5300, Pharmacy

Revision 22-2; Effective April 1, 2022

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 family planning clinic site, 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.

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

Pharmacies must follow federal and state laws relating to security and record keeping for drugs and devices. The inventory, supply and provision of pharmaceuticals must be conducted according to state pharmacy laws and professional practice regulations. It is essential that each facility keep 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 a Class D 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 must:

  • Describe the process through which a person obtains medication from the referral pharmacy or pharmacies; and
  • Demonstrate that referring individuals to an off-site pharmacy benefits the agency and/or individuals.

The following criteria must be met to be considered for an exemption:

  • A signed and fully executed memorandum of understanding (MOU) with referral pharmacy or pharmacies which includes the purpose of cooperation and details coordination between the contractors and the referral pharmacy or pharmacies to provide the following medications:
    • Non-clinician administered hormonal contraceptive methods [oral contraceptives, transdermal hormonal contraceptives (patch) and vaginal hormonal contraceptives (ring)]; and
    • Other medications necessary to treat the health care needs of the family planning patient population. 
  • The agreement made with referral pharmacy or pharmacies must not create barriers to the client receiving the prescribed medication.
  • The referral pharmacy or pharmacies must be within a reasonable distance of 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 or pharmacies without an additional clinic visit (unless medically indicated or necessary).

An exemption request will be reviewed by HHSC FPP staff and, depending on the justification and circumstances specific to each clinic site, may or may not be granted. The HHSC FPP staff 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 in writing from the FPP program.

Note: The contractor must provide the following contraceptive methods and services on-site, regardless of Class D pharmacy exemption status:

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