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1 INFORMED CONSENT TO STERILIZATION - State of Michigan
https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Assistance-Programs/Medicaid-BPHASA/Forms/MSA-1959.pdf?rev=55baa862b3704d948db15b096fb776d5&hash=0BA0E8092E9702C79F6D920CE5F912EB
Physicians are responsible for obtaining the signed Consent for Sterilization (MSA-1959) 30 days prior to surgery. Sterilizations are covered ...
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2 ACKNOWLEDGMENT OF RECEIPT OF HYSTERECTOMY ...
https://thcmi.com/PDF/providers/PDF/MSA%20Forms/MSA-2218-AcknowledgementofReceiptofHysterectomyInformation.pdf
This hysterectomy is not primarily or secondarily for family planning reasons, to render the above named recipient permanently incapable of reproducing, i.e..
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3 635_10606_AdminCode.pdf
https://dtmb.state.mi.us/ORRDocs/AdminCode/635_10606_AdminCode.pdf
STERILIZATION AND HYSTERECTOMY CONSENT PROCEDURES ... Acts of 1939, as amended, being S400.55 of the Michigan Compiled Laws. (e) "Hysterectomy" means a ...
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4 Sterilization and Hysterectomy Consent Procedures - Casetext
https://casetext.com/regulation/michigan-administrative-code/department-health-and-human-services/medical-services-administration/sterilization-and-hysterectomy-consent-procedures
Browse Michigan Administrative Code | Sterilization and Hysterectomy Consent Procedures for free on Casetext.
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5 Medicaid Provider Manual - MI Statistics
https://www.mdch.state.mi.us/dch-medicaid/manuals/MedicaidProviderManual.pdf
The following documents comprise the Michigan Medicaid Provider Manual and ... 9.3 Prior Authorization (Medicaid Health Plans Only) .
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6 Sterilization - Meridian
https://corp.mhplan.com/ContentDocuments/default.aspx?x=ogSX9juee7zA23E69mCs6Iww6H/+HTtK2MCXheRUf3YwluF6ASxynj1WzisxeBBSvrnz0VJV5s7tlFgHHfTzpg==
› ContentDocuments
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7 Hysterectomy | Michigan Medicine
https://www.uofmhealth.org/conditions-treatments/transgender-services/hysterectomy
For hysterectomy and/or vaginectomy (vagina removal) we do not require letters of mental health support by policy. However, most insurance companies require two ...
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8 POLICY AND PROCEDURE MANUAL - Meridian
https://www.ilmeridian.com/content/dam/centene/meridian/il/pdf/sterilization.pdf
A recipient may consent to be sterilized at the time of a premature ... This policy applies to Michigan Medicaid, Illinois Medicaid, and Individual plans.
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9 Michigan Medicaid Authorization Lookup
https://www.covenanthealthcare.com/Uploads/Public/Documents/Workfiles/Insurance_Forms/August-2020/Meridian-Medicaid-08-2020.pdf
Michigan Medicaid Authorization Lookup ... vendor for prior authorization of this service. ... Laparoscopy, surgical, total hysterectomy for.
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10 The Medicaid Program reimburses claims for sterilizations ...
https://sos.ms.gov/ACProposed/00012759B.pdf
The Medicaid Program reimburses claims for sterilizations, hysterectomies and ... The beneficiary must be 21 years old when the consent form is signed.
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11 Healthy happens together - Aetna Better Health
https://www.aetnabetterhealth.com/content/dam/aetna/medicaid/michigan/provider/pdf/abhmi_provider_manual_medicaid.pdf
Our service area for Medicaid, MI Child, CSHCS, and Healthy Michigan ... Authorization List – Search for provider authorizations by Member, provider,.
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12 Medicaid Coverage for Transgender-Related Care
https://www.lgbtmap.org/img/maps/citations-medicaid.pdf
State Medicaid policy explicitly covers transgender health coverage and care ... See Michigan Provider Manual (pg.15, ...
