Section 16.03.09.681 - FAMILY PLANNING SERVICES: PARTICIPANT ELIGIBILITY01.Sterilization Procedures -- General Restrictions. The following restrictions govern payment for sterilization procedures for eligible persons. a. No sterilization procedures will be paid on behalf of a participant who is not at least twenty-one (21) years of age at the time they sign the informed consent.b. No sterilization procedures will be paid on behalf of any participant who is twenty-one (21) years of age or over and who is incapable of giving informed consent.c. Each participant must voluntarily sign the properly completed "Consent Form" HW 0034, or its equivalent, in the presence of the person obtaining consent in accordance with Section 683 of these rules.d. Each participant must sign the "Consent Form" at least thirty (30) days but not more than one hundred eighty (180) days, prior to the sterilization procedures. Exceptions to these time requirements are described under Subsection 682.03 of these rules.02.Circumstances Under Which Payment Can be Made for a Hysterectomy. Payment can be made for a hysterectomy only if: a. It is medically necessary. A document must be attached to the claim to substantiate this requirement; andb. There was more than one (1) purpose in performing the hysterectomy, and the hysterectomy would not have been performed for the sole purpose of rendering an individual permanently incapable of reproducing; andc. The participant was advised orally and in writing that sterility would result and that she would no longer be able to bear children; andd. The participant signs and dates an "Authorization for Hysterectomy" form. The form must state "I have been informed orally and in writing that a hysterectomy will render me permanently incapable of reproducing. I was informed of these consequences prior to the surgery being performed."Idaho Admin. Code r. 16.03.09.681