10.09.58.05

.05 Covered Services.

The following services are covered under this chapter:

A. Office medical visits for the primary purpose of providing age and sex appropriate family planning services, which include:

(1) Focused history, physical exam, and laboratory testing necessary to evaluate and manage the participantís choice of chemical, mechanical, or other method to prevent conception;

(2) Basic education regarding human sexuality and reproduction;

(3) Advice and counseling regarding all family planning methods, including natural family planning measures and sterilization procedures, the availability and effectiveness of methods, procedures involved in each, and untoward effects and potential complications of each method; and

(4) Referral mechanism and documented referral for all patients demonstrating illness, disease, or pregnancy;

B. Specimen collection by venipuncture or capillary puncture when performed by either the medical practitioner or the laboratory;

C. Pregnancy test if indicated by physical examination or history, or both, when performed by either the medical practitioner or the laboratory;

D. The following laboratory tests:

(1) Hemoglobin or hematocrit, or both;

(2) Urinalysis for albumin sugar;

(3) Urine culture and sensitivity studies;

(4) Appropriate laboratory tests to screen for sexually transmitted infections;

(5) Smear wet mount and KOH with interpretation;

(6) Rubella titer of females without documentation of prior rubella immunization; and

(7) Pap smear;

E. Pharmaceutical supplies and devices:

(1) To prevent conception through chemical, mechanical, or other methods, which are covered by the Maryland Medical Assistance Program under COMAR 10.09.03.04; and

(2) To treat sexually transmitted infections when diagnosed during the course of an office visit, as outlined in §A of this regulation, which are covered under COMAR 10.09.03.04 except treatment for:

(a) Human immunodeficiency virus; and

(b) Hepatitis.

F. Permanent sterilization only when performed according to criteria in 42 CFR Part 441, Subpart F, Sterilizations, as amended, and when the appropriate forms are:

(1) Properly completed; and

(2) Available in the medical record for review; and

G. Human papillomavirus vaccine.