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13 Blue Cross Complete Provider Manual
https://www.mibluecrosscomplete.com/amslibs/content/dam/microsites/blue-cross-complete/bcc-provider-manual.pdf
Blue Cross Complete of Michigan is a Medicaid managed care plan that contracts ... Note: MDHHS requires either direct or indirect patient consent for all ...
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14 Covered Services for Medicaid/MIChild Members
https://www.mclarenhealthplan.org/medicaid-member/services-mhp
› services-mhp
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15 Consent for Sterilization: Form HHS-687 - Maryland.gov
https://health.maryland.gov/mmcp/Documents/Consent%20for%20Sterilization%20-%20English.pdf
or Medicaid that I am now getting or for which I may become eligible. I UNDERSTAND THAT THE STERILIZATION MUST BE CONSIDERED. PERMANENT AND NOT REVERSIBLE.
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16 House Bill 1398 - Hysterectomy and oophorectomy informed ...
https://iga.in.gov/legislative/2022/bills/house/1398
Hysterectomy and oophorectomy informed consent. Requires a physician to obtain informed consent and provide certain information to a patient ...
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17 2022 Care Provider Manual | UnitedHealthcare Community Plan
https://www.uhcprovider.com/content/dam/provider/docs/public/admin-guides/comm-plan/MI-UHCCP-Care-Provider-Manual.pdf
provider manual for our Michigan Medicaid Program and ... In this manual, we refer to your Participation Agreement as “Agreement.”.
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18 Medicaid Providers - Forms - Wellcare
https://www.wellcare.com/new-jersey/providers/medicaid/forms
Forms for authorization, behavioral health, pharmacy services and miscellaneous purposes for WellCare of Forms providers.
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19 Women & Medicine
https://www.medicineatmichigan.org/news-research/2020/winter/women-medicine
Women who get a hysterectomy are often prescribed at least twice as many opioids as they use, but Michigan Medicine researchers discovered a simple ...
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20 Provider Preauthorization and Precertification Requirements
https://www.bcbsm.com/content/dam/public/Providers/Documents/preauthorization-precertification-requirements.pdf
Blue Cross Blue Shield of Michigan PPO (commercial) and Medicare Plus BlueSM ... Behavioral health precertification and prior authorization ...
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21 Supplements/Forms - CareSource
https://www.caresource.com/documents/17-supplements-forms-pdf/
Michigan Provider Medical Prior Authorization Request Form . ... hysterectomy was done that after the hysterectomy I would not be able to become pregnant.
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22 settlement agreement - Department of Justice
https://www.justice.gov/usao-edmi/press-release/file/1421626/download
professional and facility fees for radical hysterectomies, chemotherapy, ... Michigan from Medicare, Medicaid, and other Federal health care programs under ...
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23 Informed Consent for Hysterectomy and Sterilization - NET
https://eastmainsiteprodsa.blob.core.windows.net/cms/metroplusmvc12/media/provider/forms/additional%20forms/qmd109_informed_consent_for_hysterectomy_and_sterilization.pdf
LOB: Medicaid ... Providers who preform hysterectomy or other sterilization ... informed consent from all MetroPlus Health Plan members ...
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24 Provider Manual - HAP
https://www.hap.org/-/media/project/hap/hap/files/hap/providers/2022-provider-directories/hap-empowered-provider-manual-february-2022.pdf
HAP Empowered Health Plan, Inc., a Michigan Medicaid Health Plan, ... Upon approval from HAP's legal counsel, the Director of Provider ...
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25 Blue Care Network of Michigan - OPM
https://www.opm.gov/healthcare-insurance/healthcare/plan-information/plan-codes/2019/brochures/73-153.pdf
e., physicians, etc.) are in Sections 5(a) or (b). • YOUR PHYSICIAN MUST GET PLAN APPROVAL FOR HOSPITAL STAYS. Please refer to.
