Current through September 2, 2024
Section 16.03.09.433 - SURGICAL PROCEDURES FOR WEIGHT LOSS: PROCEDURAL REQUIREMENTS01.Medically Necessary. The Department must determine the surgery to be medically necessary, as defined in Section 011 of these rules.02.Prior Authorization. The surgery must be prior authorized by the Department. The Department will consider the guidelines of private and public payors, evidence-based national standards of medical practice, and the medical necessity of each participant's case when determining whether surgical correction of obesity will be prior authorized.Idaho Admin. Code r. 16.03.09.433