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MISSISSIPPI LEGISLATURE REGULAR SESSION 2013 By: Senator(s) Hill, Gandy, Hudson, Smith, AN ACT TO CREATE WOMEN'S HEALTH DEFENSE ACT OF 2013; TO 2 DECLARE CERTAIN FINDINGS OF THE LEGISLATURE; TO MAKE IT UNLAWFUL 3 TO KNOWINGLY PROVIDE OR PRESCRIBE ANY ABORTION-INDUCING DRUG TO A 4 PREGNANT WOMAN FOR THE PURPOSE OF INDUCING AN ABORTION IN THAT 5 PREGNANT WOMAN UNLESS THE PERSON WHO PROVIDES OR PRESCRIBES THE 6 ABORTION-INDUCING DRUG IS A PHYSICIAN, AND THE PROVISION OR 7 PRESCRIPTION OF THE ABORTION-INDUCING DRUG SATISFIES THE PROTOCOL 8 TESTED AND AUTHORIZED BY THE FDA AND AS OUTLINED IN THE DRUG LABEL 9 FOR THE ABORTION-INDUCING DRUG; TO REQUIRE THE PHYSICIAN 10 PROVIDING OR PRESCRIBING ANY ABORTION-INDUCING DRUG TO SCHEDULE A 11 FOLLOW-UP VISIT FOR THE WOMAN AT APPROXIMATELY 14 DAYS AFTER 12 ADMINISTRATION OF THE ABORTION-INDUCING DRUG TO CONFIRM THAT THE 13 PREGNANCY IS COMPLETELY TERMINATED AND TO ASSESS THE DEGREE OF 14 BLEEDING; TO REQUIRE PHYSICIANS WHO PROVIDE AN ABORTION-INDUCING 15 DRUG TO ANOTHER FOR THE PURPOSE OF INDUCING AN ABORTION TO REPORT 16 THOSE ACTIONS TO THE STATE DEPARTMENT OF HEALTH, AND TO REPORT 17 ADVERSE EVENTS FROM THE USE OF THE ABORTION-INDUCING DRUG TO THE 18 FDA AND TO THE STATE BOARD OF MEDICAL LICENSURE; TO PROVIDE THAT A 19 PERSON WHO INTENTIONALLY, KNOWINGLY OR RECKLESSLY VIOLATES ANY 20 PROVISION OF THIS ACT IS GUILTY OF A MISDEMEANOR; TO PROVIDE THAT 21 FAILURE TO COMPLY WITH THE REQUIREMENTS OF THIS ACT SHALL PROVIDE 22 A BASIS FOR A CIVIL MALPRACTICE ACTION FOR ACTUAL AND PUNITIVE 23 DAMAGES, PROVIDE A BASIS FOR A PROFESSIONAL DISCIPLINARY ACTION 24 AGAINST A PHYSICIAN, AND PROVIDE A BASIS FOR RECOVERY FOR THE 25 WOMAN'S SURVIVORS FOR THE WRONGFUL DEATH OF THE WOMAN; TO AMEND 26 SECTION 73-25-29, MISSISSIPPI CODE OF 1972, TO CONFORM TO THE 27 PRECEDING PROVISIONS; AND FOR RELATED PURPOSES. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: SECTION 1. This act may be known and cited as the "Women's
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SECTION 2. (1) The Legislature finds that:
(a) The Food and Drug Administration (FDA) approved the 33 drug mifepristone, a first-generation [selective] progesterone 34 receptor modulator ([S]PRM), as an abortion-inducing drug with a 35 specific gestation, dosage and administration protocol. (b) As approved by the FDA, and as outlined in the drug 37 label, an abortion by mifepristone consists of three (3) two 38 hundred (200) milligrams tablets of mifepristone taken orally, 39 followed by two (2) two hundred (200) micrograms tablets of 40 misopristol taken orally, through forty-nine (49) days LMP (a 41 gestational measurement using the first day of the woman's "last 42 menstrual period" as a marker). The patient is to return for a 43 follow-up visit in order to confirm that a complete termination of 44 pregnancy has occurred. This FDA-approved protocol is referred to (c) The aforementioned treatment requires three (3) 47 office visits by the patient, and the dosages may only be 48 administered in a clinic, medical office or hospital and under (d) The Mifeprex final printed labeling (FPL) outlines 51 the FDA-approved dosage and administration of both drugs in the 52 Mifeprex regimen, namely mifepristone and misoprostol. (e) Court testimony by Planned Parenthood and other 54 physicians demonstrates that physicians routinely fail to follow ~ OFFICIAL ~
55 the Mifeprex regimen as approved by the FDA, and as outlined in (f) Specifically, Planned Parenthood and other 58 physicians are administering a single oral dose of two hundred 59 (200) milligrams of mifepristone, followed by a single vaginal or 60 buccal dose of eight-tenths (0.8) milligrams misoprostol, through 61 sixty-three (63) days LMP, without medical supervision, and (g) The use of mifepristone presents significant 64 medical risks to women, including, but not limited to, abdominal 65 pain, cramping, vomiting, headache, fatigue, uterine hemorrhage, 66 viral infections, pelvic inflammatory disease, severe bacterial (h) Abortion-inducing drugs are associated with an 69 increased risk of complications relative to surgical abortion. 70 The risk of complications increases with increasing gestational 71 age, and, in the instance of mifepristone, with failure to 72 complete the two-step dosage process. (i) In July 2011, the FDA reported two thousand two 74 hundred seven (2,207) adverse events in the United Sates after 75 women used the Mifeprex regimen for the termination of pregnancy. 76 Among those were fourteen (14) deaths, six hundred twelve (612) 77 hospitalizations, three hundred thirty-nine (339) blood 78 transfusions, and two hundred fifty-six (256) infections 79 (including forty-eight (48) "severe infections"). ~ OFFICIAL ~