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26 Forced sterilization policies in the US targeted minorities and ...
https://ihpi.umich.edu/news/forced-sterilization-policies-us-targeted-minorities-and-those-disabilities-and-lasted-21st
Alexandra Minna Stern, University of Michigan ... new federal programs like Medicaid also started funding nonconsensual sterilizations.
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27 Family Planning and Medicaid Managed Care
https://publichealth.gwu.edu/sites/default/files/Appendix%201.pdf
Family planning services (including voluntary sterilization if consent form is signed after ... January 2016, Michigan Medicaid Managed Care Model Contract).
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28 Do Women Always Need a Man's Consent to Get a ...
https://nwhn.org/is-it-true-that-some-states-require-a-woman-to-have-a-mans-consent-to-talk-to-a-doctor-about-getting-a-hysterectomy-what-if-the-procedure-is-medically-necessary/
Do Women Always Need a Man's Consent to Get a Hysterectomy? No state mandates spousal consent for this procedure, and any such proposals ...
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29 Plan Information and Forms - UnitedHealthcare Community Plan
https://www.uhccommunityplan.com/learn-about-medicare/plan-information-and-forms.html
Authorization forms and information ... Medication authorization forms ... UnitedHealthcare Connected® (Medicare-Medicaid Plan) is a health plan that ...
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30 How do I get a tubal ligation procedure? - Planned Parenthood
https://www.plannedparenthood.org/learn/birth-control/sterilization/how-do-i-get-tubal-ligation-procedure
... Consent and Sexual Assault · Sexually Transmitted Infections (STDs) ... cost) with some health insurance plans, Medicaid, and other government programs.
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31 Medicaid Coverage of Family Planning Benefits - KFF
https://www.kff.org/report-section/medicaid-coverage-of-family-planning-benefits-results-from-a-state-survey-sterilization-procedures/
An individual may consent to be sterilized at the time of a premature delivery or emergency abdominal surgery, if at least 72 hours have passed ...
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32 PROVIDER MANUAL - Physicians Health Plan
https://www.phpmichigan.com/upload/docs/Providers/Provider%20Manual%20update%20PDF%20version%20011518%20FINAL.pdf
manual, the provisions of your participation agreement shall take precedence. ... website is located at, PHPMichigan.com and the PHP Portal.
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33 Medicaid needs to change its rules for women seeking tubal ...
https://www.statnews.com/2020/09/16/medicaid-change-archaic-rules-tubal-ligation/
If a woman covered by Medicaid wants her tubes tied, she must complete the “Consent to Sterilization” section of Medicaid's Title XIX form ...
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34 In quiet decision, Michigan continues Medicaid coverage of ...
https://www.bridgemi.com/michigan-health-watch/quiet-decision-michigan-continues-medicaid-coverage-gender-changes
Michigan Gov. Gretchen Whitmer's administration with little fanfare last month clarified that sex change surgery and hormone replacement ...
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35 Gender Affirming Surgery - Medical Clinical Policy Bulletins
http://www.aetna.com/cpb/medical/data/600_699/0615.html
Requirements for Gonadectomy (Hysterectomy and Oophorectomy or Orchiectomy) ... Capacity to make a fully informed decision and to consent for treatment; and ...
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36 State Medicaid Payment Policies for Inpatient Hospital Services
https://www.macpac.gov/wp-content/uploads/2018/12/State-Medicaid-Fee-for-Service-Inpatient-Hospital-Payment-Policies.xlsx
178, MDHHS, Michigan Department of Health and Human Services ... (B) Medicaid-covered organ transplants require prior approval. All inpatient hospital ...
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37 EFFECTIVE 1-2023 - Paramount Health Care
https://www.paramounthealthcare.com/assets/documents/provider/providermanual_fnl.pdf
Consent for Sterilization form instructions. Hysterectomy. Per Ohio Medicaid state rule OAC 5160, all claims submitted for hysterectomies, whether.
