Statewide standing order
This standing order is issued by the Massachusetts Department of Public Health, which permits pharmacists to dispense emergency contraception pills to prevent pregnancy after unprotected sex or sexual assault. These include ulipristal acetate (UPA or ella®) and levonorgestrel (LNG, Plan B One-Step®, or generic versions).
Review the Emergency Contraception Statewide Standing Order (PDF) | (DOCX)
Reporting requirement
Any EC dispensed pursuant to the standing order within a calendar year (January 1 – December 31) must be reported using the Annual Emergency Contraception Standing Order Report. Send an email to pharmacy.dph-ec@mass.gov to request the link for the report.
Frequently asked questions
What training is necessary for a pharmacist to dispense EC under the statewide standing order?
No additional training is required. If a pharmacist desires additional training on dispensing EC under the statewide standing order and learn more about Massachusetts provisions of 2017 An Act Relative to Advancing Contraceptive Coverage and Economic Security in our State (ACCESS Law), The MGH Institute of Health Professions offers an ACPE accredited 2.5 contact hours synchronous training.
Review the following link for additional information: Fulfilling the Promise of ACCESS: Ensuring Contraceptive Equity for Massachusetts Patients
Is a pharmacist required to dispense EC to a pharmacy customer who does not have a prescription?
No. Dispensing under this standing order is voluntary.
Must all pharmacists who practice at a certain pharmacy location dispense EC under the standing order?
No. The state law on emergency contraception does not require all pharmacists employed at a particular location to dispense under the standing order. Conditions of employment and scheduling of shifts of pharmacists who opt to prescribe under the standing order are matters left to the management prerogative of the employer.
Is it necessary for minors (persons under age 18) to obtain parental consent to obtain EC?
No. Chapter 127 of the Acts of 2022 does not mandate parental consent.
How should the pharmacist dispense EC pursuant to the standing order?
The pharmacist must generate a patient-specific prescription, fill, and label as with any other prescription.
Can a pharmacist provide anti-nausea medication to a person who requests EC?
Yes. A pharmacist may dispense one of the antiemetics specified in the standing order in the same manner as EC.
Can the pharmacist provide a second dose of EC to a person who vomits their dose within 2 - 3 hours of taking it?
Yes, as described in the standing order.
Can the pharmacist dispense an advance supply of EC with instructions for future use?
Yes, as described in the standing order.
Will MassHealth (Medicaid) or private insurance pay for EC under the standing order? Will insurance also pay if the request is for future EC use, before they need to take it?
- The standing order does not address matters related to insurance coverage and benefits.
- Currently, MassHealth (Medicaid) provides coverage for EC. For questions regarding MassHealth coverage and benefits and applicable co-payments for prescription medications, call MassHealth Customer Service Center: (800) 841-2900 (TTY: (800) 497-4648 for people with partial or total hearing loss).
- Questions regarding private insurance products, coverage, and benefits should be addressed to the patient’s health insurance plan.
Can pharmacists charge a counseling or assessment fee?
Chapter 127 of the Acts of 2022 neither authorizes nor prohibits a counseling or assessment fee.
Can a prescriber still issue prescriptions now that EC medications are available via the standing order?
Yes. Prescribers may continue to issue prescriptions for EC medications. Patients may also continue to purchase EC as available over-the-counter if they prefer.
Can a pharmacist dispense EC under the standing order to a person who requests EC for someone other than themselves?
No. A pharmacist must assess the patient either in-person or over the phone before dispensing. A person may purchase EC as available over the counter for someone other than themselves.
What should a pharmacist do if a pharmacy customer discloses that the need for EC results from sexual assault?
After dispensing EC pursuant to the standing order, provide appropriate referrals for people who disclose sexual assault to a local rape crisis center and/or hospital emergency department for care and treatment.
- Search here for the nearest Rape Crisis Center
- For nearest DPH-designated hospital emergency room that uses DPH-certified Sexual Assault Nurse Examiners to collect forensic evidence, see the Sexual Assault Nurse Examiner (SANE) page
Who in the Department of Public Health handles questions regarding access to EC?
- Public/Consumers:
- Pharmacists/Pharmacies: