptives1 have surfaced in ,states across the ,nation1 including ,alabama1 ,arizona1 ,california1 the ,district of ,columbia1 ,georgia1 ,illinois1 ,louisiana1 ,massachusetts1 ,michigan1 ,minnesota1 ,missouri1 ,montana1 ,new ,hampshire1 ,new ,mexico1 ,new ,york1 ,north ,carolina1 ,ohio1 ,oklahoma1 ,oregon1 ,rhode ,island1 ,tennessee1 ,texas1 ,washington1 ,west ,virginia1 and ,wisconsin4 #c4 ,duties of pharmacies to ensure provision of ,,fda-approved contraception and medication related to contraception ,part ,b of title ,,ii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bch et seq47 is amended by adding at the end the following3 #bdi4 ,duties of pharmacies to ensure provision of ,,fda-approved contraception and medication related to contraception 7a7 ,in ,general ,subject to subsection 7c71 a pharmacy that receives ,food and ,drug ,administration-approved drugs or devices in interstate commerce shall maintain compliance with the following3 7#a7 ,if a customer requests a contraceptive or a medication related to a contraceptive that is in stock1 the pharmacy shall ensure that the contraceptive or the medication related to a contraceptive is provided to the customer without delay4 7#b7 ,if a customer requests a contraceptive or a medication related to a contraceptive that is not in stock and the pharmacy in the normal course of business stocks contraception or the medication related to contraception1 the pharmacy shall immediately inform the customer that the contraceptive or the medication related to a contraceptive is not in stock and without delay offer the customer the following options3 7,a7 ,if the customer prefers to obtain the contraceptive or the medication related to a contraceptive through a referral or transfer1 the pharmacy shall-- 7i7 locate a pharmacy of the customer's choice or the closest pharmacy confirmed to have the contraceptive or the medication related to a contraceptive in stock2 and 7ii7 refer the customer or transfer the prescription to that pharmacy4 7,b7 ,if the customer prefers for the pharmacy to order the contraceptive or the medication related to a contraceptive1 the pharmacy shall obtain the contraceptive or the medication related to a contraceptive under the pharmacy's standard procedure for expedited ordering of medication and notify the customer when the contraceptive or the medication related to a contraceptive arrives4 7#c7 ,the pharmacy shall ensure that-- 7,a7 it does not operate an environment in which customers are intimidated1 threatened1 or harassed in the delivery of services relating to a request for contraception or a medication related to contraception2 7,b7 its employees do not interfere with or obstruct the delivery of services relating to a request for contraception or a medication related to contraception2 7,c7 its employees do not intentionally misrepresent or deceive customers about the availability of contraception or a medication related to contraception or its mechanism of action2 7,d7 its employees do not breach medical confidentiality with respect to a request for a contraception or a medication related to contraception or threaten to breach such confidentiality2 or 7,e7 its employees do not refuse to return a valid1 lawful prescription for a contraception or a medication related to contraception upon customer request4 7b7 ,contraceptives or medication related to a contraceptive not ordinarily stocked ,nothing in subsection 7a77#b7 shall be construed to require any pharmacy to comply with such subsection if the pharmacy does not ordinarily stock contraceptives or medication related to a contraceptive in the normal course of business4 7c7 ,refusals ,pursuant to ,standard ,pharmacy ,practice ,this section does not prohibit a pharmacy from refusing to provide a contraceptive or a medication related to a contraceptive to a customer in accordance with any of the following3 7#a7 ,if it is unlawful to dispense the contraceptive or the medication related to a contraceptive to the customer without a valid1 lawful prescription and no such prescription is presented4 7#b7 ,if the customer is unable to pay for the contraceptive or the medication related to a contraceptive4 7#c7 ,if the employee of the pharmacy refuses to provide the contraceptive or the medication related to a contraceptive on the basis of a professional clinical judgment4 7d7 ,relation to other laws 7#a7 ,rule of construction ,nothing in this section shall be construed to invalidate or limit rights1 remedies1 procedures1 or legal standards under title ,,vii of the ,civil ,rights ,act of #aifd4 7#b7 ,certain claims ,the ,religious ,freedom ,restoration ,act of #aiic 7#db ,u4,s4,c4 #bjjj;bb et seq47 shall not provide a claim concerning1 or a defense to a claim under1 a covered title1 or provide a basis for challenging the application or enforcement of a covered title4 7e7 ,preemption ,this section does not preempt any provision of ,state law or any professional obligation made applicable by a ,state board or other entity responsible for licensing or discipline of pharmacies or pharmacists1 to the extent that such ,state law or professional obligation provides protections for customers that are greater than the protections provided by this section4 7f7 ,enforcement 7#a7 ,civil penalty ,a pharmacy that violates a requirement of subsection 7a7 is liable to the ,united ,states for a civil penalty in an amount not exceeding #a1jjj per day of violation1 not to exceed #ajj1jjj for all violations adjudicated in a single proceeding4 7#b7 ,private cause of action ,any person aggrieved as a result of a violation of a requirement of subsection 7a7 may1 in any court of competent jurisdiction1 commence a civil action against the pharmacy involved to obtain appropriate relief1 including actual and punitive damages1 injunctive relief1 and a reasonable attorney's fee and cost4 7#c7 ,limitations ,a civil action under paragraph 7#a7 or 7#b7 may not be commenced against a pharmacy after the expiration of the #e-year period beginning on the date on which the pharmacy allegedly engaged in the violation involved4 7g7 ,definitions ,in this section3 7#a7 ,the term contraception or contraceptive means any drug or device approved by the ,food and ,drug ,administration to prevent pregnancy4 7#b7 ,the term employee means a person hired1 by contract or any other form of an agreement1 by a pharmacy4 7#c7 ,the term medication related to contraception or medication related to a contraceptive means any drug or device approved by the ,food and ,drug ,administration that a medical professional determines necessary to use before or in conjunction with contraception or a contraceptive4 7#d7 ,the term pharmacy means an entity that-- 7,a7 is authorized by a ,state to engage in the business of selling prescription drugs at retail2 and 7,b7 employs one or more employees4 7#e7 ,the term product means a ,food and ,drug ,administration-approved drug or device4 7#f7 ,the term professional clinical judgment means the use of professional knowledge and skills to form a clinical judgment1 in accordance with prevailing medical standards4 7#g7 ,the term without delay1 with respect to a pharmacy providing1 providing a referral for1 or ordering contraception or a medication related to contraception1 or transferring the prescription for contraception or a medication related to contraception1 means within the usual and customary timeframe at the pharmacy for providing1 providing a referral for1 or ordering other products1 or transferring the prescription for other products1 respectively4 7h7 ,effective ,date ,this section shall take effect on the #cast day after the date of the enactment of this section1 without regard to whether the ,secretary has issued any guidance or final rule regarding this section4 4