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38 Ascension Michigan to pay $2.8 million to settle claims of ...
https://www.macombdaily.com/2021/08/05/ascension-michigan-to-pay-2-8-million-to-settle-claims-of-unnecessary-hysterectomies
The deal settles claims of false billings made by Ascension Michigan and its related hospitals to Medicare, Medicaid and another federal ...
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39 Provider Manual - AmeriHealth Caritas VIP Care Plus
https://www.amerihealthcaritasvipcareplus.com/assets/pdf/provider/provider-manual.pdf
Michigan Medicaid to provide benefits of both programs to enrollees. ... participating Network Provider Agreement is intended to be interpreted as ...
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40 Medicaid Provider Manual - Improving MI Practices
https://www.improvingmipractices.org/application/files/5315/9733/6847/MedicaidProviderManual.pdf
The following documents comprise the Michigan Medicaid Provider Manual and address ... enrollment and participation, prior authorization,.
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41 Buckeye Health Plan - Provider Manual
https://www.buckeyehealthplan.com/content/dam/centene/Buckeye/medicaid/pdfs/Buckeye-Health-Plan-Provider-Manual.pdf
sensitive healthcare services to Ohio's Medicaid eligibles, by combining the ... must have executed a Participating Provider Agreement with the Buckeye.
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42 Nurse Practitioner Manual Policy Guidelines - eMedNY
https://www.emedny.org/ProviderManuals/NursePractitioner/PDFS/Nurse_Practitioner_Policy_Guidelines.pdf
concerning the acknowledgement agreement;. 3. The woman was not a Medicaid client at the time the hysterectomy was performed but subsequently applied for ...
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43 Does Medicaid Cover Hysterectomy? - HelpAdvisor.com
https://www.helpadvisor.com/medicaid/does-medicaid-cover-hysterectomy
Medicaid is unlikely to cover a hysterectomy if the primary reason for the surgery is sterilization. This means that you can't usually have a ...
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44 Michigan Complete Health (Medicare-Medicaid Plan): Home
https://mmp.michigancompletehealth.com/mmp.html
Michigan Complete Health (Medicare-Medicaid Plan) ... form a hospital or skilled nursing facility (prior authorization is required) ...
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45 Services | Transgender Health | Henry Ford Health - Detroit, MI
https://www.henryford.com/services/lgbtq-health/transgender-health/services
Henry Ford is among the few programs in Michigan delivering comprehensive care to ... Hysterectomy to remove internal female reproductive organs (uterus, ...
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46 Prevalence and Trends in Smoking Among Surgical Patients ...
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2776945
The requirement for informed consent was waived because of the lack of ... among patients with Medicaid in Michigan has not been described, ...
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47 How Old Do You Have to Be to Get Your Tubes Tied?
https://www.healthline.com/health/womens-health/how-old-do-you-have-to-be-to-get-your-tubes-tied
There are also variations about consent in state law. Medicaid requires a consent form to be signed between 30 and 180 days prior to getting ...
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48 Access to Postpartum Sterilization - ACOG
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/06/access-to-postpartum-sterilization
Among Medicaid enrollees with adequate consent documentation, up to 50% do not ... postpartum sterilization, interval sterilization, and hysterectomy.
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49 Upper Peninsula Community Health Needs Assessment 2018
https://www.wupdhd.org/wp-content/uploads/2019/03/Upper-Peninsula-Community-Health-Needs-Assessment-2018-Second-Edition.pdf
By 2017, that rate had declined to an estimated 7.0 percent due to Michigan's. Medicaid expansion and the newly created health insurance marketplace.
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50 Range of interventions reduces likelihood of infection after ...
https://www.mdedge.com/obgyn/article/226316/surgery/range-interventions-reduces-likelihood-infection-after-hysterectomy
... hysterectomy via any route at the University of Michigan Medical Center ... by the Centers for Medicare & Medicaid Services decreased.