(j) "Off-label" or so-called "evidence-based" use of 81 the Mifeprex regimen can be deadly. To date, fourteen (14) women 82 have reportedly died after administration of the Mifeprex regimen, 83 with eight (8) deaths attributed to severe bacterial infection. 84 All eight (8) of those women administered the regimen in an 85 "off-label" or "evidence-based" manner advocated by abortion (k) Medical evidence demonstrates that women who 88 utilize abortion-inducing drugs incur more complications than (2) Based on the findings in subsection (1) of this section, (a) Protect women from the dangerous and potentially 93 deadly off-label use of abortion-inducing drugs, such as, but not (b) Ensure that physicians abide by the protocol 96 approved by the FDA for such abortion-inducing drugs, as outlined SECTION 3. As used in this act, the following terms shall
99 have the meanings ascribed herein unless the context indicates (a) "Abortion-inducing drug" means a medicine, drug or 102 any other substance prescribed or dispensed with the intent of 103 terminating the clinically diagnosable pregnancy of a woman, with 104 knowledge that the termination will with reasonable likelihood ~ OFFICIAL ~
105 cause the death of the unborn child. This includes off-label use 106 of drugs known to have abortion-inducing properties, which are 107 prescribed specifically with the intent of causing an abortion, 108 such as misoprostol (Cytotec), and methotrexate. This definition 109 does not apply to drugs that may be known to cause an abortion, 110 but that are prescribed for other medical indications (e.g., 111 chemotherapeutic agents and diagnostic drugs). Use of those drugs 112 to induce abortion is also known as "medical abortion."
(b) "Abortion" means the act of using or prescribing 114 any instrument, medicine, drug or any other substance, device or 115 means with the intent to terminate the clinically diagnosable 116 pregnancy of a woman, with knowledge that the termination by those 117 means will with reasonable likelihood cause the death of the 118 unborn child. That use, prescription or means is not an abortion (i) Save the life or preserve the health of the (ii) Remove a dead unborn child caused by (iv) Treat a maternal disease or illness for which (c) "Department" means the State Department of Health. (d) "Final printed labeling (FPL)" means the 129 FDA-approved informational document for an abortion-inducing drug ~ OFFICIAL ~
130 which outlines the protocol authorized by the FDA and agreed upon 131 by the drug company applying for FDA authorization of that drug. (e) "LMP" or "gestational age" means the time that has 133 elapsed since the first day of the woman's last menstrual period. (f) "Mifeprex regimen" means the abortion-inducing drug 135 regimen that involves administration of mifepristone (brand name 136 "Mifeprex") and misoprostol. It is the only abortion-inducing 137 drug regimen approved by the FDA. It is also known as the "RU-486 138 regimen" or simply "RU-486." (g) "Mifepristone" means the first drug used in the (h) "Misopristol" means the second drug used in the (i) "Physician" means any person licensed to practice 144 medicine in this state. The term includes medical doctors and (j) "Pregnant" or "pregnancy" means that female 147 reproductive condition of having an unborn child in the woman's (k) "Unborn child" means the offspring of human beings SECTION 4. (1) It shall be unlawful to knowingly give,
152 sell, dispense, administer or otherwise provide or prescribe any 153 abortion-inducing drug to a pregnant woman for the purpose of 154 inducing an abortion in that pregnant woman, or enabling another ~ OFFICIAL ~
155 person to induce an abortion in a pregnant woman, unless the 156 person who gives, sells, dispenses, administers or otherwise 157 provides or prescribes the abortion-inducing drug is a physician, 158 and the provision or prescription of the abortion-inducing drug 159 satisfies the protocol authorized by the FDA and as outlined in 160 the Final Printed Labeling (FPL) for the abortion-inducing drug. 161 In the case of the Mifeprex regimen, the Mifeprex label includes 162 the FDA-approved dosage and administration instructions for both 163 mifepristone (Mifeprex) and misoprostol. (2) Because the failure and complications from medical 165 abortion increase with increasing gestational age, because the 166 physical symptoms of medical abortion can be identical to the 167 symptoms of ectopic pregnancy, and because abortion-inducing drugs 168 do not treat ectopic pregnancies but rather are contraindicated in 169 ectopic pregnancies, the physician giving, selling, dispensing, 170 administering or otherwise providing or prescribing the 171 abortion-inducing drug must first examine the woman and document, 172 in the woman's medical chart, gestational age and intrauterine 173 location of the pregnancy before giving, selling, dispensing, 174 administering or otherwise providing or prescribing the (3) Every pregnant woman to whom a physician gives, sells, 177 dispenses, administers or otherwise provides or prescribes any 178 abortion-inducing drug shall be provided with a copy of the drug's ~ OFFICIAL ~
