IM-141 REVISED BREAST AND CERVICAL CANCER TREATMENT MO HEALTHNET APPLICATION (IM-1BC)

Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri

TO:  ALL FAMILY SUPPORT OFFICES

FROM: KIM EVANS, DIRECTOR

SUBJECT: REVISED BREAST AND CERVICAL CANCER TREATMENT MO HEALTHNET APPLICATION (IM-1BC)

FORM REVISION #
IM-1BC

 

DISCUSSION:

The IM-1BC is used by Show Me Healthy Women providers to assist participants applying for Breast and Cervical Cancer Treatment coverage.

The IM-1BC was revised to use updated terms and remove outdated information. The IM-1BC has a revision date of 10/2022. Providers should begin using the updated form with a 10/2022 revision date immediately, but outdated forms may still be accepted as valid applications through 1/31/2023.

The IM-1BC is available in the public and internal forms manuals.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Begin using the revised form (10/2022) immediately.
  • Discard outdated forms.
  • Provide updated form to community partners.

 

 

 

KE/cj