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51 Patient Acknowledgement For Hysterectomy {MA 30}
https://www.formsworkflow.com/form/details/138675-pennsylvania-patient-acknowledgement-for-hysterectomy
CLAIM REFERENCE NUMBER Leave this space blank PATIENT ACKNOWLEDGEMENT FORM FOR HYSTERECTOMY MEDICAL ASSISTANCE PROGRAM 2. PATIENT NAME 3.
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52 - MEDICAL LIABILITY: NEW IDEAS FOR MAKING THE ...
https://www.govinfo.gov/content/pkg/CHRG-109shrg28417/html/CHRG-109shrg28417.htm
Merely obtaining the patient's signature on one more consent form at the time ... This is because Medicare and Medicaid both enforce second payer rules of ...
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53 Provider Manual - AmeriHealth Caritas Pennsylvania
https://www.amerihealthcaritaspa.com/pdf/provider/resources/manual/provider-manual.pdf
Authorization of Inpatient Admission Following ER Medical Care . ... enrolled in the Pennsylvania State Medicaid program before a payment of a Medicaid ...
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54 TENNCARE INSTRUCTIONS FOR COMPLETING THE ...
https://www.tn.gov/content/dam/tn/tenncare/documents/hysterectomyacknowledgmentform.pdf
ELIGIBLE INDIVIDUALS ONLY - a copy of the Medicaid card which covers the date of the hysterectomy, or a copy of the retroactive approval.
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55 Hysterectomy Rates Differ by Race and Geography, with ...
https://academyhealth.org/blog/2021-09/hysterectomy-rates-differ-race-and-geography-greater-racial-disparities-tied-county-socioeconomic-status
Hysterectomy is the second most common surgical procedure for ... Michigan State University, East Lansing, Michigan, and colleagues wanted ...
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56 Premier (POS) Plan - Southwestern Michigan College
https://www.swmich.edu/media/website/content-assets/documents/Premier(POS)Plan.pdf
The Plan Administrator has entered into an agreement that provides access ... covered under Medicaid or a state sponsored Children's Health ...
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57 Prior authorization forms | Blue Shield of CA Provider
https://www.blueshieldca.com/bsca/bsc/wcm/connect/provider/provider_content_en/authorizations/authorization_forms
Blue Shield of California Promise Health Plan, Medi-Cal and Cal MediConnect · Blue Shield Medicare · Prescription drug prior authorization and step therapy ...
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58 A Woman Needed Her Husband's Consent to Get Her Tubes ...
https://www.insider.com/a-woman-needed-husbands-consent-to-get-her-tubes-tied-2020-2
Women who want sterilization must sign a consent form and wait 30 days before the procedure if they are on Medicaid, compared to privately ...
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59 FTM Top Surgery Insurance Coverage: What You Need To ...
https://www.topsurgery.net/costs/ftm-top-surgery-insurance-coverage.htm
(For example, hysterectomy coverage for a trans man.) ... Who Accept Medicare for Top Surgery · Surgeons Who Accept Medicaid for Top Surgery ...
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60 2022 Western Medical Research Conference
https://jim.bmj.com/content/70/1/112
You will be able to get a quick price and instant permission to reuse the ... 6Pediatric Surgeons of West Michigan, PC, Grand Rapids, MI.
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61 Claim Error/EOB/ANSI Code Crosswalk
https://www.medicaid.nv.gov/Downloads/provider/Error_Code_to_EOB_to_ANSI.pdf
authorization/pre-certification was requested. ... billed to Medicare before billing Medicaid. Complete the Medicare payment ... Hysterectomy Form Required.
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62 Sexually Transmitted Infections Treatment Guidelines, 2021
https://www.cdc.gov/mmwr/volumes/70/rr/rr7004a1.htm
No state requires parental consent for STI care, although the age at ... Transgender men who have not chosen to undergo hysterectomy with ...
