Reimbursement for an abortion is available when a physician has found and so certified in writing to the Texas Department of Health (department) or its designee that, on the basis of his or her professional judgment, the life of the mother would be endangered if the fetus were carried to term, or that the pregnancy was the result of rape or incest. In cases which do not clearly satisfy the criteria for reimbursement under the Medicaid program, as established by the department or its designee, a second medical opinion may be required.