(4) The physician giving, selling, dispensing, administering 181 or otherwise providing or prescribing the abortion-inducing drug 182 must have a signed contract with a physician who agrees to handle 183 complications and be able to produce that signed contract on 184 demand by the patient or by the department. Every pregnant woman 185 to whom a physician gives, sells, dispenses, administers or 186 otherwise provides or prescribes any abortion-inducing drug shall 187 receive the name and phone number of the physician who will be 188 handling emergencies, and the hospital at which any emergencies 189 will be handled. The physician who contracts to handle 190 emergencies must have active admitting privileges and 191 gynecological/surgical privileges at the hospital designated to 192 handle any emergencies associated with the use or ingestion of the (5) The physician giving, selling, dispensing, administering 195 or otherwise providing or prescribing any abortion-inducing drug, 196 or an agent of the physician, must schedule a follow-up visit for 197 the woman at approximately fourteen (14) days after administration 198 of the abortion-inducing drug to confirm that the pregnancy is 199 completely terminated and to assess the degree of bleeding. The 200 physician or agent of the physician shall make all reasonable 201 efforts to ensure that the woman returns for the scheduled 202 appointment. A brief description of the efforts made to comply 203 with this subsection, including the date, time and identification ~ OFFICIAL ~
204 by name of the person making those efforts, shall be included in SECTION 5. (1) If a physician provides an abortion-inducing
207 drug to another for the purpose of inducing an abortion as 208 authorized in Section 4 of this act: (a) The physician shall report that action to the (b) If the physician knows that the woman who uses the 212 abortion-inducing drug for the purpose of inducing an abortion 213 experiences, during or after the use, an adverse event, the 214 physician shall provide a written report of the serious event 215 within three (3) days of the event to the FDA via the Medwatch 216 Reporting System and to the State Board of Medical Licensure, 217 which shall compile and retain all reports it receives under this 218 section. No identifying information of the woman shall be 219 reported to the State Board of Medical Licensure. (2) For the purposes of this section, "adverse event" shall 221 be defined according to the FDA criteria given in the Medwatch SECTION 6. (1) A person who intentionally, knowingly or
224 recklessly violates any provision of this act is guilty of a (2) No criminal penalty may be assessed against the pregnant 227 woman upon whom the drug-induced abortion is performed. ~ OFFICIAL ~
SECTION 7. (1) In addition to any remedies that are
229 available under the statutory laws of this state, failure to 230 comply with the requirements of this act shall: (a) Provide a basis for a civil malpractice action for (b) Provide a basis for a professional disciplinary (c) Provide a basis for recovery for the woman's 236 survivors for the wrongful death of the woman under Section (2) No civil liability may be assessed against the pregnant 239 woman upon whom the drug-induced abortion is performed. (3) When requested, the court shall allow a woman to proceed 241 using solely her initials or a pseudonym and may close any 242 proceedings in the case and enter other protective orders to 243 preserve the privacy of the woman upon whom the drug-induced (4) If judgment is rendered in favor of the plaintiff, the 246 court shall also render judgment for a reasonable attorney's fee 247 in favor of the plaintiff against the defendant. SECTION 8. (1) Nothing in this act shall be construed as
249 creating or recognizing a right to abortion. (2) It is not the intention of this act to make lawful an 251 abortion that is currently unlawful. ~ OFFICIAL ~
SECTION 9. Any provision of this act held to be invalid or
253 unenforceable by its terms, or as applied to any person or 254 circumstance, shall be construed so as to give it the maximum 255 effect permitted by law, unless the holding is one of utter 256 invalidity or unenforceability, in which event the provision shall 257 be deemed severable from this act and shall not affect the 258 remainder of the act or the application of the provision to other 259 persons not similarly situated or to other dissimilar SECTION 10. Section 73-25-29, Mississippi Code of 1972, is
73-25-29. The grounds for the nonissuance, suspension, 264 revocation or restriction of a license or the denial of 265 reinstatement or renewal of a license are: (1) Habitual personal use of narcotic drugs, or any 267 other drug having addiction-forming or addiction-sustaining (2) Habitual use of intoxicating liquors, or any 270 beverage, to an extent which affects professional competency. (3) Administering, dispensing or prescribing any 272 narcotic drug, or any other drug having addiction-forming or 273 addiction-sustaining liability otherwise than in the course of (4) Conviction of violation of any federal or state law 276 regulating the possession, distribution or use of any narcotic ~ OFFICIAL ~
