STERILIZATION

Sterilization procedures will be reimbursed by Medicaid only if the following requirements are met:

1. The sterilization must be the result of a voluntary request for such
   services by a recipient legally capable of consenting to such a procedure;
2. The individual is at least twenty-one years old;
3. The individual has not been declared mentally incompetent by any court;
4. The individual is not institutionalized;
5. The individual has had the consent form and the sterilization procedure thoroughly explained;
6. Written consent was obtained at least thirty (30) days, but not more than one hundred eighty (180) days, prior to the date of the sterilization, except for premature delivery or emergency surgery. OAC § 5101:3-21-01 (A)

Informed consent for sterilization of a Medicaid recipient must not be obtained while the individual to be sterilized is in labor or childbirth, seeking an abortion, or under the influence of alcohol or other substances that affect the individual's state of awareness. OAC § 5101:3-21-01 (B)

Medicaid reimbursement cannot be made for hysterectomy procedures when the primary intent of the hysterectomy is for fertility control. OAC § 5101:3-21-01 (C)

Medicaid requires that special consent forms be used for sterilization or hysterectomies performed on Medicaid recipients.

For additional information, contact:
The Ohio Department of Human Services

Medicaid Policy Division
30 East Broad Street
Columbus, Ohio 43266-0423
(614) 466-7987

Informed consent for sterilization of institutionalized mentally retarded individuals can only be given by the individual to be sterilized. ORC § 5123.86 (B)

Informed consent for sterilization of hospitalized mentally ill individuals can only be given by the individual to be sterilized. ORC § 5122.271 (B)

STERILIZATION