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2012 Texas Medicaid Provider Procedures Manual

Gynecological and Reproductive Health and Family Planning Services Handbook : 3. Women’s Health Program (Title XIX Family Planning) : 3.2 WHP Overview : 3.2.1 Guidelines for WHP Family Planning Providers

WHP provides an annual family planning exam, family planning services, and contraception for women who meet the following qualifications:
Does not currently receive full Medicaid benefits including Medicaid for pregnant women, Children’s Health Insurance Program (CHIP), or Medicare Part A or B.
Does not have other insurance that covers family planning services, or has insurance that covers family planning services, but filing a claim on the health insurance would cause physical, emotional or other harm from a spouse, parent, or other person
Women who have received a sterilization procedure, but have not been confirmed to be sterile, may be eligible for sterilization follow-up services.
Family planning services are provided by a physician or under physician direction, not necessarily personal supervision. A physician provides direction for family planning services through written standing delegation orders and medical protocols. The physician is not required to be on the premises for the provision of family planning services by an RN, PA, NP, or CNS. WHP participants may receive services from any provider that participates in the WHP.
Family planning clients must be allowed freedom of choice in the selection of contraceptive methods as medically appropriate. They must also be allowed the freedom to accept or reject services without coercion. All FDA-approved methods of contraception must be made available to the client, either directly or by referral to another provider of contraceptive services. Services must be provided without regard to age, marital status, sex, race, ethnicity, parenthood, handicap, religion, national origin, or contraceptive preference. Only family planning clients, not their parents, spouses, or any other individuals may consent to the provision of family planning services funded by Title XIX.

Texas Medicaid & Healthcare Partnership
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