Idaho Admin. Code r. 16.03.09.682, Family Planning Services: Coverage and Limitations

Identifies the family planning treatments, supplies, and services covered by Medicaid and places limits on such coverage. Prohibits reimbursement for sterilizations of participants that reside in a correctional facility, rehabilitative facility, or mental hospital unless a court orders the procedure. Clarifies that providers, when performing a sterilization procedure, must comply with state and local laws regarding patient consent except for those regarding spousal consent. Requires providers to make sure that informed consent information is properly conveyed to participants with disabilities. Permits providers to receive Medicaid reimbursement for sterilizations that were performed due to a medical emergency if the provider obtains the participant’s informed consent between 72 hours and 30 days before the procedure and submits documentation to the Department of Health and Welfare justifying the emergency procedure. Requires providers that perform sterilizations pursuant to a court order to obtain a copy of the order before the procedure and to submit the court order and a signed Department issued consent form to the Department alongside their claim.