The department covers the following services under the family planning only program:
(1) One of the following, per client, per year as medically necessary:
(a) One comprehensive family planning preventive medicine visit billable by a TAKE CHARGE
provider only. Under a delayed pelvic protocol, the comprehensive family planning preventive medicine visit may be split into two visits, per client, per year. The comprehensive family planning preventive medicine visit must be:
(I) Provided by one or more of the following TAKE CHARGE
(A) Physician or physician's assistant (PA);
(B) An advanced registered nurse practitioner (ARNP); or
(C) A registered nurse (RN), licensed practical nurse (LPN), a trained and experienced health educator, medical assistant, or certified nursing assistant when used for assisting and augmenting the clinicians listed in subsection (A) and (B) of this section.
(II) Documented in the client's chart with detailed information that allows for a well-informed follow-up visit; or
(b) A gynecological examination, billed by a provider other than a TAKE CHARGE
provider, which may include a cervical and vaginal cancer screening examination, one per year when it is:
(i) Provided according to the current standard of care; and
(ii) Conducted at the time of an office visit with a primary focus and diagnosis of family planning.
(2) An office visit directly related to a family planning problem, when medically necessary.
(3) Food and Drug Administration (FDA) approved prescription contraception methods meeting the requirements of chapter 388-530
WAC, Prescription drugs (outpatient).
(4) Over-the-counter (OTC) family-planning drugs, devices, and drug-related supplies without a prescription when the department determines it necessary for client access and safety (as described in chapter 388-530
WAC, Prescription drugs (outpatient)).
(5) Sterilization procedure that meets the requirements of WAC 388-531-1550
, if it is:
(a) Requested by the client; and
(b) Performed in an appropriate setting for the procedure.
(6) Screening and treatment for sexually transmitted diseases-infections (STD-I), including laboratory test and procedures only when the screening and treatment is:
(a) For chlamydia and gonorrhea as part of the comprehensive family planning preventive medicine visit for women thirteen to twenty-five years of age; or
(b) Performed in conjunction with an office visit that has a primary focus and diagnosis of family planning; and
(c) Medically necessary for the client to safely, effectively, and successfully use, or to continue to use, her chosen contraceptive method.
(7) Education and supplies for FDA-approved contraceptives, natural family planning and abstinence.
[11-14-075, recodified as § 182-532-530, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 74.09.800. 08-11-031, § 388-532-530, filed 5/13/08, effective 6/13/08. Statutory Authority: RCW 74.08.090, 74.09.520, and 74.09.800. 05-24-032, § 388-532-530, filed 11/30/05, effective 12/31/05; 04-05-011, § 388-532-530, filed 2/6/04, effective 3/8/04.]