Section 16.03.09.682 - FAMILY PLANNING SERVICES: COVERAGE AND LIMITATIONSFamily planning includes counseling and medical services prescribed or performed by an independent licensed physician, or a qualified certified nurse practitioner or physician's assistant. Specific items covered are diagnosis, treatment, contraceptive supplies, related counseling, and restricted sterilization.
01.Contraceptive Supplies.a. Contraceptive supplies include condoms, foams, creams and jellies, prescription diaphragms, intrauterine devices, or oral contraceptives.b. Contraceptives requiring a prescription are payable subject to Section 662 of these rules.c. Payment for oral contraceptives is limited to purchase of a three (3) month supply.02.Sterilization. a. No sterilizations for individuals institutionalized in correctional facilities, mental hospitals, or other rehabilitative facilities are eligible for payment unless such sterilizations are ordered by a court of law.b. Hysterectomies performed solely for sterilization purposes are not eligible for payment (see Subsection 681.02 of these rules for those conditions under which a hysterectomy can be eligible for payment).c. All requirements of state or local law for obtaining consent, except for spousal consent, must be followed.d. Suitable arrangements must be made to insure that information as specified in Subsection 681.01 of these rules is effectively communicated to any individual to be sterilized who is blind, deaf, or otherwise disabled.03.Exceptions to Sterilization Time Requirements. If premature delivery occurs or emergency abdominal surgery is required, the physician must certify that the sterilization was performed because of the premature delivery or emergency abdominal surgery less than thirty (30) days, but no less than seventy-two (72) hours after the date of the participant's signature on the consent form; and a. In the case of premature delivery, the physician must also state the expected date of delivery and describe the emergency in detail; andb. Describe, in writing to the Department, the nature of any emergency necessitating emergency abdominal surgery; andc. Under no circumstance can the period between consent and sterilization exceed one hundred eighty (180) days.04.Requirements for Sterilization Performed Due to a Court Order. When a sterilization is performed after a court order is issued, the physician performing the sterilization must have been provided with a copy of the court order prior to the performance of the sterilization. In addition they must: a. Certify, by signing a properly completed "Consent Form" HW 0034, or its equivalent, and submitting the consent form with their claim, that all requirements have been met concerning sterilizations; andb. Submit to the Department a copy of the court order together with the "Consent Form" and claim.Idaho Admin. Code r. 16.03.09.682