5160-21-03 Medicaid covered reproductive health services: infertility services.

 

 

 

TO BE RESCINDED

 

5160-21-03                  Medicaid   covered   reproductive   health   services:   infertility services.

 

 

 

(A)  Definitions.

 

(1)   For the purposes of this rule, "infertility" means any one of the following:

 

(a)   A woman of childbearing age is unable to get pregnant, after at least one year of trying; or

 

(b)   A man is unable to impregnate a woman, after at least one year of trying.

 

(2)   For the purposes of this rule, "infertility services" means services:

 

(a)     Performed solely for the purpose of enabling an infertile individual capable of reproducing; and

 

(b)   With more than one desired outcome that would not have been performed if not for the fact that the services would of enable an infertile individual capable of reproducing.

 

(B)     Medicaid  recipients  are  not  denied  medically  necessary  services  based  on  their fertility status.

 

(C)     Medicaid  does  not  cover  infertility  services.  Under  no  circumstances  are  the following procedures covered:

 

(1)    Drugs prescribed in accordance with Chapter 5101:3-9 of the Administrative Code and/or drugs administered in accordance with Chapter 5101:3-4 of the Administrative Code;

 

(2)   Assisted reproductive technologies (ART);

 

(3)   In vitro fertilization;

 

(4)   Intrauterine insemination/artificial insemination; and

 

(5)   Surgery, including procedures for the reversal of voluntary sterilization.

 

 

 

 

5160-21-03         Effective:	TO BE RESCINDED         07/01/2016	2
Five Year Review (FYR) Dates:	02/03/2016
CERTIFIED ELECTRONICALLY
Certification
05/27/2016
Date
Promulgated Under:	119.03
Statutory Authority:	5164.02
Rule Amplifies:	5162.03, 5164.02, 5164.70
Prior Effective Dates:	07/01/2009