MedicaidAdministrativeLow impact
Sterilization consent form (HHS-687), expiration date
Washington Apple Health·WA · OB-GYN, Urology, General Surgery·Provider Alert
Effective date
Apr 30, 2022
We identified it
Jun 20, 2026
Summary
The sterilization consent form HHS-687 that was set to expire on April 30, 2022, has been temporarily extended for use through May 30, 2022. Providers should continue using the current form until CMS publishes an updated version.
Action Required
Through May 30, 2022: Continue using the current sterilization consent form (HHS-687) for all sterilization procedures covered under Apple Health (Medicaid). Monitor for updates from HCA when the new form is published on the HHS Office of Population Affairs website.