277 drug or any drug considered a controlled substance under state or 278 federal law, a certified copy of the conviction order or judgment 279 rendered by the trial court being prima facie evidence thereof, 280 notwithstanding the pendency of any appeal. (5) Procuring, or attempting to procure, or aiding in, 282 an abortion that is not medically indicated. (6) Conviction of a felony or misdemeanor involving 284 moral turpitude, a certified copy of the conviction order or 285 judgment rendered by the trial court being prima facie evidence 286 thereof, notwithstanding the pendency of any appeal. (7) Obtaining or attempting to obtain a license by (8) Unprofessional conduct, which includes, but is not (a) Practicing medicine under a false or assumed 292 name or impersonating another practitioner, living or dead. (b) Knowingly performing any act which in any way 294 assists an unlicensed person to practice medicine. (c) Making or willfully causing to be made any 296 flamboyant claims concerning the licensee's professional (d) Being guilty of any dishonorable or unethical 299 conduct likely to deceive, defraud or harm the public. (e) Obtaining a fee as personal compensation or 301 gain from a person on fraudulent representation of a disease or ~ OFFICIAL ~
302 injury condition generally considered incurable by competent 303 medical authority in the light of current scientific knowledge and 304 practice can be cured or offering, undertaking, attempting or 305 agreeing to cure or treat the same by a secret method, which he 306 refuses to divulge to the board upon request. (f) Use of any false, fraudulent or forged 308 statement or document, or the use of any fraudulent, deceitful, 309 dishonest or immoral practice in connection with any of the 310 licensing requirements, including the signing in his professional 311 capacity any certificate that is known to be false at the time he (g) Failing to identify a physician's school of 314 practice in all professional uses of his name by use of his earned 315 degree or a description of his school of practice. (9) The refusal of a licensing authority of another 317 state or jurisdiction to issue or renew a license, permit or 318 certificate to practice medicine in that jurisdiction or the 319 revocation, suspension or other restriction imposed on a license, 320 permit or certificate issued by such licensing authority which 321 prevents or restricts practice in that jurisdiction, a certified 322 copy of the disciplinary order or action taken by the other state 323 or jurisdiction being prima facie evidence thereof, 324 notwithstanding the pendency of any appeal. (10) Surrender of a license or authorization to 326 practice medicine in another state or jurisdiction or surrender of ~ OFFICIAL ~
327 membership on any medical staff or in any medical or professional 328 association or society while under disciplinary investigation by 329 any of those authorities or bodies for acts or conduct similar to 330 acts or conduct which would constitute grounds for action as (11) Final sanctions imposed by the United States 333 Department of Health and Human Services, Office of Inspector 334 General or any successor federal agency or office, based upon a 335 finding of incompetency, gross misconduct or failure to meet 336 professionally recognized standards of health care; a certified 337 copy of the notice of final sanction being prima facie evidence 338 thereof. As used in this paragraph, the term "final sanction" 339 means the written notice to a physician from the United States 340 Department of Health and Human Services, Officer of Inspector 341 General or any successor federal agency or office, which (12) Failure to furnish the board, its investigators or 344 representatives information legally requested by the board. (13) Violation of any provision(s) of the Medical 346 Practice Act or the rules and regulations of the board or of any 347 order, stipulation or agreement with the board. (14) Violation(s) of the provisions of Sections 349 41-121-1 through 41-121-9 relating to deceptive advertisement by 350 health care practitioners. This paragraph shall stand repealed on ~ OFFICIAL ~
(15) Failure to comply with the requirements of In addition to the grounds specified above, the board shall 355 be authorized to suspend the license of any licensee for being out 356 of compliance with an order for support, as defined in Section 357 93-11-153. The procedure for suspension of a license for being 358 out of compliance with an order for support, and the procedure for 359 the reissuance or reinstatement of a license suspended for that 360 purpose, and the payment of any fees for the reissuance or 361 reinstatement of a license suspended for that purpose, shall be 362 governed by Section 93-11-157 or 93-11-163, as the case may be. 363 If there is any conflict between any provision of Section 364 93-11-157 or 93-11-163 and any provision of this chapter, the 365 provisions of Section 93-11-157 or 93-11-163, as the case may be, SECTION 11. This act shall take effect and be in force from
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ST: Women's Health Defense Act of 2013; create.

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