23 Miss. Code. R. 202-5.3 - Sterilization
A. The Division of Medicaid covers
sterilization procedures in an inpatient or outpatient hospital setting in
accordance with current standards of medical practice for beneficiaries who:
1. Are male or female,
2. Are non-institutionalized,
3. Are twenty-one (21) years of age or older
at the time of consent, and
4. Are
mentally competent, able to understand the nature and consequences of the
procedure, knowingly and voluntarily request the procedure, and give informed
consent to be sterilized.
B. The informed consent form for
sterilization:
1. Must be accurate and
complete with all required signatures,
2. Must be voluntarily and knowingly signed
by the beneficiary,
3. Must be
signed by the beneficiary, defined as the individual to be sterilized and not
the personal or legal representative,
4. Is valid for one hundred eighty (180) days
from the date it is signed by the beneficiary, and
5. Must comply with 42 CFR § 441 et
al.
C. At least
thirty (30) days but not more than one hundred eighty (180) days must have
passed between the date of the beneficiary signature on the informed consent
form and the date the sterilization will be performed except in the case of
premature delivery or emergency abdominal surgery.
1. In the case of premature delivery, defined
as a delivery prior to the expected due date, informed consent must have been
given at least thirty (30) days before the expected date of delivery.
2. A beneficiary may be sterilized at the
time of premature delivery or emergency abdominal surgery if at least
seventy-two (72) hours have passed since signing the informed consent form for
the sterilization. A Caesarean delivery is not routinely considered emergency
abdominal surgery.
3. The physician
must justify and describe the circumstance for any premature delivery or
emergency abdominal surgery and document the expected date of delivery for
premature deliveries in the medical record and further certify that at least
thirty (30) days have passed between the date of the beneficiary's signature on
the informed consent form and the date the sterilization was
performed.
D. The
Division of Medicaid covers a subsequent sterilization that is due to a
previously failed sterilization. Documentation in the beneficiary's medical
record must reflect the date of the first sterilization and the reason for the
procedure failure.
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No prior version found.