DHS 107.06(3)(d)3.3. An interpreter was provided if the individual to be sterilized did not understand the language used on the consent form or the language used by the person obtaining consent. DHS 107.06(3)(d)4.4. The individual to be sterilized was permitted to have a witness of his or her choice present when consent was obtained. DHS 107.06(3)(d)6.6. Any additional requirement of state or local law for obtaining consent, except a requirement for spousal consent, was followed. DHS 107.06(3)(d)7.7. Informed consent is not obtained while the individual to be sterilized is in any of the following situations: DHS 107.06(3)(d)7.c.c. Under the influence of alcohol or other substances that affect the individual’s state of awareness. DHS 107.06 NoteNote: A copy of the informed consent form can be found in the Wisconsin medical assistance physician provider handbook.
DHS 107.06(3)(e)3.3. The person securing the consent and the physician performing the sterilization shall certify by signing the consent form that: DHS 107.06(3)(e)3.a.a. Before the individual to be sterilized signed the consent form, they advised the individual to be sterilized that no federally funded program benefits will be withdrawn because of the decision not to be sterilized; DHS 107.06(3)(e)3.b.b. They explained orally the requirements for informed consent as set forth on the consent form; and DHS 107.06(3)(e)3.c.c. To the best of their knowledge and belief, the individual to be sterilized appeared mentally competent and knowingly and voluntarily consented to be sterilized. DHS 107.06(3)(e)4.a.a. Except in the case of premature delivery or emergency abdominal surgery, the physician shall further certify that at least 30 days have passed between the date of the individual’s signature on the consent form and the date upon which the sterilization was performed, and that to the best of the physician’s knowledge and belief, the individual appeared mentally competent and knowingly and voluntarily consented to be sterilized. DHS 107.06(3)(e)4.b.b. In the case of premature delivery or emergency abdominal surgery performed within 30 days of consent, the physician shall certify that the sterilization was performed less than 30 days but not less than 72 hours after informed consent was obtained because of premature delivery or emergency abdominal surgery. In the case of premature delivery, the physician shall state the expected date of delivery. In the case of abdominal surgery, the physician shall describe the emergency. DHS 107.06(3)(e)5.5. If an interpreter is provided, the interpreter shall certify that the information and advice presented orally was translated, that the consent form and its contents were explained to the individual to be sterilized and that to the best of the interpreter’s knowledge and belief, the individual understood what the interpreter said. DHS 107.06(4)(a)(a) Physician’s visits. A maximum of one physician’s visit per month to a recipient confined to a nursing home is covered unless the recipient has an acute condition which warrants more frequent care, in which case the recipient’s medical record shall document the necessity of additional visits. The attending physician of a nursing home recipient, or the physician’s assistant, or a nurse practitioner under the supervision of a physician, shall reevaluate the recipient’s need for nursing home care in accordance with s. DHS 107.09 (4) (m). DHS 107.06(4)(b)(b) Services of a surgical assistant. The services of a surgical assistant are not covered for procedures which normally do not require assistance at surgery. DHS 107.06(4)(c)(c) Consultations. Certain consultations shall be covered if they are professional services furnished to a recipient by a second physician at the request of the attending physician. Consultations shall include a written report which becomes a part of the recipient’s permanent medical record. The name of the attending physician shall be included on the consultant’s claim for reimbursement. The following consultations are covered: DHS 107.06(4)(c)1.1. Consultation requiring limited physical examination and evaluation of a given system or systems;