IM-120 December 18, 2007; IM-111 November 26, 2007
Section 1902(a)(10)(A)(ii)(XVIII) of the Social Security Act [42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII)] allows states the option of providing medical assistance to uninsured women under age 65, that have been screened for breast and cervical cancer under the Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection Program and need treatment for breast or cervical cancer. Section 1920B [42 U.S.C. 1396r.lb] allows states to provide a period of Presumptive Eligibility. Missouri opted to provide this coverage when the Breast and Cervical Cancer Treatment Act (HB 762) was signed June 21, 2001. The program began effective August 28, 2001.
The Department of Health and Senior Services (DHSS) is responsible for ensuring that providers meet criteria for screening under the Breast and Cervical Cancer Treatment Act. Originally DHSS limited screenings to medical providers that participated in and were paid for screening by its Show Me Healthy Women (SMHW) program, formerly known as Breast and Cervical Cancer Control Project (BCCCP). In 2007 DHSS changed the definition of a SMHW screening to include a diagnosis of breast or cervical cancer by a MO HealthNet provider (fee-for-service as well as Managed Care). A screening by MO HealthNet provider (fee-for-service as well as Managed Care) must have been completed while the participant was eligible for and receiving MO HealthNet benefits, except for Presumptive Eligibility for Children and Temporary MO HealthNet During Pregnancy (TEMP) Programs, in order for the participant to qualify for BCCT.
NOTE: An exception would be if the MO HealthNet Provider is also a SMHW contracted provider.