OAR 333-004-3080: Reproductive Health Access Fund Excluded Services by Funding Source

(1) Title X does not cover: (a) Sterilizations for enrollees assigned female at birth; (b) Treatment for sexually transmitted infections (STIs) not pursuant to a family planning visit; (c) Stand-alone visits for repeat Pap tests not pursuant to a family planning visit; (d) Hysterectomies or abortions; (e) Procedures performed for medical reasons, whether or not the procedure results in preventing or delaying pregnancy or restoring fertility; (f) Human papillomavirus (HPV) vaccinations; or (g) Any other medical service or laboratory test that is not described in OAR 333-004-3070(2) (Reproductive Health Access Fund Covered Services by Funding Source) and whose primary purpose is other than preventing or achieving pregnancy. (2) CCare does not cover: (a) Sterilizations for enrollees assigned female at birth; (b) Treatment for STIs; (c) Preconception or prenatal care, including pregnancy confirmations; (d) Stand-alone visits for repeat Pap tests; (e) Hysterectomies or abortions; (f) Procedures performed for medical reasons, whether or not the procedure results in preventing or delaying pregnancy or restoring fertility; (g) Human papillomavirus (HPV) vaccinations; or (h) Any other medical service or laboratory test that is not described in OAR 333-004-3070(3) (RH Access Fund Covered Services by Funding Source), and whose primary purpose is other than preventing unintended pregnancy. (3) Reproductive Health Equity Act (RHEA) does not cover: (a) Treatment for STIs; (b) Stand-alone visits for repeat Pap tests; (c) Hysterectomies; (d) Human papillomavirus (HPV) vaccinations; (e) Any other medical service or laboratory test that is not described in ORS 743A.067; (f) Mammography services. These services are available through the ScreenWise program (OAR 333-010-0120(2)(a) (Covered Services)); (g) Abortion services not occurring in clinics certified by the Reproductive Health Program (RH Program). These services, for individuals with a household income and size at or below 185 percent of the federal poverty level (FPL), are available under the benefit package for this population in OAR 410-134-0003(2)(c) (Healthier Oregon and Healthier Oregon Cover All Kids Coverage); or (h) Sterilization procedures. These services, for individuals with a household income and size at or below 138 percent of the FPL, are available under the benefit package for this population in OAR 410-134-0003(2)(c) (Healthier Oregon and Healthier Oregon Cover All Kids Coverage).