5300, Pharmacy

Revision 25-3; Effective Oct. 29, 2025

To facilitate immediate client access to and compliance with contraceptive methods, related medications and drugs for treatment of chronic diseases specified in 5000, Clinical Guidelines, grantees must be capable of providing pharmaceutical services to family planning clients at each clinic site funded by HHSC.

Grantees are required to have at least:

• a Class D pharmacy on-site with an expanded drug formulary to include chronic disease management at each HHSC family planning clinic site,
• applied for a Class D pharmacy license with expanded drug formulary through the Texas Pharmacy Licensing Board or
• obtained approval for a Class D pharmacy exemption from HHSC.

To petition the Texas State Board of Pharmacy to expand formulary, reference Texas Administrative Code (TAC) Title 22, Part 15, Chapter 291, Subchapter E, Section 291.93(e)(D).

Grantees who have a Class A or Class C on-site pharmacy are not required to have a pharmacy exemption. However, grantees are required to notify HHSC of their on-site pharmacy type via email at famplan@hhs.texas.gov.

It is the grantee’s responsibility to make sure all HHSC FPP-covered contraceptive methods and medications approved for reimbursement are made available.

Pharmacies must follow federal and state laws about security and recordkeeping for drugs and devices. The inventory, supply and provision of pharmaceuticals must be conducted per 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 clients.

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, related medications and drugs for treatment of chronic diseases, a grantee may request an exemption to the requirement to have at least a Class D pharmacy.

A request for an exemption must be made to HHSC in writing with Form 1061, Class D Pharmacy License Exemption Request. Requests 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 clients to an off-site pharmacy benefits the agency, clients or both.

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 grantees and the referral pharmacy or pharmacies to provide the following medications:
  • non-clinician administered hormonal contraceptive methods such as:
    • oral contraceptives,
    • transdermal hormonal patch contraceptives, and
    • vaginal hormonal ring contraceptives.
  • medications for treatment of:
    • uncomplicated diabetes,
    • elevated cholesterol,
    • uncomplicated hypertension, and
    • postpartum depression.
  • other medications necessary to treat the health care needs of the family planning client population.
• The agreement made with a 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 added costs, such as a copayment, to obtain medications.
• The grantee has a written policy that makes sure clients can obtain prescribed medication refills from the cooperating pharmacy or pharmacies without an added clinic visit unless post-medically indicated or necessary.

HHSC staff will review an exemption request. Depending on the justification and circumstances specific to each clinic site, HHSC staff may or may not grant the request. HHSC staff reserves the right to approve or deny an exemption request based on the merit of the justification.

The pharmacy exemption process is not complete until the grantee receives written approval or denial from HHSC. Once approved by HHSC, the pharmacy exemption is valid for the life of the grant. Grantees are responsible for notifying HHSC of any changes to clinic’s pharmacy status.

Note: The grantee 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.