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63 Abortion Reporting: Michigan (2018) - Charlotte Lozier Institute
https://lozierinstitute.org/abortion-reporting-michigan-2018/
Seventeen were chemical abortions (25 percent), one was a dilation and evacuation abortion, and one was a hysterectomy/hysterotomy abortion.
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64 Unwanted Sterilization and Eugenics Programs in the United ...
https://www.pbs.org/independentlens/blog/unwanted-sterilization-and-eugenics-programs-in-the-united-states/
... on men and women, often without their full knowledge and consent. ... unnecessary hysterectomies performed at teaching hospitals in the ...
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65 The Outrageous Reasons These Women Couldn't Get Their ...
https://www.vice.com/en/article/9kxam7/tubal-ligation-requirements-doctor-denials
Then there are insurance barriers: For those who have Medicaid, there's a ... He also had to give consent for my hysterectomy,” she says.
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66 iPLEDGE REMS - Home
https://ipledgeprogram.com/

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67 UPHP Provider Manual
https://www.uphp.com/wp-content/uploads/providers/UPHPProviderManual.pdf
Michigan Medicaid Health Care Program and Centers for Medicare and Medicaid ... UPHP reserves the right to end/terminate provider authorization for a BMP.
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68 hysterectomy Certification and Consent
https://manuals.medicaidalaska.com/docs/dnld/Form_Hysterectomy_Certification_Consent_Form.pdf
This form must be completed, signed, and submitted with the Medicaid claim for reimbursement. If you have received this in error, please mail to: Conduent ...
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69 Michigan Medicaid Hysterectomy Consent Form - Google Groups
https://groups.google.com/g/s5d0zxp/c/ANL5Ywkifx8
English and michigan department of the beneficiary has incapacity to five multiple dose drawn from michigan medicaid hysterectomy consent form is in this ...
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70 American Eugenics: Race, Queer Anatomy, and the Science of ...
https://books.google.com/books?id=5qHGELC_h-4C&pg=PA288&lpg=PA288&dq=michigan+medicaid+hysterectomy+consent&source=bl&ots=WlgWfzzThq&sig=ACfU3U1kMw8JiuiWw9KmoU2c2Q5iH0hTLw&hl=en&sa=X&ved=2ahUKEwj-t_Hiicz7AhUTlGoFHSizAr0Q6AF6BQiBAhAD
... Jr .: on consent forms , 262n69 ; on tubal ligation and hysterectomy ... 35 ; scrutiny of , 32 ; sterilization of , 175 Michigan State Board of Health ...
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71 Reproduction, Sexuality, and the Family
https://books.google.com/books?id=k2ycVwMA2moC&pg=PA132&lpg=PA132&dq=michigan+medicaid+hysterectomy+consent&source=bl&ots=o5o6JDe99k&sig=ACfU3U3GAtPpPaHK-53Klym3MgpxnD4PDg&hl=en&sa=X&ved=2ahUKEwj-t_Hiicz7AhUTlGoFHSizAr0Q6AF6BQiHAhAD
... have the highest rates of hysterectomy and tubal ligation in the United States . ... regulations have been adopted to ensure that informed consent is ...
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72 Federal Register
https://books.google.com/books?id=7Y1LyK7ya_gC&pg=PA60817&lpg=PA60817&dq=michigan+medicaid+hysterectomy+consent&source=bl&ots=ct7JBNLOOZ&sig=ACfU3U2dor6Q1d1vBdhiqKN0FuPtBeIvZg&hl=en&sa=X&ved=2ahUKEwj-t_Hiicz7AhUTlGoFHSizAr0Q6AF6BQiAAhAD
09-70-0059 SYSTEM NAME : The Medicaid Necessity , Appropriateness , and Outcomes of Care ... Georgia , and Michigan ) chosen to participate in the study .
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