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WAC 182-532-740

TAKE CHARGE program—Covered yearly exams for women.

(1) The medicaid agency covers one of the following services per client per year, as medically necessary:
(a) A cervical, vaginal, and breast cancer screening exam; or
(b) A comprehensive prevention visit for family planning. (Under a delayed pelvic protocol, the comprehensive prevention visit for family planning may be split into two visits, per client, per year.)
(2) The cervical, vaginal and breast cancer screening exam must be:
(a) Provided following the guidelines of a nationally recognized protocol;
(b) Conducted at the time of an office visit with a primary focus and diagnosis of family planning; and
(c) Performed by a TAKE CHARGE provider.
(3) The comprehensive prevention visit for family planning:
(a) Must be provided by one or more TAKE CHARGE-trained providers. (See WAC 182-532-730.)
(b) Must include:
(i) A clinical breast examination and pelvic examination that follows the guidelines of a nationally recognized protocol; and
(ii) Client-centered counseling that incorporates risk factor reduction for unintended pregnancy and anticipatory guidance about the advantages and disadvantages of all contraceptive methods.
(c) May include:
(i) A pap smear according to current, nationally recognized clinical guidelines; and
(ii) For women ages thirteen through twenty-five, routine gonorrhea and chlamydia testing and treatment.
(d) Must be documented in the client's chart with detailed information that allows for a well-informed follow-up visit.
(e) Must be billed by a TAKE CHARGE provider only.
[Statutory Authority: RCW 41.05.021, 74.09.520, 74.09.657, 74.09.659, and 74.09.800. WSR 13-16-008, § 182-532-740, filed 7/25/13, effective 9/1/13. WSR 11-14-075, recodified as § 182-532-740, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090 and 74.09.800. WSR 08-11-031, § 388-532-740, filed 5/13/08, effective 6/13/08. Statutory Authority: RCW 74.08.090, 74.09.520, and 74.09.800. WSR 05-24-032, § 388-532-740, filed 11/30/05, effective 12/31/05. Statutory Authority: RCW 74.08.090, 74.09.520, 74.09.800, and SSB 5968, 1999 c 392 § 2(12). WSR 02-21-021, § 388-532-740, filed 10/8/02, effective 11/8/02.]
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